Passing the Torch with Angel Alliance

Passing the Torch with Angel Alliance

Featuring a Q&A with our Executive Director, Jereme Lambert

The idiom “Passing the Torch” comes from Ancient Greece. Though many think its origin lies in their infamous Olympic Games, it is actually a religious ritual in the form of a relay race using a lit torch. This was done to honor gods and goddesses such as Athena and Hestia represented there. Now, it is a phrase used to represent giving over responsibility to someone who deserves it. It means trusting one’s successor to complete the task at hand with honor.

Essentially, The Angel Alliance Fund embodies this idiom, ‘Passing the Torch,’ to empower communities without the benefits of established infrastructure and business. TAAF uses business to create business. Empowering an entrepreneur through Angel Alliance means passing the torch and creating hope for water-deprived communities. 

The Angel Alliance Fund Vision

The Angel Alliance Fund is built to provide micro-loans to emerging entrepreneurs in developing countries like Asia, Latin America, and Africa. By correctly timing and distributing this capital, these businesses can strengthen their supply chain and better meet their real water needs. To be able to achieve business success, individuals must have something to work with. Angel Alliance does just that: gives opportunity to those without it. 

Not Just A ‘Spend’ Donation 

There are many charities that provide clean water. Many are pipeline charities that seem to buy products for those who need them. Though this approach is generous and reputable, this money is spent already; it is used up. The Angel Alliance Fund is different. Capital is distributed to small business owners in the global south on a cyclic basis (not all at once). Placement of the capital is negotiated by the TAAF financial team. With over 50 years of combined experience, the TAAF financial team makes reputable and wise decisions about where to invest.

Q&A With our Executive Director, Jereme Lambert 

I was able to interview Jereme Lambert, the executive director of Connect for Water. Like many others associated with Business Connect and Connect for Water, Jereme has had firsthand experience with several global partnerships and truly understands business operations.

How do you find these worldwide entrepreneurs? 

JL: They come two different ways: they do reach out to us directly sometimes, but typically it comes through a partnership with Business Connect. There are entrepreneurs on the ground that we get to know through travels, through being in-country. The TAAF is based on relationships, even if someone reaches out to us, we usually spend a little time getting to know them before we would invest in their project. 

Most come through interpersonal relationships. 

And that was really the catalyst of it– which was knowing we could give a hand-up to people and create an economic difference. The unique aspect of how we do work at Connect For Water is through economic change, not just a giveaway. 

Have you had any personal experience, either domestically or internationally, with a specific group that has influenced your heart behind this mission? 

JL: There’s been a lot of things for me personally that has led to this. In growing several businesses that I’ve run– in business you talk a lot about how cash is king. In traveling to these developing worlds, there isn’t access to that cash. There isn’t the ability to raise your business to the next level. You can have just as brilliant of people, with all the skills–and more skills than I’ve ever had–and they just don’t have the capital. They’re just stuck. It really came out out of years of business experience for me, but also watching international development work that said,

 ‘This can be done differently, more than just charity work.’  

So what I hear you saying is… this is sort of an equity thing, just being able to grant that opportunity? 

JL: Yes. Absolutely. It’s building into their life, into their business, it absolutely is an equity thing. That’s why it’s the ‘Angel’ Alliance… it is an angel coming in, giving these people a hand-up. 

Why should any person give to the Angel Alliance Fund? 

JL: I think people are tired of just giving the same gift each year. This is a repeating gift, a new way, a different way, a better way to bring change in people’s lives. It isn’t an ‘every December I’ve gotta write a check,’ this is a fund that is renewing, and makes a difference, a larger difference with every dollar that’s brought in. 

Can someone be sure their contribution will target the right niche? 

JL: That’s a frequently asked question! There’s always a risk when it comes to the global south, so I cannot say there isn’t risk. We do base it on long-standing relationships and 100% of the money received goes to the recipients. In addition, we also have a group of advisors that help us decide on the strongest business plan.

What is the process for the entrepreneur to request a loan? Do they need to submit a business plan or anything else for review?

JL: It is a business plan that has to be submitted. We have to talk through what they want, and they also have to have a sales plan: a projection for how they’ll sell that product within the first six months. So it’s a business plan and a specific sales plan for their channels. Within the sales plan, we want to check for if they know their competitors if they know the sales channels they have… if they have a good path forward. 

