Hand washing

World Vision promotes good hygiene and proper sanitation to tackle cholera outbreaks

By Martin Muluka, Emergency Communications Specialist, World Vision Kenya

For Ralia, a resident of Madogo ward located in Kenya’s Tana River County, the mention of cholera is like rubbing salt into a raw wound.

She lost her first-born child, aged two, to the killer disease. And just as she was preparing to bury him, her one-year-old son, Hawo, fell ill with cholera too. She was rushed to a medical facility known as the Madogo Health Centre for treatment.

According to Ken Kiprono, a clinical officer at the health centre, cholera outbreaks within the area usually claim many lives - especially of children and the elderly.

There is a great risk of the numbers rising and more lives being lost due to cultural beliefs that are hampering cholera prevention and treatment initiatives.

Ralia attends to her sick child
Cholera spreads rapidly and affects communities, especially children and the elderly. Promotion of hygiene practices and health messages helped Ralia to save the life of her son Hawo from the disease.©World Vision Photo/Martin Muluka.


“Most local residents have resorted to traditional herbs to cure the disease while only rushing their sick ones to hospital when it is too little too late,” says Kiprono.

Ralia adds that she took Hawo to the health centre for treatment after his brother had already died.

“I used to believe that Cholera was a curse that could be cured by traditional medicine. I later learnt from the outreach that Cholera was dangerous and that I needed to use water from clean sources," she says.

The short rains season proceeding a prolonged drought usually offers relief to many families in Kenya. It means livestock that trekked for long distances in search of a drop to quench their thirst can get water at filled up water pans. However, for villages in the lowlands of Tana River County, these short rains are both a blessing and a curse.

When it rains upstream, water flows into water pans but most of it is not safe for human consumption. It flows downstream washing up waste and carcasses of animals that died during the drought.

Access and use of this unsafe water is harmful because it leads to water borne diseases such as cholera.

Awareness creation on the significance of consuming safe and clean water, as well as embracing good hygiene, is the panacea for mitigating the spread of cholera.©World Vision Photo/Martin Muluka.


According to the World Health Organisation (WHO), cholera is an extremely virulent disease that can cause severe acute watery diarrhoea.

It takes between 12 hours and five days for a person to show symptoms of the disease after ingesting contaminated food or water. Cholera affects both children and adults, and can kill within hours if left untreated.

Dr. Japheth Ayako, the Tana River County Director of Medical Services notes that interventions at the community level are vital in helping save lives.

He states that promoting awareness on proper Water, Sanitation and Hygiene (WASH) will go a long way in combating practices like open defecation that contribute to increased cholera cases.

Dr Ayako adds, “With the support of World Vision, we have set up a cholera treatment unit. Tents and poles donated by the organisation have helped create more space for attending to patients as our hospital wards were full and our facilities are stressed.”

With funding from UNICEF and the International Organisation for Migration (IOM), World Vision is also distributing Non-Food Items (NFIs) comprising of buckets and soap to improve the hygiene and sanitation of patients, both in hospital and at homes, among those who have been discharged so as to avoid reinfection.

NFI distribution
The distribution of non-food items that promote good hygiene - such as buckets, soap and water storage cans - is helping save lives among communities worst hit by cholera oubreaks.©World Vision Photo/Martin Muluka.


A Memorandum of Understanding signed last year (May 2022) between IOM and World Vision in Kenya has ensured that both organisations can collaborate effectively in strengthening emergency response mechanisms for the most vulnerable communities.

“The prepositioning of NFIs is helping save lives,” says Omondi Oyoko, World Vision’s manager in Tana River County, Kenya.

He adds that in collaboration with the Ministry of Health officials, World Vision is carrying out health outreaches in targeted villages to increase access to information on cholera prevention and control.

Water trucking in times of drought enables communities to access clean and safe water.  This protects them from waterborne diseases like cholera.©World Vision Photo/Martin Muluka.


Farale, another resident of Madogo, lost her two-year-old to the disease in December 2022. However, through community level advocacy interventions, she has embraced proper hygiene and sanitation practices. As a result, she is taking good care of her only surviving child.

Bodhole, another parent notes, “My child was sick but has now recovered because I abide by good hygiene practices that I learnt during the health outreaches. Instead of using dirty pots, I now use buckets that I received to store water. In addition, I have adopted practices like handwashing in my house because it can make a difference between life and death.”

happy children
Access to clean and safe water enables children to be healthy and enjoy life in all its fullness. ©World Vision Photo/Martin Muluka.


To further protect communities from the cholera disease, World Vision is partnering with the Ministry of Health, county governments among other development agencies to roll out the Oral Cholera Vaccination (OCV) campaign. During this period, World Vision staff will be moving from house to house, sensitising eligible community members on the significance of taking the vaccine.

Additionally, World Vision under its Kenya Integrated Emergency Response Project (KIEREP), which is funded by the USAID Bureau for Humanitarian Assistance, has been doing water trucking to increase access to clean and safe water for affected communities. This exercise is targeting households as well as schools.

Thanks to the adequate water provision in schools, girls can now concentrate on their studies as they no longer need to walk long distances in search of water ©World Vision Photo/Martin Muluka.


The water trucking services could not have come at a better time for school children.

“Many children used to miss school as they used to spend a lot of time walking long distances in search of water. I am happy that we received water tanks and also enjoy a regular supply of clean water twice a week. This access to water has been instrumental in improving the sanitation and health of children. They now come to school regularly unlike before, especially the girls,” notes Esther, the head teacher of one of the schools in Tana River that is benefitting from the water trucking services.

Leah, a pupil at the school spots a big smile as she does various sanitation activities within the school.

Pupils are glad that they can carry their dirty clothes and wash them after classes, thanks to the sustainable supply of water in their schools. They also attend classes regularly because there is water for use and also for cooking food in school.©World Vision Photo/Martin Muluka.


“I used to shy away from coming to school because I felt dirty. My uniform would go unwashed for days and our toilets had no water. There was no need to come to school because I would feel uncomfortable. The tanks are a blessing because I can now carry my clothes to school and wash them after classes. I also attend classes regularly because there is water for our use and also for cooking food in school,” she says.

The interventions rolled out by World Vision and its partners have helped combat cholera in Tana River County. Families have embraced good hygiene practices and no longer abide by myths and traditional medicine to tackle the disease.