Cholera outbreaks are not particularly hard to avoid, and places like Kenya continue to have them only because (a) the will is not there to deal with the problem; and (b) there continue to be misplaced priorities that places things, e.g. infrastructure, above "human development" issues, such as basic health.
Part of my growing up in Kenya included being "in the middle" of a few cholera outbreaks. Comparing then and now, my observations are:
*
no-change: not a great deal has been done to reduce the occurrence of these outbreaks; and
*
change: when outbreaks occur, the government response is more cavalier than it used to be.
Until there are changes in "attitude", such outbreaks will be as "routine" as they have been for the last 40+ years.
Anyway, overall, cholera is relatively "small potatoes": consider the number of deaths that occur in these outbreaks with the about 20,000 that die each year as a result of diarrhea, which is also not particularly difficult to avoid.
Here are some figures from a report by Kenya's ministry of health:
* Approximately 19,500 Kenyans, including 17,100 children under the age of five years, die each year from diarrhoeaunless drastic action is taken.
* In addition to the health and nutrition effect, poor sanitation is expensive. Kenya loses an estimated KES 27 Billion (365 million USDyet eliminating the practice would require less than 1.2 million latrines to be built and used.
http://www.communityledtotalsanitation.org/sites/communityledtotalsanitation.org/files/media/DEH_Annual_Report_2012_2013.pdfSo, that's the government itself saying that drastic action is required and that the high cost of not shitting right could easily be eliminated. But what the government ever actually does in a serious way---beyond formulating policies, making plans, and writing reports---is never clear and certainly does not correspond to the magnitude of the problem: even at the best of times, something like over one-third of Kenyans do not have access to clean drinking water and over one-half lack proper sanitation. Consider the figures above: compared with the given cost ($365 million per year) of poor sanitation, how much does the government spend to eliminate the problem? How much would it cost to build 1.2 million latrines?
Latrines and clean-water supplies are not very exciting things, and improvements in health that would occur with better access to clean water and sanitation are different from roads, buildings, and standard gauge railways: there is not much to point at excitedly with an "
I see it with my own eyes!". But they need to be done, and until that happens some aspects of Kenyan life will remain grim.