cholera outbreak in MozambiqueOn Feb. 24, the World Health Organization (WHO) released a report documenting the current cholera outbreak in Mozambique. Since the first cholera case in this particular outbreak on Sept. 14, 2022, concerns have grown as the WHO fears the outbreak will worsen due to recent heavy rainfalls, which increase the risk of cholera. The number of cases started to pick up in December 2022. All provinces affected by the cholera outbreak in Mozambique are areas susceptible to flooding. As of Feb. 19, Mozambique records 5,237 possible cases of cholera and 37 deaths in six of 11 provinces.

Concerns Over the Situation

Mozambique is currently in its rainy season and the WHO’s report expresses concern over the possibility of heavy rainfalls only worsening the situation. The peak of the rainy season typically occurs in February, but the rainy season still continues through April.

Mozambique reports cholera cases during the rainy season (October through April) every year, but the WHO reports that the current cholera outbreak in Mozambique has impacted more geographical locations than in recent years. In the past few years, cholera impacted up to three provinces yearly; however, this season, the geographical locations impacted have doubled. The Niassa province is reporting its first cases in more than five years.

Heavy rainfalls and flooding increase the risk of cholera because flooding can lead to inadequate access to clean water and sewage treatments, causing bacteria to spread.

Another concern is that one of Mozambique’s neighboring countries, Malawi, is grappling with the most fatal outbreak ever experienced. Even with the outbreak in Malawi, there continues to be a lot of movement across the borders of the two countries.

Cholera and How it Spreads

Cholera is an infectious disease caused by ingesting food or water infected by the bacteria Vibrio cholerae. After exposure to contaminated food or water, cholera incubates between 12 hours and five days. The most common symptoms include diarrhea, dehydration and vomiting.

According to the WHO, the bacteria remains in a person’s feces for one to 10 days. The stool produced by sick individuals can affect others if not disposed of properly. Others can ingest the bacteria if the patient or caretaker does not thoroughly wash their hands. Both children and adults can get cholera. Though it is a preventable disease, it can be fatal if untreated.

Response to the Outbreak

The government and the WHO are working together to address the cholera outbreak in Mozambique efficiently. When the outbreak first began, a national cholera task force formed. The WHO and national cholera task force are combining forces to create preventive and remedial responses, such as handing out brochures in local languages to residences and placing educational posters all over towns and treatment centers in affected districts. If communities do not understand the risks associated with treating patients and ingesting unsanitary food or water, the spread of the disease will only continue. Education and communication of potential contamination are necessary to control an outbreak.

The response also included distributing rapid test kits in areas most impacted. National Rapid Response Teams (RRT) are overseeing the investigation of cases in affected provinces. The teams aim to record data and track family members or friends of patients who are exposed or vulnerable to exposure.

The International Coordinating Group (ICG) on Vaccine Provision responded to a request for 700,000 doses of Oral Cholera Vaccine (OCV) to address the cholera outbreak in Mozambique. Health workers began administering the oral vaccines on February 27, 2023.

Mozambique’s government along with support from the WHO and other global communities is working toward administering vaccines, treatment and contamination protocols while also educating locals on how the disease spreads. A critical preventative measure that the WHO mentions in its report is the establishment of lasting infrastructure for safe drinking water. It is not likely that rainy seasons will cease in Mozambique and neighboring nations, but ensuring sanitary water for citizens can prevent further outbreaks.

– Maya Steele
Photo: Flickr

Crisis in Haiti
Haiti has been experiencing political, economic and social conflict since someone assassinated the former president, Jovenel Moïse, in July 2021. Haiti’s parliament has become ineffective as it struggles to govern amidst the recent earthquake and the prominence of gang violence in Haiti. The crisis in Haiti does not only involve one issue but rather multiple crises all at once. The three most predominant crises in Haiti are gang violence, the cholera outbreak and the aftermath of a deadly earthquake in August 2022.

Gang Violence

The number of gangs in Haiti has grown over the past five years. With more than 95 gangs occupying large portions of Port-au-Prince Bay, the crisis in Haiti has accelerated into deeper chaos. Organized crime disproportionally affects vulnerable communities, especially children. UNICEF’s Regional Director for Latin America and the Caribbean has warned that women and children have become targets of gangs. She stated that “more and more incidents of gang violence have involved children and women in the past few weeks and months,” referring to kidnapping, rapes and killings.

