USAID Partners with Zambia to Respond to Cholera

During the country’s worst cholera outbreak in decades, USAID and its partners quickly mobilized to save lives

Since October 2023, Zambia has been battling its worst cholera outbreak in decades. As of March 26, the country had reported over 22,000 cases and 719 deaths.

This is a disease linked to contaminated water.

And in Zambia, over six million people lack access to a safe and reliable water supply and 12 million people have no access to proper sanitation facilities — both factors contributing to current transmission and infections.

When left untreated, cholera can cause rapid dehydration and death within hours.

USAID supports ongoing activities in Zambia to improve water, sanitation, and hygiene, and prevent infectious diseases like cholera. Since 2021, the U.S. government has improved access to safe water for over 200,000 people and improved sanitation for 1.5 million people.

Elizabeth lives in Malangilisho Village (Central Province, Zambia) and is a member of the Village’s Water, Sanitation, and Hygiene committee. In 2023, USAID installed a new safe water source closer to the Malangilisho Village making it easier for Elizabeth to collect water. / Liz Squire for USAID

Take, for example, one community in Zambia’s Central Province, Malangilisho Village, that has reported zero cholera cases.

Malangilisho Village receives support through both USAID and the Zambian Ministry of Health to increase access to safe water, sanitation, and hygiene.

Members of the Malangilisho Village Water, Sanitation, and Hygiene committee meet monthly to discuss the water and sanitation needs of the community and the maintenance of their water source. / Liz Squire for USAID

For over 40 years, the community of 60 households had relied on the same open well (a water access point, which is less secure than a borehole) for their water needs. But the well was close to the roadside, and debris and litter would fall in contaminating their only water source and becoming a potential cholera threat.

In November 2023, the USAID Scaling Up Nutrition Technical Assistance (SUN-TA) project installed a new borehole fully fitted with a hand pump, closer to the community and away from the roadside.

Timothy Nyirongo, the community pump minder, is responsible for ensuring that the new water pump is functioning as it should. Timothy received training through the USAID SUN-TA project so that he can maintain the pump for his community. / Liz Squire for USAID

This partnership also provides ongoing sanitation and hygiene education for supported communities. During these education sessions, community members learn how to create effective hand washing stations out of readily available materials.

During the most recent cholera outbreak, USAID SUN-TA and the Ministry of Health worked together to raise awareness for cholera prevention strategies such as boiling water and only eating foods that have been thoroughly cooked.

Two members of the Malangilisho Village community demonstrate how they have created a hand washing station with available materials. / Liz Squire for USAID

As the cholera outbreak first began to spread throughout Zambia’s 10 provinces, USAID and its partners quickly mobilized to respond to the government’s urgent needs and requests for support.

USAID donated chlorine, anti-diarrhea kits, water purification solution, and personal protective equipment to health facilities and households. USAID also ramped up its ongoing infection prevention control efforts at Agency-supported facilities and in partnership with the Zambia National Public Health Institute developed a web-based dashboard to provide public health officials a with a clear, real-time understanding of provincial and national cholera statistics.

USAID, through its partners in Zambia’s 10 provinces, has been donating chlorine for water purification, personal protective equipment, anti-diarrhea kits, and other supplies to support the Ministry of Health’s cholera response. / Dominic Mukumbila

One urgent request was the need for more trained health workers to detect and treat patients with cholera.

The USAID Zambia Accessible Markets for Health project, which expands access to high-quality health services for Zambians through partnerships with private sector facilities, trained 55 health workers in cholera detection and treatment.

Among them were nurses Don Musonda and Aline Umutoni from Anthu Omwe Health Center in Mungule, Chibombo District — located just down the road from Malangilisho Village.

During Zambia’s recent cholera outbreak Aline (left) and Don (right) helped to treat and discharge 36 patients with cholera at the USAID supported Anthu Omwe Health Center in Mungule. / Liz Squire for USAID

For patients with cholera, the loss of fluids can become fatal within a few hours if they do not receive urgent medical attention. Don and Aline said because of their training, they had the knowledge and skills needed to properly assess patients with cholera and keep them hydrated.

Don remembers one patient in particular that came in to Anthu Omwe at the most severe stage of cholera. With proper assessment and treatment from Don, Aline, and their colleagues, the patient was able to eat and walk on her own after three days.

As part of USAID’s support to the Ministry of Health to respond to cholera, USAID donated 14,000 bottles of Klori-Safe Chlorine, 2,000 packs of Kit Ya Moyo-oral rehydration salt, and 60 gumboots to Central province to support the cholera response in the area. / Dominic Mukumbila

USAID is committed to working with the Government of Zambia to create a future where people can live, work, attend school and follow their dreams without a preventable disease like cholera disrupting their plans.

In 2023, USAID’s Mission in Zambia provided over 108,000 people with access to a safe water supply and over 550,000 people with access to basic sanitation services.

About the Author

Elizabeth Squire is the Health Communications Advisor at USAID’s Mission in Zambia.