How does the money come back to the fund? Is there interest or a payment schedule?

JL: It is a payment schedule, so it’s typically a monthly payment. Based on what they sell, they pay back, and that goes back into the fund. There’s no interest–the loans are based on product. As they sell products, they put the funds back. They pay back the product they sold that month. 

Your Challenge 

Make The Angel Alliance Fund your holiday gift. If you have your water needs covered for the holiday season, think of those who may not. It is clear TAAF is a gift that grows exponentially for families across the globe. Though you may not see them, they will feel your support. Trust those who know their community’s needs best. Pass the torch for Giving Tuesday, this holiday season, here.

Empowering Women with Clean Water

Empowering Women with Clean Water

Young girl walks down road with water canister on her head to collect water.

“We cannot all succeed when half of us are held back.” 

-Malala Yousafzai

Could you, yourself, envision cleaning a wound that bleeds for 7 days… with just disposable rags? Imagine being a teenage girl in schooling, facing this wound every month. Imagine then discontinuing your schooling because of the shame that it brought you and the lack of resources to contain it. 

The empowerment of women is crucial in a morphing world such as ours. Women know that cleanliness and hygiene are a staple for feeling content in daily life. Barriers for women in the area of safe water access, sanitation, and hygiene (WASH) have resulted from a lack of available water-supported infrastructure and resources such as menstrual cycle materials. Discussion upon these lines will include the unique sanitation needs women in developing countries possess, why these characteristics matter, the retrieval of water and how proximity to water affects health, and the steps needed in which these are to be systematically improved in infrastructure and education—on the basis of equity. 

Reproduction and Menstruation

Women are genetically bound to reproductive processes. Menstruation and childbearing are just two of the main things which bear greater hygienic needs, especially for women facing limited access to water.

Menstration on Education

Firstly, on the basis of education: women and girls who go to school and do not have the materials to properly manage menstruation. One article from Lifewater suggested that many schools do not have the proper resources to accommodate menstruation, which can sometimes even lead to the end of their education. In parts of Africa, India, and Southeast Asia, access to menstrual products, especially disposable ones, is highly limited. Women in these regions typically use a reusable cloth to absorb menstrual blood but do not always have facilities or proper cleaning products to appropriately clean soiled cloths. (Society of Obstetricians and Gynecologists of Canada, 2021). Even soap and water can prevent the negative and sometimes embarrassing results of menstruation—the same soap and water which many women still do not have. 

Childbearing and Water

Childbearing mothers are another group of women who need water-supported infrastructure. In A Systematic Review of Water and Gender Interlinkages: Assessing the Intersection With Health, by Pouramin, Nagabhalta, and Miletto, it was found that new mothers and pregnant women represent a vulnerable population. More specifically, it was revealed that religious new mothers who were fasting were more likely to be underweight as a result of a lack of improved sanitation and clean water. 

Both of these characteristics of womanhood—menstruation, and childbearing—are not ones to be ashamed of. Attitudes toward these normal processes are often considered taboo in areas around the world. These practices are still viewed as dirty and impure to many. This can make it harder for women to voice their needs in male-domineered politics.

In developing countries, women and girls are the primary water retrievers. According to UNICEF, women and girls are responsible for water collection in 8 out of 10 households. Numerous studies demonstrated that women’s role as the sole water purveyor exposed them to multiple health risks. “Women have an increased risk of musculoskeletal disorders as a result of carrying water long-term and across long distances…women who fetched water from a drill pipe may also be at increased exposure to toxins,” (Pouramin, Nagabhalta, and Miletto). 

Giving Power

Talking about all of the issues women face is only part of the equation. Achievable solutions such as education and proper systems for using the bathroom and hand-washing are what is required for women to feel comfortable in their hygienic practices. 

Accomadating Power

Infrastructural intervention is another component of achieving growth for women in these situations. Women need:

  • Latrines/Toilets
  • Education
  • Filters

Installing latrines and toilets, even basic ones, have provided benefits to overall health for women in countries where they are needed. Furthermore, a comprehensive intervention that combined hand-pumps and hygiene education demonstrated significant success after a 7-years follow-up, increasing the number of women using improved WASH practices, lowering the number of bacteria on mothers’ hands, and therefore the incidence of diarrhea in their children (Pouramin, Nagabhalta, and Miletto). Another successful observation from this study featured that of water filters and their positive relationship with water quality for these same women. 