The crisis in Haiti is worsened by gangs developing strong political and economic footing as they make themselves mercenary partners of politicians and administrators. Recently, gangs seized Haiti’s fuel terminal (its main source of energy), thus sending the country into an economic and health crisis. Many schools and hospitals have no power and small businesses have shut down completely. The Inter-American Foundation (IAF) has increased funding for 22 grassroots organizations focused on helping Haitians adapt to the various political, economic and environmental collapses. The fuel crisis has prevented more than three-quarters of hospitals from operating. The IAF has been able to supply the country with community clinics and ambulances to meet the pressing need for medical care in the midst of the cholera outbreak.

In terms of suppressing gang violence, there is disagreement on which strategy is the best. The U.N. has issued $5 million to help those that the violence has affected, as humanitarians try to negotiate with the gangs. Other experts and Haitians suggest that intervention may be a more plausible step as a large portion of money meant for more diplomatic relations has been relatively ineffective.

Health and Environmental Concerns

More than a quarter of all suspected cholera cases are children under 9. Cholera is much more likely to infect children, according to the Health Ministry. Between October and December 2022, there were reports of 13,672 cases of cholera, with 86% being hospitalized. From 2010 to 2019, there were reports of 820,000 cases in Haiti. U.N. agencies and Médicins sans Frontières (MSF), along with local organizations, have distributed medicines and treatments throughout the country. They have also established some clean water centers free of cholera while pushing for the development of vaccines for Haiti. Human Rights Watch believes that there is still a great deal that is necessary to resolve the health crisis in Haiti.

There are also environmental concerns for Haiti. A 7.2 earthquake shook the country in April 2021, leaving 620,000 people in desperate need of humanitarian assistance. The earthquake destroyed 70% of schools. UNICEF is continuing to provide water, food and shelter to vulnerable populations.

As violence proceeds, the crisis in Haiti will require more aid and assistance to help rebuild and develop a more resilient political and economic order. Organizations within Haiti and around the world have already begun to provide relief but more must happen to ensure vulnerable peoples are safe.

– Anna Richardson
Photo: Flickr

Cholera in Africa
Cholera, a disease that has prevailed since the 19th century, is more dominant in some parts of the world than in others. As of 2022, the casualties as a result of cholera in Africa continue. A stronger global response is necessary to properly address cholera in Africa.

7 Facts About Cholera in Africa

  1. Lack of access to sanitation and clean water in Africa exacerbates cholera. According to UNICEF, as of March 2022, in Africa, 418 million people are without basic drinking water services, 779 million are without basic sanitation and 839 million Africans live without access to basic hygiene facilities.
  2. Africa has the highest number of cholera casualties. The African region reports higher numbers of cholera deaths than any other region. A lack of access to clean water and proper sanitation as well as inadequate access to timely health care services contributes to the high burden of cholera cases in Africa. In 2022, Somalia, Cameroon and Malawi noted the highest cases of cholera in Africa. According to The Conversation, “between 2014 and 2021 Africa accounted for 21% of cholera cases and 80% of deaths reported globally.”
  3. Shortages of the oral cholera vaccines impact cholera in Africa. Currently, the world faces a global shortage of oral cholera vaccines as facilities only produce about 2.5 million doses a month, the maximum capacity for production. To resolve this issue, global cholera vaccine production must significantly expand. Since 2013, mass treatment campaigns have administered more than 50 million doses of the vaccine. According to the World Health Organization (WHO) in 2022, “Of the total 36 million doses forecast to be produced in 2022, 24 million have already been shipped for preventive (17%) and reactive (83%) campaigns and an additional 8 million doses were approved by the [International Crisis Group] for the second round [of] emergency vaccination in [four] countries, illustrating the dire shortage of the vaccine.”
  4. Displaced populations in Africa are vulnerable to cholera. Displacement in Africa is common due to several outbreaks of conflicts and violence in several African nations, such as Somalia, Ethiopia and Nigeria. Displaced persons are more susceptible to food and water contamination and typically lack access to clean water and proper sanitation.
  5. Cholera in Africa comes at a high economic cost. In 2015, estimates indicated that more than 1 million cholera incidents in 44 African nations led to an economic cost of $130 million as a result of cholera-related illness and the necessary treatments.
  6. The DOVE Project. The DOVE (Delivering Oral Vaccine Effectively) project, which ran from 2012 to 2019, aimed to ensure that people worldwide with the highest risks of contracting cholera received an oral cholera vaccine. Over five years, a cholera vaccine can decrease one’s risk of cholera infection by between 65% and 75%. The project received funding from the Bill and Melinda Gates Foundation and its main implementing partner was the Johns Hopkins Bloomberg School of Public Health.
  7. Recent efforts to address cholera in Africa. In January 2023, Red Cross Kenya launched a three-month-long initiative to support the Kenyan government’s efforts to control and manage cholera outbreaks considering the rising number of cholera-related deaths in Kenya. The Red Cross “will strengthen surveillance at the community level as a report from the department shows that the disease is spreading to the outskirts of Bura town,” according to the Kenya News Agency. The Red Cross will also provide training to more than 160 volunteers on cholera prevention and management and will “conduct door-to-door and community-wide sensitization on cholera prevention.” Furthermore, the Red Cross will utilize radio broadcasts to raise awareness and will also educate chiefs and authorities in villages about cholera. The Red Cross will secure the supplies necessary to manage the outbreak and will employ the services of medical personnel to help with the initiative.

