When the fishermen are living on the water, they spend their days on wooden boats and their nights sleeping in huts made of straw or grass that need to be relaid daily to prevent them from sinking. With the lack of solid land inside the swamp, there is no way to build a proper sanitary latrine.
The result is that they fish and drink from the same water they use as a toilet, creating an environment where cholera outbreaks are more a matter of when and not if.
These conditions underscore the need for additional preventive measures: A safe, affordable, two-dose oral vaccine is being widely used to prevent cholera in areas at risk.
Funded by the Bill & Melinda Gates Foundation, the Delivering Oral Vaccine Effectively (DOVE) project at the Johns Hopkins Bloomberg School of Public Health works globally to distribute oral cholera vaccine to the people most in need. The Johns Hopkins Center for Communication Programs supports these efforts.
A joint research study between the DOVE project and the Centre for Infectious Disease Research in Zambia is being conducted to determine if the second dose can be delivered at longer intervals and if it provides the same or even better protection at six months when compared to the standard two weeks. This is the first study of its kind.
The study participants are mostly fishermen and their families who live in the Waya Health Clinic District.
Along with getting two doses of the vaccine, participants provide a small blood sample before and during the study to assess protection at the different dose intervals.
“We are very grateful for the cooperation of the people in Lukanga swamp for their willingness to partner with us on this research study," says Roma Chilengi, MD, chief scientific officer at the Centre for Infectious Disease Research in Zambia. "They understand the importance of this vaccine for themselves and their children.”
Based on what they learn from this study, the Centre for Infectious Disease Research in Zambia plans to assist Zambia's national cholera prevention, control and elimination program in deploying the oral cholera vaccine to other fishing camps in the country.
They also travel through the swamp and visit the fishermen who live in the floating villages. Mwape tries to educate fellow fishermen about the importance of drinking safe water and the signs and symptoms of cholera.
They also discuss the cholera vaccine study. Here, Mwape helps a fisherman as he smokes his catch.