Leading in Power

Another feature of empowerment is leadership. Giving women the platform they deserve will optimize their voice of concern relating to their needs. With respect to cultural values, women should have the option to take on the role they should want in or out of the household. Gender mainstreaming and education of the resource imbalance due to gender are some of the ways these women can feel their lives elevated to the level they prefer. 

What Can You Do?

There are several ways in which to support women and all who require clean water. Educating yourself and others about worldly topics and engaging in helpful media are part of the solution. Empowering the sisters, mothers, and all women in our lives are the interpersonal building blocks of a world we should strive for.

If you would like to take your own route to secure water for women and people who need it, you can set up your own fundraising platform through the Champion a Project campaign. By creating a championed project, you will have your own webpage to help raise funding for whichever water problem you’d like to tackle.

Joining the network of our partners at Business Connect means being part of a community of people who truly care about transforming lives. On the infrastructural level, they can support your cause. If you have access to a region in which to water for women and those in need, see their water filter products here

Clean Water and Hygiene: Keeping Children in School Worldwide

Clean Water and Hygiene: Keeping Children in School Worldwide

During the last year, we have all been reminded of the importance of proper handwashing and hygiene to help prevent the transmission of diseases. Just twenty seconds with warm, clean water and soap can help remove the bacteria and dirt that cause sickness. During our global quarantine, we became hyper-aware of all the ways we could stay clean and protect ourselves. We had intense anxiety when we couldn’t buy things like soap, sanitizer and bottled water. For many of us, these shortages were only short-term, but for others, this was pretty normal. Did you know that in many countries around the world, shortages of basic hygiene products and clean water are typical? When these things are not available, lives are affected. Children are some of the most vulnerable, especially young, elementary students. 

What does this mean for the children? The truth is that seventy-five percent of school absences are due to illness. Around the world, illness is caused or exacerbated by a lack of clean water and hygiene education. The dirty water hosts parasites and bacteria, as well as can cause waterborne illnesses that often target the respiratory tract and cause diarrhea. Worldwide, children are at higher risk to contract these diseases, especially if they are from a low income family. This also leads to higher mortality rates among children. 

A comprehensive study done by the University of Nebraska shows that handwashing with clean water alone can reduce absences at school up to 50%. A study in Côte d’Ivoire saw that not only did waterborne disease decrease when children had clean water to drink and proper hygiene education, but so did transmission of other diseases like typhoid fever. Researchers in Egypt found that enforcing hand-washing decreases infection rates of diarrhea, conjunctivitis and influenza by up to 67%. Less waterborne illnesses from access to clean water means higher attendance for all students and their teachers.

If children are drinking dirty water and missing school, there can be lasting negative impact. Missing instruction can leave a child behind in coursework and lead to lower grades, even in future years. Those who are frequently absent are more likely to drop out of school and are at higher risk for addiction and other risky behavior. It has also been found that lack of education can lead to less opportunities for success for these students and higher rates of unemployment. 

Research done by the Institute of Education Studies has found that higher attendance means higher grades. School can also create other strong, successful skills in children like time management and healthy conflict resolution. Teacher attendance is important, too. When teachers are in class regularly, students learn more. According to the Journal of Educational Evaluation and Policy Analysis, even if a class has a substitute, classes lose the continuity and intensity of their learning. Just 10 days more can increase student achievement by 10%. With these things in mind, we know that clean water is key for students and teachers. 

A simple glass of clean water might be all that is missing for a student to be successful in school. Would you like to partner with us to provide this glass? Our heart is to connect you with clean water projects so that you can make a difference in lives around the world. Becoming a water sponsor for five dollars a month will mean you can provide clean water to five students for all of their years in elementary school. Together, we can keep them healthy and strong, at a time when they are most vulnerable.

Water’s Effect on Malnutrition

Water’s Effect on Malnutrition

What If…

In the morning you wake up before the sun to walk miles to collect water for your family. As you approach the river, you are relieved to find that there are no cows around and you will not have to push your way through to the water. You bend over and your bucket is heavy as you lift it from the slow moving river. The water is discolored, but you still raise it to your head to take it home to your children.