Looking Ahead

Addressing cholera in Africa requires greater political commitment and more significant funding. Furthermore, global production of the oral cholera vaccine must be ramped up. It is critical for countries to secure proper water and sanitation systems for communities and establish a disease-preparedness response before outbreaks occur. As communities living in conditions of poverty face higher risks of cholera, leaders must address poverty in order to curb the spread of this disease and others.

– Robin Kalellis
Photo: Flickr

Cholera Outbreak in Malawi
According to the World Health Organization (WHO), “cholera is an intestinal infection that ingesting the bacteria Vibrio cholera in contaminated food and water causes.” Inadequate sanitation and lack of safe drinking water is the most common way to contract cholera, which causes severe diarrhea, vomiting and dehydration. Although it is an easily treatable disease, it can be fatal without treatment for even a few hours. Displaced populations and overcrowded camps on top of a lack of safe water and medication lead to an increased risk of the spread of cholera. Beginning in March 2022, a cholera outbreak in Malawi infected about 6,056 people with 183 deaths as of the end of October.

The Current Situation

Since 1998, cholera has plagued Malawi, specifically in the southern regions where there is frequent flooding in the rainy season. The current outbreak is the “largest reported Cholera outbreak in Malawi in the past 10 years” and comes after tropical storm Ana in January 2022 and Cyclone Gombe in March 2022, WHO reports. These storms spurred flooding and displacement of an already susceptible population who now lack access to safe water and sanitation.

Over the holidays, the outbreak surged causing 19 deaths on New Year’s Eve and the closure of primary and secondary schools in the capital Lilongwe and the commercial hub Blantyre. In these two cities, one of the main sources of the outbreak is improper drainage systems, which leads to polluted water sources.

The current cholera outbreak in Malawi exacerbates the country’s existing hunger crisis. With around “5.4 million individuals facing hunger,” a lack of sufficient nutrients weakens people’s immunity and leaves them highly susceptible to a fatal case of cholera. Malawi is one of the poorest nations in the world with 70% living in the country on less than $1.25 a day. In addition, 80% of the country’s population is in agriculture, an industry that storms and flooding deeply affect.

Some of the most at-risk populations during the cholera outbreak in Malawi are pregnant women and mothers with young children as they experience an increased workload and extra risk of infection as primary caregivers. This also threatens the advancement of women and girls in education and economic empowerment as they focus first on survival.

Malawi’s Response & International Aid

In response to the cholera outbreak in Malawi, the Ministry of Health and WHO are conducting an emergency response that consists of “surveillance, social mobilization, treatment, water sanitation, hygiene and oral cholera vaccines,” WHO reports. A cholera response plan and national and district-level emergency operation centers are mobilized nationally. The most affected districts received cholera kits, IV fluids, antibiotics, protective equipment, diagnostic tests, tents and cholera beds.

