Cholera Health Crisis in Yemen
A massive resurgence of cholera afflicts Yemen, a bacterial infection that can kill within hours if untreated. Between January 2018 and June 2019, reports have determined there have been about 800,000 cases of cholera in the country. Here is a breakdown of the cholera health crisis in Yemen and the response from four notable organizations.

What is Cholera?

Cholera is a potentially fatal bacterial infection that can cause diarrhea, severe dehydration, nausea and vomiting. It mainly spreads through the consumption of water and food contaminated with the bacterium Vibrio cholerae.

Industrialized countries with proper water sewage filtration systems are unlikely to experience surges of cholera outbreaks. However, countries with inadequate water treatment are at a much higher risk of experiencing a cholera epidemic. Areas afflicted by natural disasters, poverty, war and refugee settings are at an exacerbated risk of experiencing cholera outbreaks.

The oral cholera vaccine is highly effective but the vaccine was not available in Yemen prior to the epidemic outbreak in 2017. Since then, more than 300,000 Yemenis received the cholera vaccination but continuous conflict provides a barrier between health care officials and the rest of the population. Doctors Without Borders maintains that the vaccine, while highly effective, is not enough to end cholera due to its low supply and short term protection.

Cholera Health Crisis in Yemen

As Yemen faces its fourth year of war, the country also fights a looming health crisis. The cholera health crisis in Yemen affects 22 of 23 governorates and almost 299 of Yemen’s 333 districts. Recording over one million cholera cases in 2017, Yemen’s crisis is the worst cholera epidemic on record.

Driven by years of war, the country has experienced a significant collapse in access to food, safe drinking water and health care. With millions of Yemenis facing famine, malnourishment increases the risk of cholera infections becoming fatal.

Many organizations are on the ground in Yemen, treating as many cholera cases as possible. Organizations responding to the health crisis in Yemen include Médecins Sans Frontières (MSF) or Doctors Without Borders, Save the Children, Islamic Relief Foundation and World Health Organization (WHO).

If left untreated, the mortality rate of cholera can be very high. With proper treatment, cholera is very easy to cure. The problem is that it is not easy for cholera victims to get to a medical center quickly, especially amidst times of war. One MSF treatment center in the governorate of Khamer explains the hardship that increasing fuel prices pose on those seeking health care.

During the peak of the cholera health crisis in Yemen, MSF treated over 100,000 patients with cholera. The use of cholera kits, essentials to treat the infection, allows the charity to respond quickly and effectively to any cholera outbreak. MSF also has cholera treatment centers in the heart of areas with cholera outbreaks.

Since cholera can lead to severe dehydration, the main cause of death in cholera cases, MSF has rehydration points conveniently located closer to communities than medical centers. Such rehydration points are effective in treating mild cholera cases.

Save The Children Offers Health Care

Since children with malnutrition are three times more likely to die from cholera, groups that provide nourishment in Yemen are essential. Save the Children, the first-ever international aid group in Yemen, not only distributes cash and food vouchers to families but also provides food for children and pregnant women.

Supporting 167 health facilities in Yemen, Save the Children provides training to health care professionals and volunteers in malnutrition management and prevention, a step taken to further alleviate the cholera crisis in Yemen.

Islamic Relief USA Provides Access to Clean Water

Islamic Relief USA works to provide vital aid, emergency food assistance and emergency water supply in the war-torn country. Clean water is vital to the country because cholera mainly spreads through contaminated drinking water. Islamic Relief USA is actively providing a clean supply of water to the governorates of Aden and Taiz. Both Taiz and Aden will have water tanks installed close to homes and schools so they remain water-secure when the organization is no longer active in these governorates. About 4,000 internally displaced people in these governorates will be at a decreased risk of cholera infection due to an increase of clean water supply from the water tanks.

The World Health Organization Increases Defenses Against Cholera

The World Health Organization maintains that Yemen is beginning to see a decrease in cholera infections. Financial aid from Saudi Arabia and the United Arab Emirates are contributing to this decrease. Millions of Yemenis now have access to health care unlike before. WHO is working on increasing the availability of diarrheal treatment centers, cholera vaccines and training of health providers in Yemen.