You and your family are blessed to have a little bit of food and this water, but the bellies of your children are bloated and they don’t seem to be growing very much. They lack energy to go to school and run and play with the other children. You try to give them as much food as possible, but it just isn’t enough. What if this was your reality?

We often hear about malnutrition when organizations are working in developing communities. It is a wide-spread issue touching one of every three children in the world. According to the World Health Organization, “malnutrition is characterized by inadequate or excess intake of protein, energy, and micronutrients such as vitamins, and the frequent infections and disorders that result.” We think that the best way to help them is to provide nutritious food, but this is not the only thing we must do.

A little known fact is that clean water is key to fighting against malnutrition. When children have access to clean water, their bodies are able to absorb the key nutrients that will make them healthy. As published by WashAid, “half of all cases of undernutrition are estimated to be associated with repeated diarrhea, intestinal worms and other infections as a direct result of inadequate WASH.”

With this understanding, we are taking action to help children to grow up to be healthy and strong. We are working with our partners to make sure that clean water is a part of nutrition programs by including distributions of water filters. If you would like to help children around the world to enjoy health, become a water sponsor. Your $5 per month gift for a year supplies 5 children with safe water for over 5 years. This gives mothers peace of mind, knowing the water they work so hard to collect is enabling their children to go to school and run and play.


Understanding The Deadly Salmonella Bacteria

Understanding The Deadly Salmonella Bacteria

What a gift it is to have pure, clean water!

Not just for drinking and cooking, but to wash produce, scrub hands, brush teeth, and bathe.

Clean water is a basic human need, yet the UN’s Institute for Water, Environment and Health reports that 663 million people still lack ‘improved’ drinking water. That’s despite efforts being made each year to supply more people with better quality water.

One side of this reality is the diseases that routinely accompany contaminated water. A salmonella infection, or salmonellosis, is one common bacterial infection. It can happen anywhere, but this disease plagues developing countries with contaminated water supplies.

What are salmonella, salmonella infection, and salmonellosis?

These three terms are sometimes used interchangeably, but salmonella is the name of the bacteria, while salmonellosis and salmonella infection are the resulting illness.

This genus of bacteria is responsible for one of the most common forms of food poisoning worldwide. Globally, millions of cases of salmonellosis are reported every year. Many more go unreported.

Discovered by a doctor in the 1870’s, the bacteria became known as salmonella when a veterinary pathologist involved in the U.S. Department of Agriculture’s microorganism research program found salmonella in hogs that were dying. The genus “salmonella” was named for this researcher, Daniel Salmon.

Most salmonella infections can be classified as stomach flu or gastroenteritis. The infection strikes the intestinal tract. The bacteria typically live in human and animal intestines, including birds, and then are shed through their feces. Even someone with no symptoms can be a carrier and infect others.

The way most humans become infected is through ingesting water that’s been contaminated with the bacteria, or tainted food – in particular raw/undercooked meat, poultry, eggs or egg products. Salmonella infections are more common in the summer than winter.

Where is Salmonella bacteria found?

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The bacteria itself is found worldwide. Humans carry certain types of salmonella. It’s found in wild and domestic animals. Poultry, swine, cattle, wild birds, and rodents can carry it, but so can reptiles – iguanas, turtles, and others. Even dogs and cats may harbor the bacteria.

What are the symptoms of salmonella infection?

Sometimes people with salmonella infection have no symptoms. Others develop diarrhea, abdominal cramps, and fevers within a few hours to 3 days.

A complete list of symptoms may include:

  • Nausea
  • Vomiting
  • Abdominal cramps
  • Diarrhea
  • Fever
  • Chills
  • Headache
  • Blood in the stool

The salmonella infection generally lasts from four to ten days. It’s normally not life-threatening, and without treatment, most healthy people recover within two weeks.

Unfortunately, that’s not always the case. Infants, young children, the elderly, transplant recipients, pregnant women and unborn babies, and those with compromised immune systems are more likely to have an acute form of the illness or be in danger if complications occur.

Diarrhea linked to salmonella can be dehydrating. Dehydration occurs when you aren’t able to drink enough liquids to replace fluid lost from diarrhea. Even after abdominal pain and diarrhea subside, it may be months before bowels are back to normal.