CARE will distribute chlorine powder for water purification in affected communities as well as supply Oral Rehydration solutions.

On November 7, 2022, Lilongwe received 2.9 million doses of Oral Cholera Vaccine (OCV) for a single-dose reactive campaign to the current Cholera outbreak in Malawi. The OCV campaign targets “adults and children aged 1-year-old and above living in highly affected districts.” The second campaign will prioritize providing vaccines to 14 districts with a large number of cholera cases.

UNICEF joins WHO and the Government of Malawi to strengthen water treatment systems, train health care workers, distribute medical supplies, provide clinical care and raise awareness regarding cholera prevention methods and best hygiene practices. The Government of Malawi has also appealed to the public and private companies and organizations for aid and constructed new, clean water spots in affected areas. As of November 6, around 6,398 people have recovered from the disease, UNICEF reports.

While numbers from January 11, 2023, reported 3,415 new cholera cases, according to Nyasa Times.

– Arden Schraff
Photo: Flickr

Fight Against Cholera
Syria is in the midst of a cholera outbreak that has resulted in more than 75 deaths as of October 2022. Infecting more than 20,000 people, the current outbreak is spreading throughout Syria’s 14 governorates and bordering countries. Fortunately, the World Health Organization (WHO) and other U.N. agencies are currently mitigating the issue by creating treatment centers, providing chlorine dosages, and raising awareness about sanitation practices. To better understand the crisis, here are five facts about Syria’s fight against cholera.

5 Facts About Syria’s Fight Against Cholera

  1. Syria’s water crisis initiated the outbreak. Many researchers have linked the outbreak to the Euphrates and a lack of effective water infrastructure. According to UNICEF, Syria’s decades of war have resulted in the destruction of effective water and sanitation systems, causing 47% of Syrians to depend on alternative water sources. Seeing as how 70% of Syria’s “discharged sewage is untreated,” millions of people are at risk for catching diseases such as cholera. In addition to a lack of water and sanitation infrastructure, Syria faces undeveloped power supplies and annual droughts, further exacerbating the water crisis. As more households draw unsafe water from the Euphrates and resort to untreated, alternative water sources, Syria’s fight against cholera is going to become more difficult to control.
  2. Turkish troops control the water flow. In addition to the natural and historical causes of Syria’s water crisis, the politics behind the crisis has hindered water from flowing to certain towns, perpetuating sanitation issues and diseases across regions. Numerous Turkish troops occupy strips of land in northeast Syria and Turkish officials have “practically turned off the spigots.” As a result, Syrians must fight for limited water from wells, exacerbating sanitation issues and directly contributing to the spread of cholera.
  3. Contaminated food is exacerbating the crisis. Untreated water carrying cholera has made vegetables more prone to contamination. Because food is already scarce in Syria, households are often willing to buy contaminated vegetables just to satisfy their hunger. Thus, millions of people are consuming contaminated vegetables, spreading cholera to their families and communities.
  4. The cholera outbreak has spread to neighboring countries. Because of its proximity to Syria, Lebanon is facing the consequences of Syria’s cholera outbreak. As of late October, Lebanon’s Ministry of Public Health recorded 803 cholera cases and 11 deaths, with children under 14 making up the majority of the cases. Similarly, Iraq has seen a rise in cholera cases, and authorities also fear that Jordan will face a similar outbreak.
  5. The Syrian health ministry is currently mitigating the issue. Fortunately, the Syrian health ministry, with support from the World Health Organization (WHO) and UNICEF, is working to alleviate the crisis. Public health officials have created camps in high-risk areas, delivered 4,000 diagnostic tests and increased response capacity to protect Syrian communities. Furthermore, organizations are actively strengthening border inspection measures to prevent the cholera outbreak from spreading to more neighboring countries.

Looking Ahead

Although Syria and Lebanon continue to experience thousands of new cases daily, health ministries, WHO and non-governmental agencies are facilitating Syria’s fight against cholera. As more organizations partner to combat cholera, there is hope that the outbreak will begin to slow down.

– Emma He
Photo: Unsplash

Cholera Outbreaks in Lebanon
As of November 4, 2022, Lebanon has reported 18 deaths and more than 400 others infected with the notoriously contagious digestive disease, cholera. The World Health Organization (WHO) has classified the disease as a global threat to “public health.” Because the disease is so virulent, it has the ability to affect hundreds of people at once if spread through sewer and water systems within a community.