With 17.8 million water insecure people, Yemen is a breeding ground for cholera. Organizations like those listed above are essential to promoting prevention, care, and hopefully soon, the suppression of the cholera health crisis in Yemen.

– Rebekah Askew
Photo: Flickr

Health care in Yemen

Yemen is currently in the midst of a violent civil war. The war has had a destabilizing effect on Yemen’s health care system. The Yemeni people face high rates of malnutrition, a cholera epidemic and a lack of access to necessary medical resources. This article provides 10 facts about health care in Yemen, the war’s effect on health care and the role of foreign aid in addressing the country’s health problems.

10 Facts About Health Care in Yemen

  1. Because medical facilities in Yemen lack access to necessary resources like clean water, diseases that are treatable elsewhere become deadly. Approximately 80 percent of Yemeni people are malnourished, forced to drink unclean water and cannot afford health care, making them more susceptible to diphtheria, cholera and other diseases. The current civil war has also been greatly destructive to infrastructure and health care in Yemen.
  2. Bombing frequently damages hospitals in Yemen and it is difficult for hospitals to maintain electricity and running water in the midst of airstrikes. Continuous fighting leaves little time to address structural damage and meet the needs of the Yemeni people. Families are often required to bring the sick and injured to hospitals without the aid of ambulances. All but one of Yemen’s 22 provinces are affected by fighting.
  3. Within less than a year of fighting in Yemen, airstrikes hit 39 hospitals. Troops from both sides of the conflict blocked outside access to the country, preventing the flow of medicine needed to treat diseases, such as cholera. This puts the Yemeni people, especially children, at risk; 144 children die from treatable diseases daily and more than 1 million children are starving or malnourished.
  4. Yemen’s rural populations lack easy access to hospitals and medical care. Rural facilities, such as those in the northern mountains, cannot provide adequate food to patients. The lack of food in many hospitals prevents successful treatment of malnourishment.
  5. The cholera epidemic began in Yemen in 2016, a year after the beginning of the civil war. By 2017, the disease spread rapidly. In 2019, cholera is still a serious problem in the country. It caused 2,500 deaths in Yemen within the first five months of 2019.
  6. Nearly one million cases of cholera were reported by the end of 2017. Yemen’s cholera outbreak is more severe than any other outbreak of the disease since 1949. Poor water filtration and sanitation triggered the outbreak’s severity.
  7. Around 80 percent of Yemen’s population, including 12 million children, require aid. During the first half of 2019, cases of cholera in children rose dramatically. 109,000 cases of cholera in children were reported between January and March of 2019. Nearly 35 percent of these cases were found in children below the age of 5.
  8. Between 2015 and 2018, Doctors Without Borders provided aid to 973,000 emergency room patients in Yemen. Volunteers for Doctors Without Borders treated about 92,000 patients injured by violence related to the war, treated 114,646 cases of cholera and treated 14,370 cases of malnutrition. Doctors Without Borders provides vital support to the health care system in Yemen.
  9. USAID cooperates with UNICEF and WHO to provide health care aid to Yemen, with a special emphasis on the health of mothers, infants and children. In 2017, USAID trained 360 health care workers at 180 facilities to treat child health problems. The facilities also received necessary resources from USAID. They also work with the U.N. Development Program to improve working conditions throughout Yemen, including the health care sector.
  10. During the 2018-19 fiscal year, USAID provided $720,854,296 in aid to Yemen. This aid funded a variety of projects, such as repaired water stations to ensure improved access to clean water. The U.S. also funds WASH, a program intended to improve access to water, sanitation and hygiene. The ultimate goal of WASH is to improve health care in Yemen, especially for the rural poor.

Yemen’s health care system is in dire need of aid. The country’s government, overwhelmed by war, cannot serve the medical needs of its people, especially in light of the ongoing cholera epidemic. The efforts of USAID and other relief organizations can provide the support that Yemen’s health care system needs at this time.