You may be dehydrated if you’re experiencing these or other signs:

  • Dry mouth and or tongue
  • Little urine output
  • Producing few to no tears
  • Sunken eyes

How does salmonella cause diarrhea?

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It’s insidious! Here’s Science Daily’s description of this cunning invader:

Salmonella is a pathogenic bacteria which penetrates intestinal epithelium cells which form the topmost layer of the intestinal tissue. Although the pathogens are killed in these cells, they succeed in provoking inflammation that destroys the intestinal flora and nullifies their protective function. Their comrades of the same species that remained in the intestine exploit this, and proliferate, and the affected person develops violent diarrhea.

Sometimes dehydration is severe enough to require medical attention or hospitalization. In those cases, blood or stool samples help medical personnel distinguish salmonella infection from other illnesses with the same symptoms.

How is a salmonella infection treated?

As noted before, some cases clear up on their own. Severe cases may require hospitalization to receive fluids intravenously. Anti-diarrhea meds may be prescribed or medications to relieve cramping, although the latter may prolong diarrhea that comes with the infection.

Antibiotics don’t help with uncomplicated cases of salmonella. They’re usually used for treatment when it appears salmonella bacteria have entered the bloodstream, and sometimes for severe cases or patients with a compromised immune system. Antibiotics could increase a risk of relapse.

Salmonella infections become life-threatening when complications develop. especially when the infection spreads beyond the intestines to the bloodstream. Once present in the bloodstream it’s called bacteremia. Bacteremia can lead to infection of any organ, like the brain, spinal cord, heart valves, lining of the heart, or bone marrow.

What is typhoid fever?

One variety of salmonella bacteria leads to typhoid fever, a bacterial infection of the intestinal tract and sometimes the bloodstream. It is caused by the Salmonella Typhi bacteria. It can be a deadly disease.

Typhoid is much more common in developing countries than in the U.S. where it is now considered very rare. In the 1800’s there were numerous outbreaks in New York traced back to one immigrant later identified as a carrier.

She herself was healthy, but she was the cause of many others becoming ill, some of whom died. Because there was no antibiotic salmonella treatment and no immunization for typhoid, she eventually ended up in isolation until her death. She was known as “Typhoid Mary.”

One other possible outcome of salmonella is reactive arthritis (Reiter’s syndrome), although only in a small number of cases. It causes joint pain, eye irritation, and pain when urinating, and can lead to chronic arthritis, a condition that’s difficult to treat.

What are the causes of salmonella infection?

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Most people become infected by eating foods or drinking water that’s been contaminated by feces. Some think this should be easy to avoid, but areas with poor sanitation and a lack of clean water are incredibly vulnerable. A home water filter can make the difference between illness and good health.

Consider just some of the situations that produce unsanitary conditions in the global south. They may drink contaminated water. People can’t clean their hands effectively after using the toilet or changing a diaper.

Raw produce brought in from fields may not be washed free of bacteria. Fish or other seafood could be harvested from contaminated water. Butchered meat might not be processed using safe methods. Food handlers may not have cleaned their hands thoroughly so feces could be left on food.

Cross-contamination during food preparation is likely if surfaces can’t be cleaned sufficiently. Lack of clean water unquestionably makes everything much more complicated.

What are commonly infected foods?

Raw meat, poultry, and seafood often are infected with salmonella bacteria if feces are present. Raw or undercooked eggs are often a culprit, even though eggs have a shell. Sometimes infected chickens produce eggs containing salmonella before the shell has even been formed.

If raw meats or eggs come into contact with foods that are eaten without cooking, like salads, bacteria will be ingested. Unpasteurized milk and milk products like raw milk cheese can be infected. The FDA has even found some salmonella outbreaks traced to contaminated spices.

Any foods can become contaminated if you touch animals (especially birds and reptiles) and then transfer bacteria by touching inside your mouth or eating without properly cleaning your hands.

Salmonella can even spread from person-to-person. Medicine.net explains that The organisms can be transferred from person-to-person by both direct (via saliva, fecal/oral spread, kissing) and indirect contact (for example, using contaminated eating utensils).

It’s easy to understand why sanitary practices such as safe food handling and hand washing are crucial, yet the difficulty of accomplishing them without clean water.

What are risk factors for salmonella infection?

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International travel in areas with poor sanitation raise your risk. Salmonella infection, including the varieties that cause typhoid fever, are more common in developing countries.