Current State of Lebanon

Since July 2021, the economic crisis in Lebanon seems to be one of the worst in the world since the 1800s. Banks are beginning to freeze withdrawals. As hospitals and pharmacies began to run out of medication and services to provide patients, the health of not only the people but also the economy began to take a dark turn. As of 2020, approximately 1.7 million refugees could be residing in Lebanon in extremely close-contact, low-budget camps. Furthermore, as of late 2019, “approximately three-quarters of Lebanon’s population” lived below the poverty line.

What is Cholera?

Cholera is a disease that spreads through the ingestion of food or water contaminated with the bacterium. The disease causes infected persons to experience a harsh acute diarrheal infection, eventually leading to severe dehydration. It can kill in hours if left untreated. The World Health Organization has reported that cholera transmission is “closely linked to inadequate access to clean water and sanitation facilities.” Commonly referred to as a “disease of poverty,” cholera outbreaks typically affect the world’s poorest people due to a lack of public sewage systems. As a result, human waste can mix with water that people use for drinking and cooking.

Cholera Outbreaks in Lebanon

After almost 30 years without a single case, cholera has re-appeared in Lebanon following a recent outbreak in Syria. Syria has recently reported more than 20,000 suspected cases and 75 deaths. There has been a high influx of Syrian refugees traveling to Lebanon. Consequently, the transition of the disease most likely occurred because of high population densities within the refugee camps. Reporter Daniel Stewart writes that the increase in cholera outbreaks is “mainly due to increased flooding, drought, conflict, migration and other factors affecting access to clean water.”

A Disease Linked to Poverty

In his research published in the National Library of Medicine, Arturo Talavera wrote that cholera outbreaks are key indicators of social development within a region. Cholera outbreaks remain a serious challenge in countries where people do not have assured access to safe drinking water and adequate sanitation. Talavera explained that cholera outbreaks affect low-income countries more than middle or high-income countries. Economic development is an important factor in determining how deadly an outbreak may be.

Solutions to the Cholera Outbreaks in Lebanon

Thankfully, France is delivering vaccines to Beirut. However, the World Health Organization warns that if not curved soon, the disease may begin to spread more rapidly. French Ambassador Anne Grillo explains that the recent cholera outbreaks in Lebanon are “a new and worrying illustration of the critical decline in public provision of access to water and sanitary services.”

The key to stopping cholera outbreaks is to provide communities with water security. Furthermore, vaccines can drastically curve the contraction of the disease. As more than 13,000 doses have already arrived in Lebanon with more to come, hopefully, Lebanon will be able to halt the spread of the disease with the help of foreign aid.

– Opal Vitharana 
Photo: Flickr

Cholera Outbreak in HaitiHaiti is a country in the Caribbean with a history of significant economic, political and social turmoil. Disease, natural disasters, violence, inflation, corruption and poverty are among the particularly relevant issues, hindering the nation’s overall growth. Haitians have been protesting against their government in hopes of change since 2018. However, recently, the protests have turned exceptionally violent following Prime Minister Ariel Henry’s announcement that the government would eliminate fuel subsidies in the nation, nearly doubling the cost of gas. Haiti can no longer afford to supply subsidies as fuel inflation is rising globally due to the Russo-Ukrainian war. And now there is another crisis to be addressed — a cholera outbreak in Haiti. 

Protest and Violence

Haiti is the poorest country in the Western Hemisphere with approximately 52.3% of the Haitian population living below the poverty line, a 15.7% unemployment rate in 2021 and over $2 billion in external debt. The elimination of fuel subsidies has an immediate impact on the livelihood of millions of Haitians. In response to the policy change, gangs are firing gunshots on open roads, burning tires on city streets, ransacking and inflaming buildings, throwing stones and getting into physical altercations.

Many children are out of school, exacerbating earlier school closures from other protest-based violence and the COVID-19 pandemic. Furthermore, the lack of fuel has already resulted in the shutdown of water delivery companies, banks and grocery stores and has caused a reduction of critical hospital-based services available to Haitians. Additionally, unemployment is also on the rise as workers are no longer able to afford the commute to their jobs.

