In Oil-Rich Angola, Cholera Preys Upon Poorest

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In Oil-Rich Angola, Cholera Preys Upon Poorest

By SHARON LaFRANIERE

LUANDA, Angola, June 10 — In a nation whose multibillion-dollar oil

boom should arguably make its people rich enough to drink Evian, the

water that many in this capital depend on goes by a less fancy name:

Bengo.

The Bengo River passes north of here, its waters dark with grit, its

banks strewn with garbage.

Two dozen roaring pumping stations suck in 1.3 million gallons from

the river each day, filling 450 tanker trucks that in turn supply

10,000 vendors across Luanda's endless slums. The vendors then fill

the jerry cans and washtubs of the city's slum dwellers, who buy the

water to drink and bathe in.

This is one reason, health experts here say, that Luanda's slums are

now the center of one of the worst cholera epidemics to strike Africa

in nearly a decade, an outbreak that has sickened 43,000 Angolans and

killed more than 1,600 since it began in February.

But it is only one reason. Cholera typically spreads through contact

with contaminated water or sewage, and in Luanda's slums, both are

everywhere. Neighborhoods here are ringed by mountains of garbage,

often soaked by rivulets of human waste. Only about half of slum

dwellers have even an outdoor latrine.

Children stripped to their underwear dance through sewage-clogged

creeks and slide down garbage dumps on sleds made of sheet metal into

excrement-fouled puddles.

Much of the city has no drainage system; in heavy rains, the filthy

water rises hip-high in some of the poorest dwellings.

One development group estimated that it would take 22,000 dump trucks

to clear away the trash. That was in 1994, when Luanda had half the

population of 4.5 million it has now.

" I have never seen anything like it, " said Weatherill, a water

and sanitation expert for Doctors Without Borders, which is leading

the response to the epidemic. " You see conditions like this on a

smaller scale. But I have never seen it on such a huge scale. It is

quite shocking. "

Angola is in the midst of a gusher in oil revenue, its hotels crammed

with oil executives and its harbor filled with tankers carrying away

the 1.4 million barrels of crude pumped here each day. The economy

grew by 18 percent last year. The government racked up a budget

surplus of more than $2 billion.

This year it is expected to take in $16.8 billion in revenue, well

over twice the $7.5 billion it received in 2004. Next year, revenue

is expected to rise by a third again, almost all because of oil.

Economists say the government simply has more money than it can

spend.

Yet it seems powerless to address even the basic issues of clean

water and sewers that would make such epidemics entirely preventable —

a paradox that critics attribute to corruption, incompetence or the

hangover of a 27-year civil war that flooded the capital with

refugees, or all three.

" We are talking about a government that has the means, " said Stephan

Goetghebuer, East Africa coordinator for Doctors Without

Borders. " There are a lot of things they could be doing. The living

conditions are really terrible, and they are terrible even if you

compare them to other places in Africa. "

Sebastião Veloso, Angola's health minister, said the scope of the

problem defied a quick fix. " We just do our best, " he said. " The lack

of infrastructure is a very complicated administrative problem. We

are doing our part at the Ministry of Health, and the rest of

government must do its part. We are pressuring the government,

because otherwise these epidemics will continue. "

Only one in six Luandan households is lucky enough to have running

water, and for many of them, it comes from a community standpipe,

according to Development Workshop, a nonprofit group in Angola. The

often-contaminated river water from trucks that roam the slums costs

up to 12 cents a gallon — a hefty sum in a nation where two-thirds of

the people live on less than $2 a day, and up to 160 times the price

paid in better-off neighborhoods with piped water.

So the poor ration their water use, limiting themselves to about two

gallons a day per person for drinking, bathing, washing clothes and

cleaning. That is far below the five-gallon daily minimum recommended

by the United Nations — and one twenty-sixth the average use in

Western countries, according to Doctors Without Borders.

In an attempt to beat back the epidemic, the government, with the

help of the United Nations, is distributing a limited amount of free

clean water. The few distribution points are easy to spot. Hundreds

of people rise before dawn to set their plastic buckets in lines that

stretch for blocks. The crowds remain long after the water is gone.

One afternoon last week, dozens of people crowded around one empty

plastic water tank about eight miles from downtown. " They are waiting

for the last drop, " said José Mateus, a neighborhood coordinator.

No one knows precisely why cholera arose out of the slums this year

after a cholera-free decade in Angola. Epidemiologists say the long

absence of the disease worsened the outbreak because the population

had no built-up immunity.