Owning a pet bird or reptile that may carry salmonella bacteria. Reptiles (which includes turtles) are not considered appropriate pets for kids.

Stomach or bowel disorders may leave you at higher risk.

The human body has natural defenses against salmonella infection, but certain medications or physical problems lower those defenses. Here are examples:

  1. Stomach acid can kill many types of salmonella bacteria. Taking antacids lowers the stomach’s acidity allowing more bacteria to survive.
  2. Anti-rejection drugs after an organ transplant
  3. Corticosteroids
  4. Inflammatory bowel disease makes your intestinal lining more vulnerable to salmonella bacteria taking hold.
  5. Recent antibiotic treatment may reduce “good” bacteria in your intestines, making it harder to battle salmonella.
  6. Immune problems, AIDS, Sickle cell disease, and malaria.

How Can You Prevent Salmonellosis?

Can you imagine the dilemma of those in developing countries who must function with no clean water? Keep their plight in mind as you consider a list of best practices to avoid salmonella infections.

Common sense dictates that avoidance of sources is the best defense against the infection. Beyond that, there are rules to steer clear of the spread of salmonella:

  • Wash hands thoroughly after using the toilet, changing a diaper, cleaning up after pets, before, during and after food preparation.
  • Cook food thoroughly, then refrigerate or freeze food without delay.
  • Those with diarrhea shouldn’t prepare food, care for hospitalized patients, the elderly or children.
  • Cook ground poultry and poultry pieces to a minimum temperature of 74°C (165°F), whole poultry to 82°C (180°F), other ground meats to 71°C (160°F). A probe thermometer is the way to verify cooking temperatures.
  • Place cooked foods on clean surfaces only, not where food was prepped, and not onto a plate which was used for the item before cooking.
  • Don’t leave food at room temperature for more than two hours.
  • Use pasteurized milk and milk products.
  • Thoroughly cook eggs. Don’t use eggs with cracked or damaged shells.
  • Avoid homemade ice cream, eggnog, or unbaked cookie dough made with raw eggs. Products made commercially like eggnog and ice cream are made with pasteurized eggs, not raw.)
  • Thoroughly wash fruits and vegetables in clean water before eating them.
  • When buying, bagging, prepping or storing food under refrigeration, keep raw meat separate from fruits, vegetables, already-cooked foods or ready-to-eat items.
  • Use separate cutting boards for meats versus fruit and veggies.
Cholera Is Becoming A Serious Problem. Here’s Why

Cholera Is Becoming A Serious Problem. Here’s Why

Cholera is a familiar name for an ailment that is not well understood in modern western society. It was eradicated in many developed nations years ago, though cholera has recently made a comeback across the globe due to changing weather patterns, increased globalism, and other factors that are not well understood.

Cholera is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae.

Cholera was last common in the U.S. in the 19th Century, before modern water and sewage treatment systems prevented its spread via contaminated water. Today, only 5-10 cases of cholera are reported annually in the U.S., and half of those are contracted abroad. Due to its waterborne nature, rare cases of cholera outbreaks can occur in the U.S. due to contaminated seafood.

In spite of its extreme rarity in the U.S. and Western Europe, cholera outbreaks are still a serious health problem in other parts of the world. The World Health Organization documents over 150,000 cases each year.

Cholera is most common in places with poor sanitation systems, overcrowding, active war zones, and famine. Cholera is still considered an epidemic in parts of Africa, South Asia, and Latin America.

Tropical climates that never get cold enough to kill bacteria combine with wet soil and unsanitary groundwater to mix with most drinking water supplies, allowing a single case of cholera to spread to entire communities and preventing the bacteria from ever being truly eradicated from regions with overcrowded, rapidly developing cities.

In recent years, storms and political turmoil have interfered with local water supplies and created sanitation crises and cholera outbreaks in countries across the globe.

Global Disease Transmission

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A recent cholera outbreak in Haiti claimed tens of thousands of lives, and the country has repeatedly claimed that it had the disease completely under control before visitors from foreign countries brought it back into its borders.

After deliberations dating back to 2010, it was determined that the outbreak began near a United Nations peacekeepers’ camp, where nearly 500 people freshly arrived from Nepal, where an ongoing cholera outbreak was occurring at the time.

