Residents lament poor sanitation in wake of Hepatitis E outbreak

By Lahja Nashuuta

Windhoek – The inhabitants of Havana, an informal settlement on the northern outskirts of the capital Windhoek, which is currently the epicentre of Hepatitis E outbreak, have expressed discontent at the continued failure by authorities to improve sanitation in the area, which they blamed for the spread of the waterborne disease.

Hepatitis E, a liver disease that spreads through faecal-contaminated water, broke out in Havana and Goreangab Dam settlements in December last year.

The World Health Organisation defines Hepatitis E virus as a liver disease caused by the hepatitis E virus (HEV), a small virus with a positive-sense, single-stranded ribonucleic acid (RNA) genome. The transmission of the virus is through faecal-contaminated water and environmental contamination due to poor sanitation.

The disease that can be fatal, especially for pregnant women, has already killed an expectant mother and about 200 people tested positive of the virus.

Following the outbreak in Windhoek, the government, including the City of Windhoek, said they have been doing everything possible to contain the outbreak.

These efforts include a public information campaign by the Ministry of Health and Social Services that is urging people to be wary of the disease and exercise proper hygiene.

The ministry also urged people to seek medical attention without delay the moment they experience signs and symptoms of Hepatitis E, including fatigue, yellow eyes, loss of appetite, vomiting, abdominal pain, dark urine, fever and nausea.

However, the number of infections has been escalating. The acting health permanent secretary Dr David Uirab on Wednesday told New Era that the number of cases of Hepatitis E climbed to 237 over the past four days from 167 recorded up to January 4.

Uirab told the daily newspaper that no more lives had been lost and that four patients have been admitted at Katutura State Hospital and were being kept in isolation.

Nonetheless, the spread of the disease has stoked anger and despondency among the residents in the affected areas who cited poor basic services, mainly sanitation facilities.

When The Southern Times, visited some parts of Havana on Wednesday morning, the area was littered with overflowing garbage with dirty water emanating from makeshift bathrooms overflowing into river beds. There are a few flushing toilets in the area, and the majority are not operational, which forces many people to relieve themselves in river beds when nature calls.

Hafeni Ndeumona (53), who has been a resident of Havana for almost 15 years and had a corrugated iron shack a few metres from a public toilet that he shared with hundreds others, said the toilet had not been functioning for almost a year. But since many people have no other options, they have been relieving themselves on the floor of the toilet or behind it.

“This is a very terrible situation we are living in and even the Hepatitis E outbreak did not come as a surprise to me because if you are living in a dirty environment like here, you should expect to get sick one day,” he said.

Nadia Gawases, another resident of Havana, said the issue of proper sanitation was a serious one that needed a strong political will in order to be solved.

“When we are saying that we are using buckets and plastic bags to relieve ourselves inside our houses at night, perhaps our leaders think it’s a joke because they have never been here to see for themselves. And the only way one could understand the situation is when he or she takes time and visits people on the ground,” she stressed.

Gawases, who is a caretaker at one of the kindergartens in the area, warned that if the poor sanitation was not addressed, there might be a cholera outbreak in the near future as most people still did not have access to proper toilets, despite the fact that it is a universal human right to have clean water and sanitation.

Amutenya Iyaloo, a senior nurse at Hakahana Clinic, told this publication that diarrhoea and intestinal worms were the main health problems that they dealt with at the public health centre due to lack of proper sanitation in the area.

The Legal Assistance Centre strongly believes the deprivation of safe drinking water and sanitation to the people in the informal settlements is a serious violation of basic human rights.

Namibia is among countries with the lowest levels of proper sanitation in Southern Africa. According to Namibia Demographic and Health Survey of 2013, only 34 percent of the national population of 2.3 million people have access to improved sanitation.

The remaining 66 percent of the population are still using inadequate toilet facilities that include open defecation, buckets and cardboard boxes as toilets to relieve themselves at night while some take security risks and walk miles to visit a public toilet shared with thousands other people.

A United Nations report indicates that although the country has achieved the Millennium Development Goal on access to potable water with over 87 percent of the households in the country having access to improved water supply, the target for sanitation was missed dismally. The absence of adequate sanitation has had a serious impact on women and children.

Meanwhile, the City of Windhoek has promised to build more toilets in the affected informal settlements and pledged to provide water purification facilities.  However, the city has lamented the vandalism of public facilities, including toilets, in the area.

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