Once it began, not even the tidiest slum household could halt it.

It first hit Boa Vista, a shantytown minutes from downtown. Ombrina

Cabanga, a 20-year-old mother of a 2-year-old girl, did everything to

protect herself, said her sister-in-law, Oriana . She washed

vegetables, rinsed plates and cleaned the latrine the family shares

with three others. As the Health Ministry recommended, she used

bleach to disinfect the drinking water she bought from the

neighborhood vendor.

But her house is a few feet from a giant trash-filled gulley. Her

latrine, like everyone else's, drains directly into it. And she sold

soap every day in the city's famously squalid outdoor market, a job

she hoped to escape by taking adult literacy classes.

One Tuesday in late March, she came home and vomited into a bucket.

Two nights later, she was dead.

" I am just a working man, I don't know why the government doesn't

help us, " said her husband, Vieira Muieba, 27, a construction

worker. " I don't know where the money goes. We become angry but we

don't know what to do. "

From Boa Vista, the epidemic moved along the major highways to all

but 4 of the nation's 18 provinces. André lost her 15-year-old

daughter, 13-year-old niece and 4-year-old nephew in the span of two

days. Five other children in the household were also taken ill but

recovered.

Ms. André is racked with guilt nearly three weeks after the

deaths. " I don't know what happened, " she said. " I heard about the

disease on the radio, and all of a sudden, it was here. They were all

healthy and now, they are dead.

" It is not easy to lose three children all at once. "

Angolan government officials say there is no overnight solution to

the lack of basic water and sanitation. In late May, President José

dos Santos promised new measures to improve conditions,

including moving Luandans out of the most appalling slums.

But the government's plans are in their infancy and, despite the

gusher of oil revenues, short on financing.

Consider the government's plan to take over some of the provision of

water to Luanda's slums. Four months into Angola's cholera epidemic,

20 trucks have been ordered — minuscule compared to the fleet of more

than 300 private trucks now supplying the poor. As of early June, Mr.

Veloso, the health minister, was still waiting for the first delivery.

The government's harshest critics blame corruption for the abysmal

living conditions. Transparency International, which promotes good

governance worldwide, ranks Angola as the world's seventh most

corrupt nation. The State Department said in a 2002 report that

Angola's wealth was concentrated in the hands of a tiny elite, in

part made up of government officials who had enriched themselves on

an enormous scale.

Other diplomats and analysts say Angola's ruling party is still

trying to get on its feet after a civil war that raged almost nonstop

from 1975, when Angola gained independence from Portugal, until mid-

2002.

Dauda Wurie, a project officer for the United Nations Children's

Fund, said the war had eviscerated the government's corps of

competent managers, leaving disarray.

" I am not defending them, " he said of the government officials. " They

buy big cars. They live in big houses. But it would be wrong to

expect that everything will turn around just because war stopped. "

Doctors Without Borders officials say the government response to the

outbreak has been woefully slow and underfinanced. A crisis committee

began work only two and a half months after the epidemic began, and

the government has set aside a mere $5 million in emergency money to

fight the disease.

Assessing the water taken by private truckers from the Bengo fell to

Doctors Without Borders. Last month it issued its report: laboratory

tests in April showed the raw river water was unsafe to drink.

But only one in 10 truckers chlorinated water tanks; the others

simply delivered untreated water to the city.

Presented with those findings, the government did nothing, the report

states. So Doctors Without Borders organized the distribution of free

chlorine. It now plans to insist that the truckers pour chlorine

crystals into their tanks while inspectors watch, lest they sell them

instead.

How much those truckers — and the neighborhood vendors they supply —

earn in profits is unclear. But Janetta Jamela's bedroom in eastern

Luanda is one hint. Fifteen bags of concrete are stacked against the

wall — to add three new bedrooms and a new kitchen and bathroom.

Since she and her husband scraped up $200 to build an underground

water tank three years ago, she estimated, she has earned about $235

a month selling water — $75 a month more than her husband earns as a

government security officer.

" But you have to have the $200 to start with, " she said.

The cholera epidemic is now waning, having run what epidemiologists

call its natural, devastating course. But without an improvement in

slum conditions, said Mr. Weatherill, the group's water and

sanitation expert, the respite may last only until the next rainy

season.

" Unless things change, we probably will be back the next year, " he

said in a telephone interview, " and the year after that. "

http://www.nytimes.com/2006/06/16/world/africa/16cholera.html