Vietnam's Cholera Outbreak - A Structural Problem

It's no secret that Vietnam is suffering from a serious, and spreading outbreak of cholera. According to the latest report, the outbreak now has spread to 19 cities and provinces – mainly, but not exclusively in the northern part of the country. Of the more than 1,800 people who have fallen ill from diarrheal diseases since March 5th, 326 have been confirmed to be infected with cholera.

Vietnam's health agencies blame the outbreak on contaminated or unhygienic food – dog meat, shrimp paste, uncooked vegetables – and water. Lakes and ponds have been dredged and disinfected in an attempt to contain the spread of cholera and other acute diarrheal diseases.

But a report presented last Friday at a conference held in Hanoi on "Clean Vegetable Growth in the Red River Delta" illustrated the magnitude of the problem. Produce grown in many areas of northern Vietnam, including supposedly "safe" areas, is often contaminated with heavy metals, toxins, and E. coli. Irrigation water used on crops contains E. coli more often than not.

The problem goes beyond water. Fecal pathogens such as E. coli also find their way into the soil when farmers use fresh manure as fertilizer. Proper composting greatly reduces the pathogen content of manure, but Vietnam does not provide its farmers with clear guidelines for fertilizing with compost.

On our recent trip to Southeast Asia, we had a chance to visit local farming villages in Myanmar and to see how manure is composted. The process is simple – it's collected in a heap until it is needed. There is no method or timetable to its accumulation or use.

A chicken foraging for it's midday snack at the edge of a manure heap in a typical village

Southeast Asia's food and water safety issues are well-entrenched, and they will only be solved when the countries in the region manage to put the necessary infrastructure in place, including a reliable supply of clean drinking water, adequate facilities for handling human waste, basic education and training for farmers in how to fertilize cropland safely.