– Emelie Fippin
Photo: Flickr

Cholera in the Democratic Republic of Congo
Cholera is a disease that causes diarrhea and severe vomiting which can be fatal if left untreated. Areas that suffer from famine and poor sanitation are particularly susceptible to contracting the disease and the people most likely to become ill with cholera are individuals with low immunity, malnourishment or HIV. Cholera in the Democratic Republic of the Congo is severe and requires immediate attention.

The Democratic Republic of the Congo has become one of the worst victims of this disease. Less than one in seven Congolese citizens have adequate hygienic conditions, and less than half have access to clean water. These are contributors to the susceptibility of the Congolese to cholera.

Cholera in the Democratic Republic of the Congo has proved itself to be a fearsome disease. As of Jan 1, 2019, the Democratic Republic of the Congo declared cholera a nationwide epidemic. In March 2019, the Democratic Republic of Congo reported 1,016 EVD cases. These cases had a fatality rate of 62 percent and resulted in 634 deaths.

Organizations Working with the Democratic Republic of the Congo

To prevent the spreading of cholera, it is essential that the people of the Democratic Republic of the Congo wash their hands, use clean bathroom facilities, eat thoroughly cooked food, have access to clean water and do not come in contact with contaminated corpses. The Democratic Republic of the Congo has partnered with numerous organizations in the hopes of implementing these changes in the country.

The Democratic Republic of the Congo teamed up with UNICEF to ensure that its people have access to clean water. UNICEF has given more than 460,000 Aquatab water-purification tablets to the country, alongside numerous water-treatment facilities along the river.

Medecins Sans Frontieres has also partnered with the Democratic Republic of the Congo to try to help the country combat its cholera crisis. MSF has set up cholera treatment units in the most affected areas of the country to ensure that constant care is available.

The World Health Organization is yet another organization that has been working alongside the Democratic Republic of the Congo to combat this disease. WHO has been trying to give technological support, send medicine and teach the people of the Democratic Republic of the Congo proper hygiene techniques. It has also been attempting to gather data to quantify the disease in the hopes of getting a better understanding of it.

The Democratic Republic of the Congo’s Immunization Plan

The Democratic Republic of the Congo’s latest plan of action has been its immunization plan. Government officials have come together to give more than 800,000 individuals cholera immunizations. WHO and the United Nations have both been involved in aiding the country in carrying out this plan.

The Democratic Republic of Congo’s Ministry of Health will carry out this program, along with further assistance from the World Health Organization and the Vaccine Alliance. Dr. Deo Nshimirimana, the World Health Organization’s Democratic Republic of Congo representative, stated, “Cholera is a preventable disease. Vaccinating people at risk in the most exposed health zones in North Kivu against cholera is a massive contribution and will protect hundreds of thousands of people.”

Cholera in the Democratic Republic of the Congo remains an imminent threat, but the country has shown that it has no intention of remaining idle in this fight. The country’s ambitious plan, which went into effect on May 27, 2019, is in full swing. Only time will tell if the program is successful, but program officials continue to be optimistic.

– Gabriella Gonzalez
Photo: Flickr

Cyclone Idai and Health Crisis
With winds equivalent to a category 3 hurricane and storm surges surpassing 20 feet, Cyclone Idai made landfall near Beira, Mozambique in the early hours of March 15, 2019. One of the most powerful storms to ever hit Southern Africa, Idai left a trail of destruction and displacement, turning life upside down for residents along the coast. Now, months later, communities throughout the region continue to cope with the aftermath.

Effects of Cyclone Idai

What is now 2019’s deadliest weather event, the latest figures put Idai’s death toll at 847. The storm left millions of people affected, thousands displaced, entire communities in shambles and thousands of hectares of crops destroyed. As authorities continue to unpack the extent of the damage, the need for increased public health initiatives is evident. With the floods triggering widespread water contamination across the region, cholera and malaria outbreaks are becoming shockingly prevalent.

