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'THANK GOD FOR CHOLERA'

You name them they were here and what a sight it was to see a grand convoy of real important people descending  on Ruben Centre, and  in particular Ruben Centre clinic on Wednesday 19th July.

 They were coming  to get first hand  information on the cholera outbreak in Nairobi. It was not as though this was new news  for Ruben Clinic has been trying to  deal with Cholera   patients since May 31st ( see cholera article on Ruben website) but maybe the big people thought the cholera outbreak was fake news or perhaps their entrenched thinking had it as just a poor slum dweller issue and of no significance to  the high and mighty?                            

Well that was until the honorable Treasurer of the Kenya government and some other cronies were stuck down with it following a three day  conference at none other than Kenya’s iconic International Conference Centre.  (KIC)

On his release from hospital Treasurer Rotich offered a defiant “ no comment” when asked by reporters  this  invasive question, ‘ Is it true  Honourable Treasurer, was it cholera that struck you down.?”

However  despite his robust,  mind your own business response, shit had truly hit the fan and it was  ‘ the  dreaded  rice coloured watery stool variety and it gave the Treasurer  a real experience of being a poor slum dweller.  After all  Cholera is an acute enteric infection caused by the ingestion of bacterium Vibrio cholerae present in faecally contaminated water or food. Primarily linked to insufficient access to safe water and proper sanitation, its impact can be even more dramatic in areas  such as Mukuru slums where basic environmental infrastructures are disrupted or have been destroyed. And for clarity as to why the very word cholera sends health officials into a nervous sweat-

A bacterium called Vibrio cholerae causes  the cholera infection. The deadly effects of the disease are the result of a potent toxin called CTX that the bacterium produce in the small intestine. CTX binding to the intestinal walls, where it interferes with the normal flow of sodium and chloride. This causes the body to secrete enormous amounts of water, leading to diarrhea  ( rice water colour) and a rapid loss of fluids and salts (electrolytes). For added effect let me add - Patients can soon be vomiting, severe  diarrhea ( 1 litre/ hour) stomach cramps, dehydration, shock ,Low blood sugar  Low potassium levels  Kidney (renal) failure.  Seizures  restlessness, rapid heart rate, loss of skin elasticity……enough?  Not quite. Death comes surprisingly quickly. Ruben had a death at our gate last Saturday night. I then got a  dire report about several others on their way out so it was with some dread  that I turned up to work on Monday morning. To lighten my dread I  had a cheeky view of a youtube and  the  90 sec version  of monty python’s Bring out your dead”

 Despite the possibility  that the Treasurer’s cholera was fake news, something moved the high ranking government officials to suddenly  go on the offensive  concerning this cholera. The treasurer announced that all human and financial resources would be made available to health workers to control this outbreak.  The Minster for Health, silent for weeks on the issue, suddenly announced he was on his way to the  cholera epicentre or to  Ruben Centre clinic. Low level health official began appearing at the centre to alert us to be  prepared but despite this two hour notice we still couldn’t help but  be amazed at the sight of such a convoy of greats among them the director of health services, the permanent secretary for health, the director of public health, head of Nairobi water  and last but far from the least the honourable Minister (cabinet Secretary  since the new constitution)  for the National Health portfolio.

He came, greeted, put himself at risk by visiting the near dead in the cholera tent, and then walked the slum to see how diabolical  life is for the slum dweller. We all followed our intrepid leader as he threw himself into this walk and soon drastic measures were announced. “This cholera outbreak must be contained, “ he announced and must be done before others suffer and die.  Quickly social media  judged the actions as pure self preservation of the government, given the close proximity to the August 8th. General election.

He announced with immediate affect several wide sweeping directives .

"We have so far closed two hotels...Jacaranda and San Valencia (not to be confused with the deputy president’s Weston hotel that had 30 people treated for cholera a few weeks back)   in Nairobi...and we shall continue to do so if there is evidence of risk to the public," he said on Wednesday after visiting some of the patients.

"The government had ordered the immediate testing of about half a million people in the food handling business in the next 21 days."

On Tuesday, the Health ministry cancelled the medical certificates of all food handlers to contain the cholera outbreak that has hit Nairobi and an afternoon walk near Ruben confirmed this edict as my favourite food vendor and expert on cow head soup along with the numerous chapatti sellers were no where to be seen.

Medical services director  announced that all county health departments  conduct fresh medical examinations before issuing any other certificates.  So with all these  dire  edicts a reader  may be confused given the  provocative title to this  article, but  let me put you all at ease.

Honerable C S Mailu said,” local authorities in Nairobi will repair all broken sewer lines. Water will return to the previously dry water pipes along with  the immediate dispatching of a water truck with free water. Some of them (measures) will not be pleasant, but we will triumph" he said.

( The Star newspaper 20th July)

Hon. Mailu said, “Kenya Red Cross Society and UNICEF will also be helping and now let me acknowledge the herculean efforts being made here at Ruben centre.  To Br. Frank and his team  the nation owes you much and to recognize your  great contribution  I wish to announce that the ministry will support your clinic with an ambulance and also the ministry will support your efforts to establish a maternity unit and  as soon as next week a clinical officer and nurse will be assigned to your facility.

Now we have a nervous wait to see if this was an elaborate  pre election stunt or in fact a  moment for all Ruben slum people to chorus those words ,’ 'Thank God for Cholera.'