As many of you may already know, the delta variant of COVID-19 has been rampaging Bangladesh. The variant has been joined by a friend that is also storming the streets of Bangladesh - Vibrio cholerae bacteria. When this bacteria infects a human’s intestines (usually through poor and dirty water supply), the person may experience a diarrheal illness called cholera (CDC). This waterborne disease is characterized by profuse watery diarrhea, which can lead to dehydration and in turn, death (News Desk).
In Bangladesh, cholera outbreaks usually occur every year with biannual peaks in cases. The peaks are typically seen during spring and autumn, which is when floods and droughts occur (Islam et. al). The warm weather and rainfall levels during those seasons have a remote association to cholera, as it creates a positive environment for bacterial survival (Hashizume et al.) At least 100,000 people are diagnosed with cholera and about 4,500 cholera patients die each year. To emphasize, these are the statistics of the diagnosed. Bangladesh has a vast urban-rural divide in the distribution of healthcare facilities.
These institutions are often concentrated in urban areas, leaving rural people with less access to healthcare (Al-Zaman). As of 2020, 101,815,917 people comprise Bangladesh's rural population, which is about 61% of Bangladesh’s total population (World Bank). Imagine the amount of rural people that have cholera and are not diagnosed.
Clearly, cholera is a huge public health threat in Bangladesh.
Thus, one may ask, ‘What has been introduced in Bangladesh to prevent cholera outbreaks?’.
Oral cholera vaccines were established by the World Health Organization in 2013 and may be given to cholera patients as needed. However, the supply of the vaccine is often vastly overtaken by the country’s demand (Islam et. al). Due to the low supply to demand ratio, the vaccine may not be the most reliable tool to eradicate cholera in all parts of Bangladesh. A prevention strategy that may be more effective is implemented by WaSH programs - improving access to water, sanitation, and hygiene. The vision of WaSH is “to ensure that everyone, everywhere has safe drinking water, a hygienic toilet, and practices good hygiene” (BRAC). These are great prevention methods for cholera because as stated earlier, it is caused by bacterial infection from the intake of dirty water. What makes WaSH programs even greater is that they are often seen in underserved areas, such as rural and slum areas. This allows underserved people of Bangladesh’s healthcare system, which include rural and low-income Bengalis (Al-Zaman), to have some resources to prevent cholera.
Bangladesh is also involved in a global fight to end cholera: Ending Cholera: A Global Roadmap to 2030. This program was launched by the Global Task Force on Cholera Control in the CDC. The roadmap was initiated in 2017 and consists of strategies to reduce 90% of cholera death counts by 2030. These strategies include promoting community engagement (e.g., having community education sessions on how to properly wash hands), enhanced epidemiological and laboratory surveillance of cholera outbreaks, and the mapping of cholera hotspots (Lufadeju and Lindmeier).
Hopefully, cholera prevention strategies continue to be enacted in Bangladesh to reduce the detrimental effects of the disease on Bengalis.
Al-Zaman, Md Sayeed. “Healthcare Crisis in Bangladesh during the COVID-19 Pandemic.” The American Journal of Tropical Medicine and Hygiene, The American Society of Tropical Medicine and Hygiene, Oct. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7543838/#!po=31.8182.
Hashizume, Masahiro, et al. “Cholera in Bangladesh: Climatic Components of Seasonal... : Epidemiology.” LWW, journals.lww.com/epidem/Fulltext/2010/09000/Cholera_in_Bangladesh__Climatic_Components_of.25.aspx.
“Illness and Symptoms.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 Oct. 2020, www.cdc.gov/cholera/illness.html.
Islam, Md Taufiqul, et al. “Cholera Control and Prevention in Bangladesh: An Evaluation of the Situation and Solutions.” OUP Academic, Oxford University Press, 28 Aug. 2018, academic.oup.com/jid/article/218/suppl_3/S171/5085578.
Lufadeju, Yemi, and Christian Lindmeier. “Global Task Force on Cholera Control Marks a Year of Progress toward Ending Cholera Worldwide.” UNICEF, 24 Aug. 2021, www.unicef.org/press-releases/global-task-force-cholera-control-marks-year-progress-toward-ending-cholera.
News Desk. “Cholera Outbreak Kills 800 in Nigeria.” Food Safety News, 13 Aug. 2021, www.foodsafetynews.com/2021/08/cholera-outbreak-kills-800-in-nigeria/.
“Water, Sanitation and Hygiene (WASH).” BRAC, www.brac.net/program/water-sanitation-hygiene/.
World Bank. “Bangladesh Rural Population 1960-2021.” MacroTrends, www.macrotrends.net/countries/BGD/bangladesh/rural-population.