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Poor sanitation, poverty behind Swazi diarrhoea outbreak

Children wash their hands at Tikhuba High School in Swaziland's eastern Lubombo District Mujahid Safodien/IRIN
A nationwide outbreak of diarrhoea attributed to rotavirus has claimed the lives of nearly 40 young children in Swaziland during the past month and highlighted the need for better sanitation and clean water in schools and homes. 

“The link between poor water quality and child mortality is not a theoretical matter. We can see in the admissions rooms of hospitals how widespread the problem is,” said Thab’sile Ndlovu, a government social welfare officer in the commercial capital, Manzini. 

At a press conference attended by most of the Cabinet on 30 July, Prime Minister Sibusiso Dlamini said 3,042 cases had been recorded in the four regions of the country.

“Most of these were successfully dealt with at outpatient stage; at least 511 children were admitted as inpatients. The majority of the latter were successfully treated and discharged. Sadly, 36 of those children died while undergoing treatment,” said the premier. 
He also announced that the World Health Organization (WHO) had sent a team to provide the government with technical assistance on controlling the outbreak. 

The Health Ministry has been broadcasting hourly bulletins on the country’s state-owned radio stations, the primary source of news for 90 percent of Swazis. Information includes tips on proper hygiene. Government officials have blamed poor hygiene for the spread of the rotavirus which is the most common cause of severe diarrhoea in young children. 

“We urge the public to practise thorough hand-washing using soap and safe running water after using the toilet, changing nappies and before preparing and consuming food. We encourage the public to observe good sanitation practices, as well as drinking water that is known to be safe, or water that is boiled before use,” said the premier. 

Nearly a third of Swaziland’s population lack access to safe drinking water. The majority of rural households rely on communal water taps or draw water from local rivers and wells. 

Projects to bring clean water to more rural residents are ongoing in all four of the country’s provinces. Swaziland is also developing a modern sanitation system, but sewer lines connect only to residences, schools, churches and businesses that have accounts with the Swaziland Water Services Corporation (SWSC), which adds a 50 percent surcharge on water consumption to pay for connections. Most rural Swazis are not connected, and depend on pit latrines or the bush to relieve themselves. 
Each year children in Swaziland die of severe diarrhoea resulting from rotavirus. The reasons behind this year’s outbreak are still unclear, but Andrew Mkhonta, a medical consultant doing research for a social welfare NGO, suggested that Swaziland’s worsening poverty levels could be a factor. 

"The economy is getting worse, and less money means lower standards of living"
“The economy is getting worse, and less money means lower standards of living,” he told IRIN. “The population of informal settlements is growing around the towns and there is no sanitation there at all. We spoke with some of the patients’ families and many are from these settlements or have children in poor schools where there is no running water or toilets.” 

Schools in Swaziland are financed primarily by school fees with the government’s education budget going mainly towards teachers’ salaries. As a result, many schools cannot afford to install plumbing and drill wells.

Immunization campaign coming

A doctor quoted anonymously in the Swazi Observer newspaper accused the Ministry of Health of blaming parents’ for poor hygiene in an attempt to shift attention away from its failure to launch a rotavirus vaccination programme. WHO has recommended that rotavirus vaccine be included in all national immunization programmes and 21 African countries have done so according to the Rotavirus Organization of Technical Allies (ROTA) Council. 

“There is just no reason or justification why so many children were left to die… The vaccine is widely available, but Swaziland chose not to vaccinate the children. We need mass immunization of children against the virus,” the doctor said.
According to the Health Ministry, a rotavirus immunization campaign was scheduled for July 2015. 

“In response to the unforeseen outbreak, government will now accelerate the introduction of the vaccine,” said Prime Minister Dlamini. 

jh/ks /cb

This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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