The disease has killed over ten thousand people and infected hundreds of thousands more in Haiti since its reintroduction, and since its recent natural disaster woes critically damaged infrastructure, the nation is now struggling to manage cholera once again.

This story is tragically familiar across the globe–developing nations manage to radically reduce the infection rate of cholera and other sanitation-related diseases, only to suffer a setback in the form of natural disaster or war that damages infrastructure and leads to high-risk transmission behaviors like obtaining water from unverified sources.

In a nation like Haiti, where civil progress effectively eradicated the disease, its reintroduction shortly after a devastating earthquake has had sobering consequences. In nations with underdeveloped medical systems that are no longer actively treating cholera, keeping up with the medical load of fast-spreading epidemics can prove daunting if not impossible.

In nations that still struggle with cholera, like Bangladesh, vaccines have been created and programs implemented in an effort to curtail cholera’s devastating effects. Nations which recognize their ineffective infrastructure or climates that make eliminating the disease nearly impossible are combating its spread by immunizing humans to its effects. But in regions where cholera is no longer common, an outbreak can have devastating consequences before medical professionals ever realize what’s happening.

Transmission and Treatment

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Part of what makes cholera so devastating is that it kills so quickly and can be transmitted rapidly. Within hours of becoming symptomatic, patients often lose so much fluid through acute gastrointestinal distress that they are critically dehydrated. While specialized blends of fluids and antibiotics can rapidly restore health, missing the treatment window renders patients incapacitated and further increases the risk of transmission.

Many tropical countries with underdeveloped water and sanitation infrastructure harbor massive amounts of cholera bacteria in groundwater and sewage systems, which often manage to contaminate public water supplies. Once an outbreak begins, the contamination worsens through infected individuals’ diarrhea and vomit, which are both constant presences in cholera patients. Those tending to the ill often fall ill, and classic epidemic conditions rapidly occur.

Thanks to the rapid travel and warmer climate of the 21st Century, infected individuals can now bring the disease to areas which have not seen it in over a century, which then creates new epidemics as those regions struggle to treat the infected and contain its spread. Recent civil wars and unrest across the globe have worsened these issues as disruptions to civil utility services and violent threats to hospitals prevent people from accessing clean water or proper treatment.

War and Cholera

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In Yemen, a brutal civil war has created even worse epidemic conditions, as the already highly-contagious disease is transmitted faster by resource shortages caused by military blockades. Without guaranteed access to water or food, people are forced to compromise on food and sanitation, which leads to infection. And with war causing crowded hospitals and blocking transport of medical supplies, hospitals cannot keep up with the mounting demand for treatment.

The World Health Organization has identified the situation in Yemen as one of the worst outbreaks of cholera in modern times. Combined with restricted access to basic resources like food and roadways, the rapid deterioration and transmission associated with cholera are proving even more damaging than usual. The correlation between survival rate and rapid access to medical care means that war-torn nations are hit particularly hard.

As The Guardian noted:

Tamer Kirolos, Save the Children’s country director for Yemen, said an outbreak of this scale and speed is “what you get when a country is brought to its knees by conflict, when a healthcare system is on the brink of collapse, when its children are starving, and when its people are blocked from getting the medical treatment they need”.

Kirolos said: “There’s no doubt this is a man-made crisis. Cholera only rears its head when there’s a complete and total breakdown in sanitation. All parties to the conflict must take responsibility for the health emergency we find ourselves in.”

Cholera In the 21st Century

Yemen and Haiti are two tragically current case studies in the epidemiology of cholera. Whether reintroduced through international travel or exacerbated by civil war, the disease still has the potential to be as devastating as it was when the first outbreaks swept across the world in the 19th Century.

This is held in tragic contrast with nations which can effectively treat patients who appear to be on the brink of death and release them from the hospital the same day they are admitted.

Modern antibiotics and rehydrating solutions are largely effective treatments, and nations like Vietnam and Bangladesh have decided to preempt rapid strains on vulnerable infrastructure by implementing vaccination programs that prevent humans from acting as transmission vectors in crowded cities.

The dichotomy between modern medicine and the strains of population growth, global travel, and human conflict combine to create situations where cholera outbreaks are still imminently possible and always tragic; but, thanks to our understanding of sanitation, disease transmission, and treatment, most outbreaks are much less catastrophic than those of the past.

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