Cholera Outbreak

Amid all this instability in Haiti comes a recent detection of a  cholera outbreak in the nation. Cholera is a potentially fatal bacterial disease spread through contaminated food or water that causes severe dehydration and diarrhea. The previous cholera outbreak in Haiti was in 2010 and it had devastating consequences. There were more than 820,000 cases and nearly 10,000 deaths, many of which could have been prevented, had the country been equipped with better infrastructure.

As of October 6, 2022, there were 12 cholera cases, 152 suspected cases, 107 hospitalizations and four deaths in the country. In its current political and economic state, the nation cannot afford a widespread outbreak. This would result in the additional closure of essential businesses and ensure the closure of schools. The lack of education for Haiti’s youth in recent years is especially a cause for concern as oftentimes education can be the key to escaping extreme poverty.

Concluding Thoughts

Though both the outbreak and the protests are valid causes for concern, there is hope for the citizens of Haiti. On October 7, 2022, the United Nations Central Emergency Response Fund allocated $7 million for U.N. agencies and their partners to provide urgent life-saving assistance. Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Martin Griffiths stated that “We must stand with the people of Haiti in their hour of need, cholera is preventable and treatable. Left unchecked, however, an outbreak could lead to cataclysmic levels of despair for the people of Haiti, who are already enduring tremendous suffering.” Furthermore, Prime Minister Henry recently sent out a request for international aid in Haiti which the United Nations responded to stating it will “support efforts to build consensus, reduce violence and promote stability in the country.” Together, the world is working to relieve the crisis in Haiti.

– Aarika Sharma
Photo: Unsplash

Diseases in Nigeria
Nigeria ranked 142 out of 195 countries in a 2018 global health access study. However, although Nigeria has a challenging health care system, the country has improved the infrastructure that has helped it fight diseases such as polio, measles and Ebola. Nigeria now has centralized offices called Emergency Operation Centers (EOCs) that serve as a base for government health workers and aid agencies to coordinate immunization programs and collect data. While there is progress, many diseases still plague Nigeria.

Cholera

Cholera is a water-borne disease that results in a quick onset of diarrhea and other symptoms such as nausea, vomiting and weakness. It is one of the many diseases impacting Nigeria in 2021. If people with cholera do not receive treatment, the disease may kill them due to dehydration. A simple oral rehydration solution (ORS) can help most infected people replace electrolytes and fluids. The ORS is available as a powder to mix into hot or cold water. However, without rehydration treatment, about half of those infected with cholera will die, but if treated, the number of deaths decreases to less than 1%.

In August 2021, Nigeria began to see a rise in cholera cases, especially in the north, where the country’s health care systems are the least prepared. The state epidemiologist and deputy director of public health for Kano State, Dr. Bashir Lawan Muhammad, said the rise in cases is due to the rainy season. It is also because authorities have been dealing with Islamist militants in the north. In Nigeria, 22 of the 36 states have suspected cholera cases, which can kill in hours if untreated. According to the Nigeria Center for Disease Control, 186 people from Kano have died of cholera since March 2021, making up most of the country’s 653 deaths.

Malaria

Malaria is another one of the diseases affecting Nigeria. Through the bites of female Anopheles mosquitos, parasites cause malaria and transmit it to humans. Globally, there were 229 million malaria cases in 2019, with 409,000 deaths. Children under the age of 5 years old are the most susceptible group, and in 2019, they accounted for 274,000 or 67% of worldwide malaria deaths. That same year, 94% of malaria cases and deaths occurred in the WHO African Region. Although the disease is preventable and curable, the most prevalent malaria-carrying parasite in Africa, P. Falciparum, can lead to severe illness and death within 24 hours.

The President’s Malaria Initiative (PMI), which USAID and the CDC lead, works with other organizations to help more than 41 million Nigerians. Despite the difficulties that COVID-19 presented in 2020, the PMI was able to assist Nigeria to distribute 14.7 million treatment doses for malaria, 8.2 million of which went to pregnant women and children. Besides that, the “PMI also distributed 7.1 million insecticide-treated mosquito nets (ITNs), provided 7.2 million rapid test kits, and trained 9,300 health workers to diagnose and treat patients” of malaria. Before the PMI, only 23% of Nigerian households had bed nets, but since 2010, that number has risen to 43%. The PMI also aims to improve health systems and the skill of health workers to administer malaria-related services.