Perhaps Cyclone Idai afflicted Mozambique the most, where Reuters News reported that it killed nearly 600 people and destroyed more than 110,000 homes. In Beira, home to roughly 500,000 people, sweeping power outages and water contamination has made the city a hotbed for disease outbreaks. “The supply chain has been broken, creating food, clean water, and healthcare shortages,” says Gert Verdonck, the Emergency Coordinator for Doctor’s Without Borders (MSF) in Beira. “The scale of extreme damage will likely lead to a dramatic increase of waterborne diseases.”

Doctors Without Borders (MSF)

Following the storm, MSF quickly scaled up operations in Beira and other cyclone-stricken areas of Mozambique. With roughly 146,000 internally displaced persons seeking refuge in 155 camps across the country, MSF has launched an enormous relief effort. Dispatching emergency response teams to communities in need, MSF is working to implement vaccination programs and distribute food, water and medical supplies throughout Mozambique. Yet the scope of the damage is proving to be a difficult challenge for authorities and relief organizations. Treating over 200 cholera cases daily, MSF is calling on the international community to step up.

The World Health Organization and Cholera Vaccines

Also integral to relief efforts, the World Health Organization (WHO) is spearheading a massive vaccination program aimed at fighting the recent outbreaks. Through partnerships with humanitarian aid organizations Gavi and UNICEF, the WHO facilitated a shipment of almost 1 million cholera vaccines that arrived in Beira on April 2, 2019. A day later, a plane carrying 6.7 tonnes of medical supplies – essentials like medicine, stretchers, clean bandages and disposable gloves – landed in the coastal city. Opening an additional 500 beds and seven cholera treatment centers across cyclone-stricken Mozambique, the WHO is hoping to stifle water-borne illnesses in the region.

Despite valiant efforts from the WHO, MSF and other aid groups, the need for more funds and resources is evident. On April 1, the WHO requested an additional US$13 million to address communities affected by Cyclone Idai. With local authorities in Mozambique overwhelmed and underequipped to handle the fallout from Idai, the WHO is seeking to lead the charge, establishing response coordination at the national and provincial levels. Annual health care and aid expenditures in Mozambique are almost five percent below the global average, making foreign aid and nongovernmental relief organizations a vital piece of the recovery process.

An International Response

While some experts initially criticized the sluggish international response to Cyclone Idai, the global community has since placed considerable emphasis on relief efforts. Countries like Turkey, Botswana, Brazil and many more have supported Mozambique, allocating emergency funds and sending military assets to facilitate food, water and medicine distribution. Although combatting the cholera outbreaks and rebuilding communities that the storm devastated will be a stout challenge, the international response is promising. The response to Cyclone Idai indicates an international community both capable and willing to respond to natural disasters that impact the developing world.

– Kyle Dunphey
Photo: Google

malnutrition in haiti

Haiti is a small island, yet it is the western hemisphere’s most impoverished nation. One of the many ways that poverty affects Haiti is through hunger. In 2015, 22 percent of Haitian children were suffering from malnutrition. Health is something that affects everyday life and is reflective of a country’s standard of living. In other words, learning about how malnutrition affects Haiti is important for understanding poverty and the development of this country.

Haiti’s History

Haiti became independent from the French government in 1804. This formerly colonized nation was the first country to achieve freedom through a slave rebellion. When Haiti became independent, most western countries (such as the U.S.) did not recognize the nation’s independence. This prevented any foreign trade from occurring with Haiti.

The first country to acknowledge Haitian independence was France; however, the acknowledgment was met with conditions. The French claimed that their economy would be hurt due to a loss in slave labor and, because of this, Haitians would have to repay the French with 100 million francs. The debt was not fully repaid until 1887 and, consequently, created negative effects on Haiti’s economy.

The country also regularly encounters natural disasters such as earthquakes, floods and hurricanes. Since 1998, Haiti has faced 10 hurricanes in addition to other tropical storms. With a lack of infrastructure, every environmental disaster takes a large toll on the economy. After the 2010 earthquake, 1.5 million Haitians were displaced and the country was said to have faced $7.8 billion in losses.

The Role of Nutrition

Today, Haiti has a GDP per capita of $870, and 59 percent of the population works for less than 2 dollars per day. With such high rates of poverty, it’s no surprise that the country also suffers from malnutrition. There are some key facts to understanding how malnutrition affects Haiti.

