Dar es Salaam - “It was on 27th March 2024 in the evening.  I got a call from my wife that my daughter was very sick. She was vomiting and having watery diarrhea. My daughter was dehydrated, and she looked pale and tired. Few hours later, I also started feeling the same symptoms. My sons realized that this was Cholera symptoms and they quickly rushed us to the nearby health facility where we got treatment and recovered on the following days.

The recurrence of Cholera outbreaks has been a threat to many lives in the United Republic of Tanzania for decades now. Situation reports from the Ministry of Health indicated that, the outbreak have been reported in 19 regions of Tanzania Mainland. So far, a total of 3,337 cases and 57 deaths were reported from Mara, Arusha, Kilimanjaro, Kigoma, Kagera, Singida, Simiyu, Shinyanga, Tabora, Ruvuma, Mwanza, Geita, Rukwa, Dodoma, Manyara, Morogoro, Katavi, Pwani and Dar es Salaam.

Following the outbreak, the World Health Organization (WHO), has been supporting the Government efforts to control of Cholera outbreak through coordination, and response mechanisms.

These interventions include, enhancing response coordination structures at national and subnational levels through activation and implementation of Incident Management System, orienting 61 health care workers working in 4 CTCs (i.e Gozba, Bumbile, Ilemela and Buswelu) in Mwanza and Kagera regions for strengthening proper case management and IPC practices during Cholera outbreak.

Despite implementation of different efforts put in place by the region and district authorities and WHO, there has been persistence of the disease in various districts including Meatu district in Simiyu region.

This necessitated the deployment of 9 (08 males and 01 female) Risk Communication and Community Engagement (RCCE) Experts to Simiyu region. Thanks to this deployment, a socio-ecological rapid assessment was conducted to deeply explore and analyze the local situation and determinants of the disease, which necessitated an intensive community sensitization in over 92 households and 32 villages to control the cholera outbreak.

“I really thank the healthcare workers at our facility who educated us prior on the outbreak, particularly the specific symptoms. Thanks to the intensive outreach and education, my sons had this knowledge and awareness and took immediate action which saved our lives”, said Masali Mhunile from Mwamishali ward.

The community enagement also accompanied the development of the joint and community-based action plan against Cholera outbreak. This is enhancing 54 community members and local authorities from the affected wards and district on community engagement strategies to generate local solutions tailored to control and prevent further transmissions. The behavioral science data from the rapid assessment were used to guide key actions tailored to control and prevent Cholera outbreak from household level.

Also. regular and intense Household visits, monitoring and community meetings were conducted to manage rumors and misinformation and promote positive WASH practices such as construction and use of latrines, regular hand hygiene, home waste management, food safety, and water treatment.

“Our communities have people with mixed beliefs and cultural practices which fuel Cholera transmission. This cannot be solved by enforcing the by-laws alone. We are happy for this impactful efforts championed by WHO to reach everyone, everywhere with cholera prevention messages, we are witnessing the change.”  said Onesmo Mwendo, from Mwanhuzi ward, Meatu district.

In line with the Astana Declaration on Primary Health Care, the UHC framework for action, and Regional Strategy for Health Security and Emergencies 2022-2030 (AFR/RC72/8) which highlight systematic community engagement as a core component for successful implementation, the World Health Organization will continue to enhance community protection and resilience by engaging the local communities to generate relevant solutions that address their challenges. In addition, use of behavioral science approaches to guide tailored interventions to community protection and resilience is enhancing many lives in Tanzania

Aside the intensive community enagement efforts, WHO’s also supported the establishment of 11 Oral rehydration points (ORPs) in Ilemela and Nyamagana district councils for Mwanza region and 5 islands (Gozba, Bumbile, Lushonga, Kinagi and Kitua) for Kagera region to enhance early rehydration of patients, timely referral and ultimately prevent mortality.  1000 pool testers were also provided to 26 regions for enhancement of water treatment at household and communities as well as procured and distributed 100 Cholera rapid test kits.

According to Dr Charles Sagoe-Moses, the Country Representatives, “The recurrence of health emergencies in the African region requires a concerted effort of all actors beyond the health sector to building community protection and resilience. WHO will continue to support Tanzania, leveraging on community structures and institutionalizing community engagement at the interface of health, to help build stronger, equitable and resilient health systems.