Rumors of daily deaths, frenzied medical activity evident in every neighborhood, and properties surrounded by lime are the order of the day in Santiago de Cuba, where cholera is an elusive threat that besets us, and we do not know where it will attack next.
It seems that cholera is here to stay. Since its appearance more than a year and a half ago, its eradication, like that of dengue fever, has proven a difficult goal to achieve. There are more than a few who say it is already endemic. The sources of contamination are unclear, as the disease arises randomly in various parts of the city. What is clear is that the hardest-hit neighborhoods are poor and marginalized.
It is no secret that a lack of sanitation is the primary cause of the epidemic. The contamination of food and water with feces and their consumption by humans is a result of poor drainage systems and a lack of basic hygiene measures, as confirmed by a general practitioner in her daily tour of houses to investigate possible outbreak sources and diseases: "The hygiene is appalling, with garbage and sewage water everywhere. We'll never put an end to the epidemics under these conditions." The immediate solution is to call for volunteers to perform sanitation work next Sunday.
The city's poor hygiene is also recognized by the authorities and the press. In a recent broadcast of "En línea contigo," aired on local television and welcoming the Party's top secretary in the province, over 360 blockages of sewage lines were acknowledged, with waste water flowing into the streets of Santiago de Cuba. The program featured disturbing footage of the consumption of greenish waters drawn from the Contramaestre reservoir; a liquid that, ironically, the local people must actually purchase.
Santiago authorities cannot cope with the problem, despite the hiring of new staff. They blame the crisis on the company's lack of material resources and subjective problems, which is hard for victims to understand.
The reality is that the root problem is the deficient state of the city's sewage systems and drains, whether due to their age, poor installation work, or outright absence in neighborhoods like Altamira. These factors are compounded by the lack of proper personal hygiene habits stemming from a lack of running water.
A primary school teacher gave a clear example, complaining that her students could not wash their hands after using the bathroom at school. She told their parents that all she could do was to force them to wash their hands with water the children brought with them to drink.
Despite the health authorities's best efforts, cholera is spreading. The intense drought is the main cause, as without water it is hard to maintain standards of hygiene.