  • Approximately 40 percent of the country is malnourished. In fact, one in five children is malnourished. In addition, 80 percent of rice, the country’s major food source, is imported, thus creating a large dependence on foreign exchange.
  • Agriculture in Haiti is also dependent upon external factors. Only 10 percent of the land is irrigated, making consistent rain a necessity for food production. When there is a drought, food production is affected. Lack of adequate crops increases malnutrition.
  • One-third of Haitian women suffer from anemia. Anemia is an illness that can be caused by iron and vitamin deficiency. It prevents oxygen from flowing through the blood to muscles and tissues, but it can be easily prevented through proper nutrition.
  • In rural areas, fewer than half of the people in Haiti have access to clean drinking water. Water is often contaminated. In 2010, the country faced a globally infamous earthquake. When U.N. workers arrived to provide aid, they accidentally created a cholera outbreak that spread quickly through the water. Since then, 770 thousand Haitians have been affected by the illness, creating an added risk to water consumption.

Who is Helping?

While the majority of Haitians still suffer from malnutrition, progress has been made. Hands up for Haiti is one nonprofit that is aiming to reduce issues surrounding nutrition in three different ways. The first way is through a supplement called Medika Mamba, a nutritional pill that is primarily nut based and is high in calories. The pill is provided to 600 children each year on the bases of medical evaluation. The second way is through educational programs that teach locals how to grow small plots of food to support their families. Lastly, the organization offers centers with professionally trained medics to treat illnesses relating to malnutrition.

Understanding how malnutrition affects Haiti is key to recognizing the effects of poverty. The country’s long-standing history of natural disasters and colonization has affected its current economic situation as well as the health of the nation. However, nonprofits such as Hands up for Haiti have been making large strides within the country, giving a hopeful outlook to the future of this nation.

Anna Melnik
Photo: Flickr

MSF in Yemen: Helping Amid Conflict

Instability continues to plague Yemen, exposing almost 20 million people to food insecurity and more than one million to cholera. The damage is evident in Yemen’s weak healthcare system, which leaves millions of people vulnerable. Medecins Sans Frontieres (MSF), or Doctors Without Borders, is an organization that provides healthcare for people affected by conflict and poverty. Though warfare complicates operations on the ground, MSF in Yemen is not giving up.

The Challenges of Aid in Yemen

In 2018, an airstrike destroyed a newly built cholera treatment center. Fortunately, there were no patients or workers present at the time, but the vital project had to be put on pause until repairs and reconstruction could begin. Events like this threaten the effectiveness of MSF in Yemen and risk the lives of the 16 million people who lack basic healthcare.

MSF also runs 12 healthcare centers of its own in addition to the 20 hospitals the organization supports. Its operations have treated more than 1.6 million people suffering from injuries, disease and chronic illnesses. MSF’s activities in Yemen take place in a constantly changing and dangerous environment. Since 2015, constant fighting between various militant groups has damaged countless Yemeni health facilities, leaving only half fully functioning. Many hospitals and health facilities in the areas have closed down because of safety concerns or because they cannot pay workers.

MSF in Yemen

The facility that was destroyed was one of many new treatment centers responding to the cholera outbreak. Cholera is a serious issue in Yemen and has killed 2,184 people since April 2017. Because of the violence, almost 16 million Yemenis have suffered from reduced access to clean water and sanitation, which increases their vulnerability to cholera. MSF quickly reacted to the outbreak by opening 37 treatment centers and oral rehydration points. In just six months after the breakout, MSF admitted more than 100,000 cholera patients. While the threat of cholera has decreased since 2017, treatment centers remain a vital safe haven for those afflicted.

MSF responded to another issue caused by the lack of healthcare facilities: pregnancy. In 2017, MSF in Yemen helped 7,900 women deliver their babies. Pregnant mothers are especially vulnerable because they lack access to clinics. Even when there is a health facility nearby, traveling may be too dangerous or time-consuming. Consequently, mothers give birth at home, which exposes them to health risks.  Many pregnant women also don’t have access to prenatal care and can have preventable but fatal complications.

