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Drought-related Cholera Outbreaks in Africa



Throughout its history, Africa has seen several periods of prolonged and extreme droughts across the continent that, along with malnutrition, poor access to water, sanitation and hygiene, and population displacement, cause food insecurity, exacerbate social inequity, boost mortality rates, and, perhaps most significantly, encourage disease outbreaks. Cholera is one such disease, and Africa has the highest global cholera burden. It is also a continent with many drought-prone regions. Despite this, research on cholera and droughts in Africa is lacking.

Vibrio cholerae is a water-borne bacterial pathogen, with symptomatic cholera causing profuse watery diarrhea and sudden onset dehydration [1]. The annual cholera burden is estimated at 1.3–4 million cases and 21,000–143,000 deaths annually [2,3], with >94% of these reported in Africa [4]. Several countries are beginning to show signs of endemicity and there is currently a Global Task Force on Cholera Control that aims to reduce cholera deaths by 90% by 2030 and eliminate cholera in 20 countries [5].

Less well understood is the impact of drought on cholera [1,2]. Droughts are a complex hazard and involve meteorological, hydrological, agricultural, and societal changes [3]. Africa has seen several periods of extreme and extended drought [14]. Despite some studies suggesting links between drought and cholera outbreaks [3], this link, especially in Africa, has been widely under-studied in isolation. One suggested mechanism through which drought may catalyze cholera outbreaks is via increasing concentrations of V. cholerae in groundwater. For example, in Bangladesh cholera concentrations were 13-49% higher in dry weather drainage flow samples compared to wet weather samples from floodwater [5].

Environmental factors may only be influential in cholera outbreaks to a certain extent, after which socio-economic conditions are key drivers for outbreaks. Eight hundred and forty-four million people worldwide lack access to basic drinking water and a further 2.4 billion are without basic sanitation [5], putting many people at risk for diarrheal diseases. Human-induced factors may therefore be of equal importance for cholera dynamics with environmental factors due to a range of risk factors and potential cascades including poverty, sanitation, drainage, water quality, poor healthcare, malnutrition, and human behavior such as eating practices, all of which could be exacerbated by drought [3].

There is a need for the involvement of people in water-related democratic dialogues at all levels to identify some of these challenges and their solutions. Democratizing water helps in bringing all stakeholders—governments, local governments, communities, private sectors, and non-profits—towards a common understanding of challenges to water quality and encourages looking for locally relevant solutions together.

[1] Ali M, Lopez AL, You Y, et al. The global burden of cholera. Bull World Health Organ. 2012;90(3):209–218.

[2] Germani Y, Quilici ML, Glaziou P, et al. Emergence of cholera in the Central African Republic. Eur J Clin Microbiol Infect Dis. 1998;17(12):888.

[3] World Health Organization. Cholera. [On-line]; 2020. Available from: https://www.who.int/health-topics/cholera#tab=tab_1

[4] Nkoko DB, Giraudoux P, Plisnier PD, et al. Dynamics of cholera outbreaks in Great Lakes region of Africa, 1978–2008. Emerg Infect Dis. 2011;17(11):2026.

[5] World Health Organization. Ending cholera a global roadmap to 2030. In: Ending cholera a global roadmap to 2030. Geneva: World Health Organization; 2017, pp.4.

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The Effects of the Cotton Industry on the Water Supply

“Cotton is the most widespread profitable non-food crop in the world.” (1) The plant is found in nearly every article of clothing, from t-shirts to jeans to socks to flannel, and it has also made its way into towels, bedsheets, curtains, and cosmetics.


Unfortunately, the textile industry in its present form is far from sustainable. The World Wildlife Fund estimates that 3% of the water used for agriculture is used for growing cotton, despite the fact that nearly all the rest of the resource is allocated to growing produce. A single outfit, approximately 1 kilogram of cotton, takes a staggering 20,000 liters of water to produce. With millions of tons of cotton being produced each year, more sustainable methods must be implemented immediately.


