And suddenly, the past resurfaced. France suddenly plunged backwards. For one hundred and thirty-two years, not the slightest epidemic of cholera had been deplored in the country. Even though patients import the bacteria almost every year, this has never been enough for it to spread. Until it suddenly flared up, in April 2024, in the slums of M’Tsangamouji and Koungou, two towns in the north of Mayotte.
Since then, 108 cases have been recorded, almost all in areas of illegal migrant housing that the state is currently trying to eradicate. A 62-year-old woman has just died, the second victim after a three-year-old girl on May 8. To find such a propagation, we must return to 1892, to the filth of the cells of yesteryear. THE Vibrio cholerae had infected a prisoner in Nanterre (Hauts-de-Seine), before spreading, taking advantage of the defects of the sewers of the time.
L’Express obtained two confidential analyzes written by scientists and submitted to the health authorities. Never made public, these reports point to a culprit in this abnormal resurgence: the lack of water connection in these shelters. A breach of French law, widespread in Mayotte, a department where there are many pressures so that foreigners do not have access to this vital resource.
Lack of water connection, main factor
While guaranteeing access to water is one of the most important levers against this disease, no additions have been made. At least, not at the location of the two epidemic outbreaks. And this until the beginning of May, after cases exploded in these places. This is highlighted in particular by the first document obtained by L’Express, a health investigation report commissioned by the Regional Health Agency (ARS), dated May 24.
“Despite the high number of inhabitants and the previous occurrence of an epidemic of typhoid fever, there was no drinking water resource in the very heart of the district”, it is thus explained in this report, long in length. about a hundred pages. Written by Professor Renaud Piarroux, a leading French specialist in cholera, dispatched to the site, it mainly focuses on the situation in the Kierson slum, in Koungou, where most of the patients were taken care of.
To bring water back to Kierson, you have to carry it in cans from the pay fountains located below the neighborhood. And walk hundreds of meters, on a steep slope. Whether to drink, wash or even do their business, residents had to turn to the adjacent Kirissoni River, which gave its name to the informal neighborhood. A sort of open-air gutter, along which 5,000 people are crowded. It is precisely in these configurations that cholera develops.
Known but ignored risks
A second document confirms this diagnosis. This is a note, written by Brigitte Autran, the president of Covars (Committee for Monitoring and Anticipation of Health Risks). Submitted to the Minister of Health himself, Frédéric Valletoux, last week, it also underlines the need to set up water points as a priority. Which in theory should have been done in February, when cholera arrived in the Comoros, where most of the illegal immigrants come from. According to our information, the executive chose not to publish this note, despite a request to this effect.
However, the risks were known. From April 26, Public health France had publicly asked to “ensure and/or maintain at a minimum” access to water. But in Mayotte, the question of water is not the subject of consensus. It is at the heart of controversies that go beyond health issues. Many local elected officials are reluctant to draw tips for the most precarious. According to them, opening the taps would fuel the anger of part of the population, and especially protest groups close to the far right, very active on the archipelago.
Starting with the very influential Citizens of Mayotte, who shout loud and clear that the ramps, these temporary taps sometimes used on the archipelago, would be “intended exclusively for illegal immigrants”, as stated in a press release from August 2023. The collective, which speaks of foreigners as “invaders “, had blocked Mayotte at the beginning of 2024, demanding to chase them away. In response, the prefecture had to dismantle one of the main immigrant camps in the department.
Water, at the heart of the immigration battle
According to the local extreme right, guaranteeing water pipes to these migrants, as required by law, would risk increasing arrivals. As dilapidated and archaic as this plumbing is, it is said to be likely to generate a “draft of air”. This term is dear to Marine Le Pen, who, in fact, tops opinion polls every year in the archipelago. Worse, the connection would deprive French citizens of this resource, rare on the island due to droughts and poor management – fake news, in reality.
Tensions are such that these temporary connections are regularly victims of sabotage: 81 of the 174 water ramps currently installed in the area were recently vandalized. Local elected officials, sometimes directly threatened, no longer hesitate to endorse these restrictions for the most precarious. In recent months, 27 ramps have been deactivated even before they were put into service, at the request of the town halls themselves.
Is it for these reasons that the piping remained insufficient? When contacted, neither the prefecture nor the city of Koungou wished to respond. While it is sometimes difficult to get water up to the steepest camps, this is not the case at Kierson. For Faysoili Bourani, elected from the opposition (DVG), there is therefore no doubt: “The town hall simply did not want it, because it is afraid that people [NDLR : en situation irrégulière] become lasting, and the situation worsens.”
Connect, or dislodge?
ARS Mayotte waited until May 21 to announce the generalization of water ramps. She had never specifically mentioned them. Neither in its press releases, which on the other hand ask to strengthen hand washing, nor in its “response plan”, detailed on February 21, when the Comoros entered the crisis. In 1999, the date of the last major African epidemic, it was the addition of public connections that contained cholera in the department, according to the publications of epidemiologists of the time. Many of these sources were later removed or left abandoned.
Visiting Paris this week, Olivier Brahic, the director of the institution, barely responds: “I refuse to enter into controversy.” The subject is not new. The agency, under previous management, had already had to fight to demand the establishment of emergency “water ramps”. It was in March 2020, when confinement prevented travel to the water taps on which 29% of the population of the archipelago depend, still not connected to running water due to lack of sufficient public investment.
According to our information, requests for additional connections have been made by the ARS to mayors and the prefecture in recent weeks. It would still have been necessary to know how to make ourselves heard, in the midst of operations Wuambushu, against informal settlements and migrant camps, and Place Net XXL, against drug trafficking. “The prefect’s priority is maintaining order and the fight against immigration. We must stand up to him, which is not always done,” regrets a former senior official of the agency, exasperated.
When the police dissuade you from fetching water
Difficult in these conditions to apply health policies. Especially since the security “takeover”, launched by Gérald Darmanin in April 2023, had the consequence of worsening unsanitary conditions. With the intensification of the destruction of illegal homes – 1,000 per year – and the lack of rehousing, many families have left a location in the city center, connected to the water network, for a riverside location. This was the case in Kierson’s tangle of sheet metal and wood, which doubled in size because of the evictions.
“When on one side the ARS raises awareness about hand washing, on the other side, the prefecture sends the police near the fountains in the hope of expelling foreigners,” remarks Aude Sturma, anthropologist and author of a thesis on Mayotte. As recently as April 19, Unicef France, the Abbé Pierre Foundation, Médecins du monde and La Cimade jointly denounced the presence of law enforcement at water points. In fact, the police discouraged people from going there. Cholera was already there. It just had to proliferate.