Treatment Centers In Yemen

MSF in Yemen dealt with the re-emergence of diphtheria in 2017. The organization acted quickly by opening up a treatment center in Ibb where 70 percent of cases were concentrated. MSF treated around 400 patients that year alone. As successful as that operation was, others remain an issue, like renal failure. Multiple renal failure treatment centers have been forced to close due to the conflict. Many facilities are under-equipped and some 4,000 patients are still left untreated.

Treatment centers are often too far, or treatment itself is too expensive. Patients require three dialysis sessions a week, so many will reduce the number of treatments to lower the cost. Unfortunately, this can be dangerous and ineffective in treating renal failure. MSF responded to the crisis and has helped more than 800 patients by offering 83,000 dialysis treatments and importing 800 tons of supplies.

More than 20 million Yemenis are in need of humanitarian assistance, facing hunger, disease and displacement. MSF continues to provide aid through one of its largest programs in the world. Since 1986, MSF in Yemen has been compensating for the lack of effective healthcare, even amid the conflict.

Massarath Fatima

Photo: Flickr

Oral Cholera VaccineCoastal cities like Beira, Mozambique thought they were prepared for cyclones. In 2012, the city built new drainage systems and barriers to help them withstand the rising seas and increased storms from climate change.

Cyclone Idai proved that they weren’t as prepared as they thought. On March 14, the cyclone hit the coast and claimed at least 847 lives in the region, as well as displacing tens of thousands. The cyclone created an inland sea from the mass flooding that spans 80 miles long and 15 miles wide.

How Beira was Affected

Since the cyclone, more than 1,300 people in Beira have been drinking from local ponds, overflowed latrines, and other unsafe water sources. These conditions are ripe for deadly diseases, including cholera.

Thousands of people are currently in displacement camps with few toilets and little clean water. While health workers have responded to the situations quickly, they have restored water supply to only 60 percent of the population. Many are still left to drink unclean water and defecate in the streets.

A cholera outbreak has been declared in Beira. The number of people affected went from five on March 27 into the hundreds. Cholera currently afflicts over 3,100 people and has resulted in six deaths.

Quick Response to Cholera Outbreak

On April 3rd, health workers started distributing oral cholera vaccines in Beira. Gavi, the vaccine alliance, is funding this movement. This Mozambique Ministry of Health is responding with support from the World Health Organization and others. They have given out an estimated 884,953 vaccine doses. They have also opened nine cholera treatment centers in the region, each with a capacity of 500.

Doctors Without Borders has called this distribution the “most ambitious campaign ever conducted using the one dose cholera vaccine strategy.”

This oral cholera vaccine is usually given in two spaced-out doses, but the aid group says one treatment is effective in emergencies. The single dose is effective after seven days and offers 85 percent protection for six months. In turbulent times, it can be hard to find people to distribute the second dose.

The success of distributing the oral cholera vaccine is primarily due to the preparedness of local authorities. They organized a campaign that mobilized 1,200 community volunteers and partners. The Ministry of Health made requests for volunteers soon as the cyclone hit and organized local aid.

The Ministry of Health used its abundant volunteers to set up distribution areas. Vaccine promoters got the word out using microphones and by handing out doses to high traffic areas. Volunteers are also passing out water purification tablets and educating people on precautions they should take with their drinking water.

– Michela Rahaim
Photo: Flickr

Preventive Cholera Vaccination
South Sudan’s health system faces major challenges. These challenges stem from prolonged civil war repercussions, a great lack in medical care and vaccinations and historically long-running cholera outbreaks. Although South Sudan recently declared the end to its longest recorded cholera epidemic, cholera is endemic to the nation and will most likely return within the next few months as the rainy season begins.

However, some improvements and achievements are being made towards South Sudan’s health system. Today, the preventative cholera vaccination campaign — operated by Doctors Without Borders — works to prevent the acute infectious disease from spreading across the nation any longer.

