Uganda is paying the price of releasing untreated sewage into the environment with a typhoid outbreak in Kampala that has claimed 14 lives and cost the government Ush4 billion ($1.3 million) so far.

According to information from the Ministry of Health, the number of people being treated for typhoid has more than doubled from 1,940 at the beginning of the month to 4,949 by March 19. 

Dr Jane Ruth Aceng, Director General of the Ministry of Health, said that the patients are at the five typhoid treatment centres of Kisenyi, Kiswa, Kisugu, Kawala and Komamboga. Mulago and Naguru hospitals are handling only critical cases requiring surgery.

The outbreak is being blamed on the consumption of water contaminated with faecal matter or the urine of infected persons.

“Contaminated drinking water and juices have been identified as the main sources of the infection,” a World Health Organisation report on the outbreak states.

The report adds that most of the water sources tested were found to be heavily contaminated with faecal matter. Water packaged in plastic bags in downtown Kampala is contaminated. Wells, boreholes and springs, which provide water to the majority of Kampala’s low-income residents, were found to be contaminated too.

Landlords have been blamed for the contamination for continually releasing sewage into the environment, which has in turn contaminated natural water sources.

Information from Water.Org, a civil society organisation providing improved sanitation solutions, shows that at least a third of Kampala’s 1.5 million residents depend on wells, boreholes and springs, since they have no access or are too poor to afford piped water. 

Dr Aceng said those using piped water are safe from the typhoid outbreak.  

“Tests showed tapped water provided by the National Water and Sewerage Corporation was not contaminated,” she said.    

Willington Amutuhairwe, a doctor working in the Public Health Section at the Kampala Capital City Authority (KCCA) said operators of market stalls and arcades usually release sewage \into the open during the rainy season, polluting systems that supply water to a large mass of people, and the soil.

Peter Kaujju, the KCCA spokesperson, said the Authority plans to prosecute landlords who release sewage into the environment. He said culprits will be identified in the ongoing surveillance in affected areas.

However, sewer system breakdown is common in Kampala, even in upscale areas like Nakasero and Kololo where overflows are frequent.

Sliver Mugisha, executive director of the National Water and Sewage Corporation (NWSC), said the contamination of wetlands around Kampala has also caused a rise in piped water treatment costs.

Currently, the treatment of piped water costs about Ush700 million ($232,800) per month. It would cost at least 20 per cent less if owners of buildings stopped releasing sewage into the water channels.

Only 7.3 per cent of Kampala is connected to the sewer system. But Dr Mugisha said that even without connection to the sewers, NWSC will collect sewage from septic tanks, if building users pay for the service.

“When they don’t pay, the system gets clogged and NWSC can’t do anything about it since enforcement is KCCA’s duty,” he said.

Additional reporting by Philomena Matsiko