The Cholera outbreak at Tiberias on the Sea of Galilee in Oct., 1918, that I am about to describe was of great importance from a military point of view. Consequently, the author and a bacteriologist, (Capt. A. Compton, R.A.M.C., O.C. 32 Mobile Laboratory) were dispatched to the scene of the outbreak in order to investigate the conditions and, in short, to adopt any measures possible to suppress the epidemic. The matter was of considerable urgency. Tiberias lay on the direct line of communication for troops operating in the Damascus area, and it was essential that all reinforcements and food supplies pass through the town. The hilly nature of the country, the arid soil, the daily extremes of temperature at that season of the year - for the days were hot and the nights bitterly cold - the deficient and defective water supply - all these factors had a bearing upon the health of the troops and the nature of the problem. Had Cholera spread at that critical period to any great extent it might have brought, what proved to be, one of the most brilliant feats in military history, to an untimely close.

Master of Public Health - MPH / Background:cholera outbreaks have almost become a norm in Lusaka district with the onset of rains.The disease forms part of the preventable diarrhea diseases that have greatly contributed to the high morbidity and mortality rates especially in children under five. In an effort to mitigate the recurrence of cholera in the district of Lusaka, various strategies have been employed to resolve the crisis. However none have investigated the skill or capacity of the public health officers involved in health promotion and disease prevention,themselves. Therefore in this study, focus is turned on one of the integral officers in this public health arena who seem directly involved in preventive health, the Environmental Health Officers. The aim is to clarify their role and skills capacity with the hope of initiating a process of developing appropriate skills and therefore positively contribute to the fight to contain cholera outbreaks.Study Design:this is mainly a qualitative descriptive study that seeks to gain insight into the problem EHOs in Lusaka may be facing in averting cholera outbreaks by exploring in-depth, their attitudes, beliefs and values concerning their role and capacity with consideration to the training they receive to prepare them for their role. The sample was drawn from the EHO’s from 26 health centers under the jurisdiction of the Lusaka Urban District Health Management Team (LUDHMT).Data Collection:data was collected from the EHOs through focus group discussions to scrutinize how their knowledge and experience interact in their setting. Consequently, a few follow-up EHO interviews were done for further clarification of recorded data. Face to face, semistructured interviews were conducted with their supervisors as well as EHO trainers from the two local colleges concerned with EHO training. UWC, SOPH, mini-thesis, Hilary Chibiya, 2520505.May 2009 Analysis of Results:a qualitative approach to data analysis was employed which commenced during data collection through member checking to comparing, coding, categorizing and seeking meaningful interpretations of emerging themes.Discussion and Conclusion:while the EHOs’ perceive themselves essentially as promoters of environmental health,this study discovered that they dwell more on control measures in the matter of cholera out breaks. Even though they feel confident to contain an outbreak they expressed a lack in the level of skills they possessed to enable them to monitor, evaluate and consequently get rid of the all the factors that cause the disease to recur. Inevitably with this lack of self-assurance to eradicate cholera they seem resolved to focusing their resources to adequately prepare for the control of cholera than its prevention, instead. Very importantly, it was found that both policy development and training are to lagging behind the demands of the EHOs current role and their work is hindered by lack of funds specific to prevention activities complicated by an unhealthy donor dependency. There also is a need for all the key players in the environmental Health arena to appreciate the shift in the role of an EHO from the former traditional responsibilities because the incidence of cholera could keep recurring unless all these stakeholders could join forces in training and supporting the EHO appropriately.UWC, SOPH, mini-thesis, Hilary Chibiya, 2520505.May 2009

The aim of this study was to identify and describe the viability of using cell phones to conduct rapid assessments, pass key health messages and conduct monitoring and evaluation in complex emergencies. The study setting was in a cholera outbreak response situation in Mogadishu, the capital of war torn Somalia. Qantitative, descriptive research was conducted to determine the feasibility. Data collection was done using structured questionnaires, self-response mailed questionnaires as well as follow-up telephone interviews. Three groups of respondents participated in the study. The respondent groups included 383 internally displaced persons (IDPs), 5 water, sanitation and hygiene (WASH) specialists and 5 specialists from 5 mobile phone providers in Mogadishu. The study showed that there is good potential for an effective, cost efficient and scalable short message service (SMS) based public health education platform in Somalia. The study has also come up with recommendations on key considerations to ensure viability of the Public health education platform. It is envisaged that the recommended platform shall increase speed, access, spontaneity, coverage and reduced cost per capita, a combination of which form the hallmark of a good emergency health response. Ultimately this effort shall contribute to improved health, reduced suffering and reduced deaths in fragile humanitarian contexts. / Health Studies / M. (Public Health)

The aim of this study was to identify and describe the viability of using cell phones to conduct rapid assessments, pass key health messages and conduct monitoring and evaluation in complex emergencies. The study setting was in a cholera outbreak response situation in Mogadishu, the capital of war torn Somalia. Qantitative, descriptive research was conducted to determine the feasibility. Data collection was done using structured questionnaires, self-response mailed questionnaires as well as follow-up telephone interviews. Three groups of respondents participated in the study. The respondent groups included 383 internally displaced persons (IDPs), 5 water, sanitation and hygiene (WASH) specialists and 5 specialists from 5 mobile phone providers in Mogadishu. The study showed that there is good potential for an effective, cost efficient and scalable short message service (SMS) based public health education platform in Somalia. The study has also come up with recommendations on key considerations to ensure viability of the Public health education platform. It is envisaged that the recommended platform shall increase speed, access, spontaneity, coverage and reduced cost per capita, a combination of which form the hallmark of a good emergency health response. Ultimately this effort shall contribute to improved health, reduced suffering and reduced deaths in fragile humanitarian contexts. / Health Studies / M.A. (Public Health)