Preventative Cholera Vaccination Campaign

From April 24th to May 12th, the preventative cholera vaccination campaign has progressed in Juba – South Sudan’s largest city and capital. Doctors Without Borders’ campaign is designated for 12 hotspot areas in Juba where numerous people were identified as at-risk in previous cholera outbreaks. Cholera outbreaks are not new to South Sudan – the country just faced its most severe and prolonged cholera outbreak in its history which protracted from June 2016 to February 2018, and lead to over 20,000 suspected cholera cases and 436 reported deaths.

Additionally, since 2013, the nation has endured multiple cholera outbreaks that particularly target vulnerable populations living in internally displaced people’s camps, urban informal settlements, cattle camps, rural populations, island dwellers and communities along the River Nile.

In order for the oral cholera vaccine to take effect, people need two doses for increased immunity. A single dose of cholera vaccine supplies some immunity for up to one year and the second dose must be ingested within eight months of the first dose to increase the level of protection and increase immunity to three to five years. Also, sustaining sanitation infrastructure and improving hygiene and water supplies, in addition to implementing vaccination campaigns, can help prevent infections by contaminated food or water, which is how cholera is spread.

Goals for Reducing Death by Cholera

In 2017, the Global Task Force on Cholera Control announced a new strategy to reduce deaths from cholera by 90 percent by 2030 in South Sudan and other affected countries. This strategy will involve strengthening case detection, prevention of avoidable cases and deaths and applying multi-sectoral interventions comprising of water and sanitation hygiene measures to eliminate cholera outbreaks in cholera transmission hotspots.

While preventative cholera vaccination campaigns aim to save lives in South Sudan, the world’s newest country still deals with several other complex challenges that need to be addressed.

Current Causes and Future Improvement

Severe food insecurity and acute malnutrition, an increased demand for care due to high HIV and AIDS prevalence, a lack of resources to purchase drugs and other medical supplies due to the oil shutdown, a 73 percent illiteracy rate for adults, limited availability to crucial maternity care services and poor access to safe drinking water and adequate sanitation are all some of the current factors contributing to the country’s extreme poverty.

However, with the current and essential health and medical care help from Doctors Without Borders and other international organizations such as Oxfam, CARE, WHO and Save the Children, conditions in the country could improve in the near future as more organizations find opportunities to provide aid to the country in need.

– Natalie Shaw
Photo: Flickr

Cholera Crisis of 2018Cholera is a disease that is both preventable and treatable, though it can be fatal under the worst of circumstances. It typically affects the most destitute areas of the globe where sanitation practices are weakest. Random outbreaks can and do occur across all continents, however. The greatest challenge to diminishing the effects of a cholera crisis is that it can spread quickly among populations with a lack of adequate hygiene measures, proper vaccination or isolated and contained care centers.

Disease Basics

According to the Center for Disease Control (CDC), cholera is caused by toxigenic Vibrio Cholerae, which leads to the acute bacterial intestinal infection. Symptoms include vomiting, diarrhea and, in severe cases, collapse and shock. Fatalities occur in approximately 25 to 50 percent of all cases. While cholera is uncommon in the U.S. and other developed nations, cases have been increasing around the world since 2005. The CDC classifies the magnitude of cholera outbreaks as a pandemic that has persisted for over four decades in Asia, Africa and Latin America.

Saltwater is the natural source where Vibrio Cholerae originates and may be passed on to humans by ingesting anything from infected water, like shellfish, crab and shrimp. The risk is heightened when any of these foods are undercooked or consumed raw. Cholera can be passed through the drinking water supply as well, which is a common form of transmission.

The Cholera Crisis

A cholera crisis occurred in February 2018 in Uganda, resulting in 700 reported cases and 27 deaths. In Malawi, an outbreak in April affected 893 individuals and caused 30 deaths. A recent outbreak has occurred in Yemen as well. The total number of cholera cases in Yemen over the past year is estimated to be 1,090,280 with 2,275 deaths. This means one out of every five people infected with cholera died last year in Yemen. In addition, Haiti has reported 432 cases of cholera this past year, with four deaths resulting from the disease.

