WINDHOEK -The Minister of Health and Social Services, Dr Kalumbi Shangula yesterday expressed fear the persisting spread of Hepatitis E to new locations and failure to contain it despite control measures in place could result in it becoming endemic in Namibia. 

Statistics from the ministry show that as of 27 January 2019, the total number of Hepatitis E cases reported in Namibia were 4432. 

So far, 40 deaths have been reported and the death toll is disproportionately highest among pregnant women and those who have given birth - constituting 17 cases and translating to 42.5 percent of the deaths so far. 

Hepatitis E was declared an outbreak in December 2017. 
Shangula said in an address to stakeholders during the consultative meeting on Hepatitis E outbreak control yesterday that response interventions were mounted immediately after the outbreak was confirmed. 
The National Health Emergency Management Committee was activated, he said. 

Various stakeholders were consulted and activities carried out to contain the outbreak, including water quality monitoring, improvement of public sanitation, provision of facilities for fecal disposal and social mobilisation. 
Despite these and many other efforts, the disease is persistent and it is spreading to new locations, Shangula noted. 
He said this was a “sad and unwelcome development”. 

“What I find distressing is the fact that there is an air of indifference towards the outbreak among the public. The presence of the disease seems to be accepted as a norm. The commitment of some of the important stakeholders seems to be declining. The urgency to take drastic measures to contain the disease seems to be waning,” said the health minister.
He suggests the current situation warrants what he termed “shock therapy.” This refers to the sudden and drastic measures taken to solve an intractable problem. 

“We need to review our response strategies and interventions,” added Shangula.  A rapid assessment of the response on Hepatitis E was conducted in October last year in the Erongo, Oshikoto, Oshana, Ohangwena, Kavango, Omusati and Khomas regions. The study revealed weaknesses in the response towards the outbreak, admitted Shangula. 
“Some regions do not have response plans and those who have are not implementing them.  Community surveillance and contact tracing are not done regularly,” said Shangula. 

The assessment also revealed that there is low risk communication through the mass media and water contamination is taking place through delivery chain, highlighted the minister. 
Additionally, sanitation remains poor in informal settlements, noted Shangula. 
“Open defecation, unsafe and irregular handwashing practice are the norm rather than the exception. Under such conditions it becomes illusionary to expect the containment of the disease,” noted Shangula.