The issue is not just the fast fashion industry spitting money and resources into the newest fads; the world population will exceed 9 billion by 2050, and with this comes a need for textiles far beyond the scope of fast fashion. Cotton differs greatly from plastic in that there is less of a demand for an environmental alternative and more of a push to optimize the growth and fabrication of cotton-based products. Current substitutes such as polyester, bamboo, and hemp all have their own drawbacks, and with the infrastructure built firmly around the cotton plant, it seems most reasonable to figure out measures to decrease the amount of water, chemicals, and land necessary.


With the development of newer technologies, farmers have attempted to grow more organic cotton without the use of pesticides and fertilizers, reducing the environmental impact of possible toxic runoff into nearby ecosystems. The amount of water needed for the growth of cotton has significantly decreased over the past few decades, and researchers are interested in developing more water-efficient and insect-resistant varieties that can further decrease its impact on the environment.


(1) https://www.worldwildlife.org/industries/cotton

The Californian Delta Smelt Controversy

The delta smelt is a little three-inch silvery blue fish that lives in the San Francisco Bay and the San Joaquin Delta, and its declining population numbers have incited California’s controversial water wars. Biologists warn the world that the pumps in the delta are harming the fish’s already delicate state and could cause extinction. However, efforts made to protect the delta smelt population in the San Joaquin Delta are countered by farmers, who complain about the lack of clean drinking water and freshwater for their crops.

How did this tiny fish become the heart of California’s water wars, and how valid is the concern for their declining population? Because of the Delta Smelt’s short lifetime (only about a year), the observed effects of pumping on their species are only immediate. However, researchers have discovered the source of the problem to be the depletion of freshwater from the delta for urban and agricultural use. A decrease in freshwater in the delta means an increase in the amount of salt water flowing in. The extra salt water hurts the ecosystem in the delta and bay as a whole.

From 2012 to 2016, California suffered yet another drought, and Northern California needed to pump more water for their cities and farms. The delta smelt population suffered as a result, to the point where only 6 smelt were found in 2015, compared to 1,673 at their peak in 1970. Currently, it is unknown how many smelt are left in the wild, and scientists are concerned that the fish are too few and too spread out to reproduce.

Water use isn’t the only force against the struggling delta smelt; the pumps that suck water from the delta are also of note. Because the smelt are poor swimmers, they can get sucked into the pumping system. There is a system in place that collects the fish and trucks them back to the delta, but the fish are exposed to stress and predators along the way, and a 2012 study found that the system was insufficient altogether. Turning down the pumps when the smelt are near them has also been tried, but the delta smelt are elusive, and no one knows exactly where they are.

Because other solutions are inefficient, state laws restrict the amount of water that the state can pump, but also allow overrides in dire situations, and this is the reason for California’s water wars. Farmers and agricultural industries argue that the restricted pumping over an “arbitrary” fish is hurting their industry. Scientists submit a thousand page report warning that more pumping would continue to endanger not only the smelt but the Chinook salmon and the resident killer whales too.

So who’s truly suffering here? The answer is both parties. According to biologist Carl Wilcox, “The issue in the delta has always been balancing the amount of freshwater outflow through the delta versus exports and upstream water diversions.” So the issue, it seems, comes down to water management, especially during the droughts that climate change has so kindly gifted us. In 2012, Californians didn’t act like it was a dry year, nor did they act in anticipation of a dry spell in the next year.

At this point biologists don’t think the smelt can bounce back from their current dire state, and it’s likely that the little fish is headed to extinction in the next few years, as it would take a massive amount of changes to the current water management system to keep them around. So why do they continue to fight? Because it’s not just the smelt that are suffering. It’s also the salmon and the killer whales and the whole ecosystem in the delta. If the smelt go, and California does nothing to their water management systems, the salmon and killer whales might be next to go, hurting the fishing industries in the process.

At the end of the day, the delta smelt are just the harbinger, signaling the tipping of the delicate balance of the delta's ecosystem and the potential damage of pumping and poor water management on wildlife.


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