Progressive Efforts

While contemplating the statistics shared in regard to the cholera crisis, it is important to think about what solutions are available to prevent this destructive disease from spreading and to know what actions are being taken to assist those who are suffering. The most obvious solution to a cholera crisis is to offer aid in the form of clean water solutions so potable water can be readily available to all.

The U.N. has made remarkable progress in its efforts to make clean water available to everyone around the world. More specifically, its efforts are known as the Water for Life International Decade for Action and took place during 2005-2015. As a result of this initiative, 1.3 billion people were provided with clean drinking water. It is estimated that there are still 2.5 billion people who drink contaminated water.

Improved sanitation practices and adequate facilities is also a dire need. The U.N. reports that there are currently 2.3 billion people worldwide who are without access to basic sanitation facilities, such as toilets. The two concurrent issues of lack of sanitation facilities and a lack of clean water interplay to cause illness amongst many in the form of communicable diseases passed through to the residents of poverty-stricken areas.  As a result, approximately 1.5 million children die from related illnesses.

Efforts to help can generate a return on investment for those in developed nations. Research has shown that every U.S. dollar spent on improved sanitation generates a return of $9. World Water Day on March 22 and World Toilet Day on Nov. 19 are international observance days set aside to raise awareness of these issues.

– Bridget Rice

Photo: Flickr


Cholera, an acute infectious disease, is not new to the east African country of Uganda. For 47 years, epidemics of cholera have occurred frequently in the country, and cases of the disease in Ugandan communities are still reported annually. Uganda’s recent cholera outbreak was reported Feb. 22, 2018.

Refugee Overcrowding

The announcement came after 668 cholera cases had been identified in the refugee settlements in Hoima District. Hoima District is a Western Ugandan district home to thousands of Congolese refugees escaping ongoing violence in the Democratic Republic of Congo’s northeastern Ituri province.

More than 4.4 million people have been forced out of their homes in Democratic Republic of Congo amid a surge in severe violence. The aggression stemmed from President Joseph Kabila’s refusal to step down at the end of his mandate in 2016. As a result of the humanitarian disaster, it is estimated that about 43,000 Congolese refugees have settled into Ugandan areas this year. This brings the total of Congolese refugees in Uganda to more than a quarter of a million.

Increased Violence

Although Uganda welcomes all those fleeing violence and seeking refuge into the country, government-funded health facilities have been overwhelmed by the sharp rise in the refugee population. Since the initial outbreak announcement in February, at least 1,747 people have become sick and at least 36 have died from the worsening situation. Most of the deaths were recent evacuees from the Democratic Republic of Congo.

In addition to plaguing the refugee resettlements in Hoima District, Uganda’s recent cholera outbreak has also now spread to two additional sub-counties. It is estimated that drinking unsafe water from Lake Albert, poor sanitation and a lack of handwashing facilities in the area have contributed to the dehydration, diarrhea, vomiting and fatality rates.

Response Efforts

Uganda’s recent cholera outbreak has proven an urgent demand for additional resources and funds to prevent the spread and deaths from the bacterial disease. However, some response efforts and services are currently in place. Thanks to a fast-acting response plan by the U.N. Refugee Agency and The Ministry of Health, health actors and community leaders are working to provide medical supplies, health personnel and other essential support. This includes demonstrations on proper food and hand hygiene and water safety to reduce transmission of the illness. Many technical teams are working to conduct medical screenings, provide treatments and produce water purification tablets near Western Uganda’s Lake Albert and Kyangwali refugee settlement.

Additionally, international agencies like the World Health Organization and UNICEF have provided two different cholera kits with vital supplies for cholera case management. Uganda Red Cross Society has actively supported social mobilization to prevent and regulate the outbreak.

Because of these life-saving efforts enforced by health workers and technical teams, there has been a significant decrease in the number of new cholera cases within the western Lake Albert region. As of Feb. 28, health care workers were detecting approximately 100 new cases of cholera a day. By March 12, the daily case number had decreased to 20. The medical assistance provided helped decrease the mortality rate by two percent. However, Uganda’s recent cholera outbreak is not over and the work in cholera-suffering hotspots is far from resolved.

– Natalie Shaw

Photo: Google