HIV

HIV (human immunodeficiency virus) attacks the immune system, leading to AIDS (acquired immunodeficiency syndrome). One can control the virus with proper medical care, but there is no cure. The disease is prevalent in Africa because it originated in chimpanzees in Central Africa. The virus likely spread to humans when the animals’ infected blood came into contact with hunters. Over the years, HIV spread across Africa and other parts of the world, becoming one of the diseases impacting Nigeria today.

The CDC works with the Federal Ministry of Health (FMOH) and other organizations to create and sustain HIV response programs in Nigeria. The CDC’s “data-driven approach” and prevention strategies and treatment strengthen the collaborative system in Nigeria. These include HIV treatment, HIV testing, counseling, services to help prevent mother-to-child transmissions and integrated tuberculosis (TB) and HIV services. TB is the leading cause of death among people living with HIV.

From October 2019 to September 2020, nearly 200,000 Nigerians tested positive for HIV and began treatment. During the same period, over 1 million HIV-positive people tested for TB. More than 5,000 of those individuals tested positive and began treatment for TB. By the end of September 2020, nearly 25,000 orphans and other vulnerable children received HIV/TB services through the CDC. Not only that, but all facilities in Nigeria that the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) supports now use TB BASICS, which is a program that “prevents healthcare-associated TB infection.”

In 2021, Nigeria will face many diseases. On the other hand, great strides are occurring to educate the Nigerian population on diseases like HIV, malaria and cholera. Despite efforts, there is still much more necessary work to reduce illness in Nigeria.

– Trystin Baker
Photo: Flickr

cholera in nigeriaBetween January and August 2021, Nigeria experienced a surge in cholera cases with more than 31,000 “suspected cases,” 311 confirmed reports and more than 800 deaths. With close to 200,000 COVID-19 cases, a surge of cholera during the pandemic has heightened public health concerns in Nigeria. As such, addressing cholera in Nigeria is currently a top priority for the country.

What is Cholera?

According to the World Health Organization, “cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae.” Despite being both preventable and treatable, cholera is very dangerous as it can kill an individual within hours without intervention. While mild cases are easily treatable with “oral rehydration solution,” more severe cases necessitate “rapid treatment with intravenous fluids and antibiotics.” These are resources that many impoverished developing countries simply cannot afford.

According to the Centers for Disease Control and Prevention, the number “of people who die from reported cholera remains higher in Africa than elsewhere.” The WHO emphasizes that the “provision of safe water and sanitation is critical to prevent and control the transmission of cholera.” The WHO also recommends oral cholera vaccines in areas where cholera is endemic.

The Nigerian Government’s Efforts

The Nigerian government continues to implement policies to control the spread of cholera. Promoting basic sanitation, improving hygiene practices and providing clean water are ways the government does this. In an attempt to mitigate the spread of cholera in Nigeria, the government has also supplied solar-powered boreholes with the help of the International Organization of Migration (IOM). As of 2019, the IOM has maintained 58 of these boreholes in Borno state and created 11 new boreholes. The IOM also “rehabilitated 10 and connected them to solar power.”

An important way to stop the spread of cholera is through improving the vaccination system in Nigeria. After an outbreak occurred in 2017, the National Primary Healthcare Development Agency instated cholera vaccination programs. The next step will be to increase the supply of vaccines.

The MSF’s Role in Eradicating Cholera

Médecins Sans Frontières (MSF), otherwise known as Doctors Without Borders, is an independent global organization working to prevent cholera in Nigeria, among other missions. Its main focus is to provide medical aid in areas where it is most needed. Beginning in the 1980s, the MSF has responded to cholera epidemics across the world. Since then, the organization has worked to come up with new and more effective ways to eradicate cholera.

The MSF’s efforts to address cholera include supplying cholera kits, investigating outbreaks, establishing cholera treatment facilities, community education, improving access to water and sanitation and vaccinations, among other efforts. Cholera kits include “rehydration salts, antibiotics and IVs, along with buckets, boots, chlorine and plastic sheeting.” Sanitation improvements allow MSF to ensure the availability of clean water to citizens of Nigeria. Additionally, soap and clean water are provided for at-home use.

