By Petronella Sibeene WINDHOEK There is a diarrhoea outbreak in the Ohangwena Region, which has claimed four lives. Health authorities have detected 33 diarrhoea cases and two cholera cases have also been reported. The disease outbreaks are suspected to have been spread through hand washing rites at funerals where all mourners are required to wash their hands in a single dish containing herbs after burial. According to the Permanent Secretary in the Ministry of Health and Social Services, Dr Kalumbi Shangula, on 3 April a villager of Onaame near Okatope Clinic in the Engela District died of a chronic illness. Two days later, the widower to the deceased and 14 other mourners contracted diarrhoea. It is suspected that the disease could have been spread by mourners who came from Xangongo and Ondjiva in the Kunene Region of Angola, where cases of cholera are endemic mainly due to lack of running water. The 14 people have recovered after receiving treatment from Okatope clinic. Nineteen other mourners received treatment at Engela Hospital. Eight of them were discharged while 11 were admitted. Of those admitted, four have died while the others are reported to be in satisfactory condition. Shangula stressed, “Special attention is given to the practice where all mourners have to wash their hands in one bowl after burial. This can facilitate transmission. The community is urged to use alternative ways of cleansing.” He appealed to the public especially those in areas where the disease has been reported to ensure that people do not wash their hands in the same water. Regarding cholera cases, the Permanent Secretary reported that, “Vibrio cholera, the causative agent was isolated in two patients. In some specimen, salmonella was isolated. These cases represent a mixture of cholera and pure diarrhoea.” He added that the Regional Management Team has embarked on mobilization and sensitization campaign in the affected communities. Since February, there have been no new cases reported until this month. The situation is, however, said to be under control following a high health alert and surveillance in the affected Northern regions. With continuous education on sanitation, where communities are encouraged to make use of potable water, the diarrhoea challenge that Namibia faces would disappear, said the Minister of Health and Social Services, Richard Kamwi, who visited the affected regions in February. Since last year, Namibia has had a run of health challenges, starting with the polio outbreak at a time when the country was on the verge of being declared polio-free by the World Health Organization (WHO). Health surveillance was also intensified since diarrhoea and cholera outbreak was announced in neighbouring countries. During the period November last year to early last month, six instances were confirmed as cholera cases but in all the cases, the victims were discharged after receiving treatment. In Angola more than 1ÃÆ’Æ‘ÀÃ…ÃÆ”šÃ‚ 200 people are reported to have died in the past five months. Apart from the outbreak in Angola, the disease was also reported in Zambia and Zimbabwe given the heavy rains that worsened the situation. Cholera is an acute intestinal infection caused by a bacterium Vibrio Cholarae. The disease is mainly characterized by severe dehydration. Symptoms include sudden onset of watery diarrhoea up to one litre per hour, the diarrhoea has a “rice water” appearance and has a “fishy odour.”