The world believed that cholera would not show its ugly face after the Corona virus pandemic but in August 2022, a cholera outbreak affected entire Ethiopia. This is one of the world’s most drought prone, poverty stricken country in the world. The humanitarian conditions in Ethiopia were at a dismally low level. Cholera is an acute diarrhoea disease and dehydration can kill within hours if left untreated. It is caused by ingestion of food or water contaminated with bacteria. It is a disease of poverty affecting people with inadequate access to safe water and basic sanitation.
Cholera is a clear indicator of the failure of governance and to see that’s the world’s holiday destination is cholera affected would only make us hang our head in shame. Probably that is the reason why it is always convenient to pass off cholera as diarrhea deaths. On 3rd September, came the news that a fish trawler labourer died from Cutbona Jetty with dengue symptoms. Thereafter another eleven had similar symptoms there and another four suspected cases at the Cuncolim Industrial Estate. These were migrant workers employed as crew members on mechanized fishing vessels and in the industry. Thousands of workers work on various fishing vessels at Cutbona jetty and the total number of non-functioning toilets were seven! It was like sitting on a time bomb ready to be exploded. Two days later newspapers announced the possibility of cholera as diarrhoea and high fever was a common symptom.
The very next day the Deputy Collector of South Goa and elected representatives of the people like the local MLA and Sarpanches, discussed measures like joint inspections, patient isolation, mapping boundaries, health check ups, FDA surveillance and requisition of additional staff at the Bali Health Centre. It must be appreciated that all of them swung into action only because of the overhanging sword of cholera. In this dangerous scenario, the concerned government departments like the Balli PHC, Margao Urban Health Centre, South Goa District hospital and the Velim Panchayat did pool in their efforts to contain the spread of the disease. The recent bad weather conditions resulted in many boats being anchored, which allowed for an increased pool of workers to be screened by the health authorities.
When this news had just subsided, it was disgusting to hear on 8th September that the Fisheries Minister and the Fisheries ex-Director’s had returned from a Norway junket at public cost a few months ago. The priorities of the Fisheries Dept should have been to monitor basic living conditions to labourers at fishing jetties like clean toilets and drinking water and the luxury of a few lemons to ensure Vitamin C, on their long stay out at sea.
This would have built immunity and maintained hygiene. Money was required to keep the grass root fishing community of Goa alive because of whose hard work we can avail of fresh fish to eat on our plates everyday! The whole junket issue needs widespread condemnation but the counter argument is that everybody does it why only single out the Fisheries Minister? This team needed to study the living conditions of the fishing labourers in Norway. Did they also sleep and have bath on unused boats and defecate in the open fields? Instead of this ,”Study Tour” they should have studied the dire conditions in the Goa Cutbona jetty.
Immediately after this news of the criminal waste of public money, came the admission of the NVBDCP (National Vector Borne Disease Control Programme) of the DHS (Directorate of Health Services) that, “The death reported in print and electronic media as a suspected dengue case was inaccurate. The deceased labourer had severe loose motions, vomiting and high fever and was directly brought to the District hospital where he was declared brought dead”. However the Health Department narrative was still on Dengue and the Urban Health Centre responded quickly to include enhanced surveillance, mosquito control programmes and public awareness campaigns.
A few dengue cases were reported in and around Margao and a dedicated health team of the UHC was focusing on targeted interventions and preventive measures to ensure that the situation remains contained.
On 11th September comes the official news from the DHS that another 5 migrant workers have died due to diarrhoea, while 163 cases had been detected in the past one month. The State epidemiologist Dr Utkarsh Betodkar informed that nearly 4 to 5 new cases are being detected per day. It is on this day that the Chief Minister issued a statement instructing the Fisheries Department to ensure hygienic standards at all fishing jetties and said that the Health Dept is also actively monitoring the situation. He directed both the Collectors to monitor the situation on the ground. That the affected workers were between 19 to 50 years, too young to die as a result of their poverty stricken conditions should have affected everybody’s conscience. Some were the sole bread earners for their families and came to Goa to provide a decent monetary support to their families and children back home, not to die of cholera! By this time, there were 10 patients in GMC and 15 in the South Goa District hospital.
Why is cholera a dangerous word? Six pandemics killed millions of people across all continents. The seventh pandemic started in South Asia in 1961, reached Africa in 1971 and the Americas in 1991. So the world has seen seven cholera pandemics with people dying like flies. Provision of safe water and basic sanitation, and hygiene practices is critical to prevent and control the transmission of cholera and other waterborne diseases. Typical at-risk areas include urban slums, as well as camps for internally displaced persons or refugees, zones of conflict and unplanned urbanization all increase the risk of cholera. Most people infected do not develop any symptoms, although the bacteria are present in their faeces for 1–10 days after infection and are shed back into the environment, potentially infecting other people.
Most of those infected with no or mild symptoms and can be successfully treated with oral re-hydration solution. Only severe cases need rapid treatment with intravenous fluids and antibiotics.
Cholera remains a global threat to public health and an indicator of poverty, inequity and a failure of governance. A global strategy on cholera control, Ending cholera: a global roadmap to 2030, with a target to reduce cholera deaths by 90% was launched in 2017. When the whole world is heading towards eradication of cholera, our State of Goa has set the clock back. Ports and jetties are a hub of economic activities. Coastal States are blessed by nature but maladministration leads to such disasters infuriating the people to oppose such economic activities. We require a governance of trust. On a very personal note, my maternal village Velim where the Cutbona ward is located has been let down.
(Dr Sushila Sawant Mendes is an Author & Professor
in History, Independent
Researcher)