Promoting health is another major goal of the organization. At the time of an outbreak, those who work in the health field visit churches, schools and homes to help educate people on measures they can take to prevent the spread of cholera. Vaccinations are also employed to address Nigeria’s cholera outbreak. Providing vaccines is difficult, despite their ease of administration. Nonetheless, the MSF is working on vaccine campaigns. With patients receiving the proper care they need at the time they need it, the MSF states that deaths can potentially decrease from as high as 50% to as low as 2%.

The MSF’s Achievements

In 2019, the MSF supplied more than 231,000 cholera vaccine doses to endemic nations across the world. With the work of the MSF and increased government initiatives, it is possible to significantly reduce cholera in Nigeria.

– Nia Hinson
Photo: Flickr

Rift Valley FeverIn 1999, NASA scientists theorized that at some point soon, they would have the ability to track outbreaks (via satellite) of Rift Valley fever (RVF). This disease is deadly to livestock and occasionally, humans, in East Africa. They already knew the method needed but did not yet have enough data. NASA scientists had already surmised that outbreaks were directly related to El Niño weather events and knew that areas with more vegetation would breed more disease-carrying mosquitoes. To see the exact areas that would be most at-risk, satellites would need to track differences in the color and density of vegetation, from year to year.

Prediction of Rift Valley Fever

In 2006, NASA scientists predicted and tracked an outbreak of Rift Valley fever in East Africa. Unfortunately, even with intervention efforts, the 2006 outbreak led to the deaths of more than 500 people and cost the regional economy more than $60 million. This was due to export restrictions as well as livestock deaths. However, the aim of researchers was not to entirely stop that outbreak. The results of that mission gave researchers confidence that they could predict the next outbreak even better the next time.

Ten years later, the NASA team successfully predicted the location of the next potential outbreak and warned the Kenyan government before the disease could strike. Thanks to the combined efforts of NASA and the Kenyan government, Kenya saw no outbreak of Rift Valley fever in 2016. This, in turn, saved the country millions of dollars and protected the lives and livelihoods of rural farmers, throughout the country.

Focus on Cholera

With the success of Rift Valley fever prediction in 2006, NASA researchers became confident they may predict all disease outbreaks. Moreover, they believed they could halt them, using satellite technology. Researchers are especially focused on neglected diseases like cholera which are connected to environmental conditions and hit developing countries and impoverished people the hardest. Newer satellites add the ability to measure variables like temperature and rainfall. This enables researchers to use more than just the visual data, used in the initial Rift Valley fever predictions. Consequently, this significantly improves their models.

Cholera is perhaps the most promising disease, analyzed by new scientific models due to its scale. Nearly 3 million people contract and almost 100,000, die each year. Moreover, it spread directly links to weather events. There are two distinct forms of cholera, endemic and epidemic. Endemic cholera is present in bodies of water primarily during the dry season. Also, communities living along coasts are typically ready for the disease. Epidemic cholera comes about during extreme weather events like floods and inland communities are often unprepared for the disease. Both forms of the disease proved to be perfect candidates for modeling by disease researchers. In 2013, a NASA team successfully modeled cholera outbreaks in Bangladesh.

The Yemen Model

The real test of the NASA team’s predictive models would come in 2017. The use of the model in Yemen proved to work near perfectly. Researchers predicted exactly where the outbreaks would occur, nearly a full month in advance. The success of the model in impoverished and war-torn Yemen is especially notable. This is because it could mean less of a need for more expensive and dangerous methods of disease research. Instead, early warning systems are an implementable option. Even if they fail, medical professionals can send vaccines and medications to exactly the right locations. Cholera outbreaks and their disproportionate death rates among the global poor will hopefully soon be a thing of the past.

By halting outbreaks before they begin, international aid lends itself more efficiently. Information is valuable and the more information poverty-fighting organizations have, the better they can spend their dollars to maximize utility and help the most people. As satellite technology advances along with newer predictive models, preventing disease outbreaks could save developing economies and aid organizations hundreds of millions of dollars each year, along with thousands of lives.

Jeff Keare
Photo: Flickr