Photo: Anne Tuiskunen Bäck/Sida
Simple solutions but great health improvements
Globally, 780 million people still lack access to clean water. This has devastating consequences to people’s health, and children are particularly vulnerable. One of the diseases that can spread in contaminated water is cholera, which kills at least 100,000 lives each year.
But in Dhaka, Bangladesh, the research centre Icddr,b develops simple but effective solutions. One example is mobile water stations that can be installed in all households. The water is purified from bacteria with chlorine, and the installation is combined with education on the health benefits of good hand hygiene.
Hand water stations make life easier
Shrishita Rani is 17 years old and lives in the Mirpur slum of north-western Dhaka. The area is very poor and is plagued by diseases like cholera. According to her, access to clean water is of great importance:
– The hand water station simplifies life. It is easy to use, and it protects us from diseases like cholera and diarrhoea. I remind both children and adults in the neighbourhood to wash their hands before they eat, after every toilet visit, and before they cook.
Icddr,b primarily educates the women, who then teach neighbours and family. This empowers women, but also means a more effective way of spreading of information, since it comes from a trusted source. There are also plans to let the women sell the water stations and keep part of the income, which would enable microbusinesses and create incentives for spreading them at the grass root level.
This innovation has led to a decrease in the prevalence of cholera and diarrhoea. According to Dr. Anne Tuiskunen Bäck at Sida, this has the potential to save hundreds of thousands of lives.
– Water is essential. We use water for cooking, drinking, cleaning and washing dishes. Try living one day without water. The people of Bangladesh are facing the impossible choice between letting their children go thirsty and possibly infecting them with cholera. This tiny molecule is the foundation for all life.
A holistic approach to cholera
Cholera is a waterborne and very infectious disease that dwells in areas with limited access to clean water. The bacteria colonize the inside of the small intestine, and exude a toxin that causes the characteristically watery diarrhoeas, which in turn cause dehydration. Without care, the disease can lead to death within a few hours. There is an effective vaccine, Dukoral. However, it is too expensive for the poor, and is mostly used by tourists.
Icddr,b is among the world leaders in cholera research. Together with Swedish researchers and other partners, they have developed the cholera vaccine Shanchol. It is far cheaper to manufacture, and has the potential to save many lives. The cholera study, with 240,000 participants, is the world’s greatest. The vaccine does provide 100 per cent protection, and the purpose of the study is to see if the addition of water purification and hand hygiene can reduce the number of cholera cases even further.
– Bangladesh is one of the world’s poorest countries, yet they have some of the world’s greatest cholera experts. When an epidemic breaks out, like on Haiti 2010 or in Sierra Leone 2012, Icddr,b immediately sends a team. They have a holistic approach and weigh in cultural and economic factors with local knowledge, while we tend to put our faith in magic pills. They are truly heroes. At the same time, this is just a step on the way while waiting for infrastructural efforts that can solve the problem more thoroughly.
ICDDR,B AND THE WAR ON CHOLERA
Besides the vaccine and the water stations,Icddr,b has developed several innovations to battle cholera. For example, they have developed a recipe for rehydration that is based on the physiologically optimal balance between sugar and salt. This is to make sure that the human body assimilates water and salt, both of which are needed when cholera has broken out. The influential medical journal The Lancet calls the solution “possibly the most important medical advance of the century”. Furthermore, Icddr,b have constructed cholera beds that can be folded. They can easily be spread out when the number of cases increases. They also have a hole with a funnel, in order to simplify measuring how much fluid has been lost.
Icddr,b was acknowledged in the Al Jazeera documentary Dhaka’s Cholera Wars, which in part took place at the organization’s hospital in Dhaka. Watch it here.
Sweden has cooperated with Icddr,b since 1981, and contributes with core support. While some countries and organizations prefer supporting individual projects, the Swedish development aid agency (Sida) has chosen to work with a long term perspective. This is to ensure that there are competent institutes for higher education and research in low income countries that are then able to perform those projects. The core funders are mentioned on special signs in the Icddr,b facilities.
Read more about the organization’s struggle against cholera here.