For a few days, possibly a week, there was a suspicion that certain people in government were taking people for a ride with talk of El-Niño. Perhaps it was just another one of those schemes to fleece. What should have made people realize that El-Niño would come was that the people who do the stealing often need little justification to do their scandalous deeds. And so the rains over the last week plus, have been welcomed with relief by those in official positions even as those who have to commute during rush hour, have occasionally suffered.
While the rains have clearly been heavier than normal in areas such as Nairobi, Thika, Embu and Western Kenya, there are those areas where the rains are yet to turn up like Machakos, Lodwar and Makindu where there has not been a drop of rain in October. So who are the lucky ones? The people for whom the rain is now becoming a daily feature of life or those who continue to experience dry weather?
The answer from a public health perspective is neither. Public health problems exist whichever the predominant weather pattern but are made worse by extreme weather change.
So people are at greatest risk when the weather is dry then becomes very wet. One of the more common diseases that emerge under such conditions and give a good indication of the quality of health services, apart from frequent strikes, is the incidence of diarrhoea.
In one four year study in Ecuador, heavy rainfall that followed periods of dry weather led to more cases of diarrhoea. And this occurred despite availability of sanitation.
The cause was attributed to contamination of drinking water, which occurred after heavy rains. The same results were found in Bangladesh, where every increase of 10mm of rain above the normal rainfall average was associated with a four percent rise in the number of cases of diarrhoea. Most affected were the poorer segments of the society together with those with inferior sanitation.
Many people describe diarrhoea to be any episode of loose stool, but the medical definition is loose, watery stool that occur more frequently than usual.
That is the stool has to be both loose and frequent. Often the symptoms and signs of diarrhoea are mild, though discomforting and resolve on their own after a day or two. But if they persist then the horrible non-word “diarrhoeaing” emerges. It is one of those words that people say, they are corrected, and refuse to yield, despite the acknowledgement that if they are asked to write it down, they cannot spell it and what; it just looks bad. Perhaps it reflects how they feel. The origin of the word diarrhoea is Greek meaning “flowing through.” In the African version, it does so violently.
More than six episodes over a 24-hour period is cause for concern because there is risk of dehydration and loss of vital minerals and elements like potassium and sodium. The cause of loose stool is when the large intestines are unable to reabsorb water during the digestion process because there an infection with some virus, bacteria or parasite. The most common bacteria are campylobacter, salmonella, shigella and Escherichia coli.
Treatment of diarrhoea involves trying to figure out what could be the cause. If you know you’ve been to a wedding and eaten some barely warm rice that has sat for a long time then that is likely the cause.
If you insisted on ‘eating healthy’ and ate the ‘salad’, raw vegetables in a place where you could not verify their food hygiene practices, then you have a good suspect. The diarrhoea due to protein food poisoning like some bad meat is much worse in terms of symptoms. Often there is nausea, headache and other constitutional symptoms. At such times apart from waiting it out, it is advisable to eat light. Avoid fatty foods, heavy meats, dairy products except sometimes natural yoghurt which can be therapeutic. Drinking plenty of water, which is not sugary is necessary for speedy recovery. In severe cases and after a confirmatory stool test, antibiotics may be necessary.
Prevention is a much better course of action. Knowing there are increased diarrhoea cases when the weather switches from dry to heavy rain is the first step.
Secondly because we know that climate change is here with increased weather variability, chances of diarrhoea epidemics occurring will be higher unless we prepare adequately.
So El-Niño is not just about traffic jams, road drainage and the chance to make some quick money. Having clean hands, by frequent hand washing, especially on entering the house and after a visit to the toilet greatly reduces the chances of contracting some disease.
Apart from avoiding disease, it gives you the chance to say, “hey look, clean hands!’