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Cholera in BurundiThe World Health Organization (WHO) has identified more than 1,000 cases of cholera in cities across the Republic of Burundi. Burundi is an East African country that has been plagued by violence, disease and poor sanitation for years. Most of the population lives in rural areas where drinking water is unsafe and sanitation practices are nearly non-existent. This has created the perfect storm for cholera to spread quickly across the country. It has led to six deaths from an otherwise treatable disease. Below are nine facts about the outbreak of cholera in the Republic of Burundi.

9 Facts about Cholera in Burundi

  1. Cholera is a gastrointestinal infection caused by bacteria. Generally, it is attributed to unsafe drinking
    water and often associated with raw or undercooked fish. It is transmitted from person to person through oral-fecal contamination due to improper sanitation and poor hygiene.
  2. This outbreak started in a time of political peril in Burundi. Rebel forces and the country’s army are fighting across rural areas, which is displacing people. Instability and lack of security make it difficult for people to find safety and sources of income. This has created a high level of poverty for Burundi’s people and exacerbated the poor water conditions.
  3. Most patients are displaced persons (IDPs) from rural Bujumbura. Fighting in Bujumbura became so violent that the government moved the capital to Gitega in February 2019. When the capital moved, many people were left without the support and resources of the government.
  4. Treatment usually takes several days per patient. Patients typically present symptoms related to dehydration. Dehydration occurs because of the excessive vomiting and diarrhea that comes with cholera. Patients are usually treated with an oral rehydration solution made up of a sugar and salt mixture in clean water. In extreme situations, patients may need intravenous fluids and antibiotics.
  5. Médecins Sans Frontières (MSF) has three treatment centers for cholera in Burundi where professionals are trained and supervised. The goal of these facilities is to provide free patient care and increase the local public health staff. These centers provide care when most of the hospitals are unable to respond to the needs of cholera patients. MSF has also set up a 50-person treatment center in Bujumbura.
  6. Sterilization is a very important part of reducing the spread of cholera, so the MSF staff uses a chlorine solution to disinfect the center. This reduces the chances of another outbreak or infecting the staff. This solution can also be used to disinfect the homes of families who have been infected.
  7. Disinfecting isn’t the only solution to preventing the spread of cholera because the problem is directly related to the distribution of water. Without proper containment of poor water sources, the disease will continue to spread. To ameliorate the risks of cholera related to unsafe drinking water, MSF installed two water distribution bladders in the most affected areas. These bladders supply 30,000 liters of potable water.
  8. UNICEF has been providing cholera kits to people in Burundi. There are four different kinds of kits to help with various aspects of need. UNICEF has also established two cholera treatment centers to control the spread of the disease.
  9. To avoid contamination, experts suggest drinking disinfected water and eating a balanced, thoroughly cooked diet. Organizations like WHO are emphasizing the importance of washing hands frequently with soap and water or an alcohol-based sanitizer to reduce the risk of transmission.

Cholera is an easily treatable and preventable disease that occurs in poverty-stricken areas with poor sanitation. Many organizations have reached out to add potable water sources and aid by training the people of Burundi to treat and prevent the disease themselves. With rebel fighting and insurgent forces crossing the country, the disease is projected to spread to further areas of rural poverty.

Kaylee Seddio, PhD
Photo: Iwacu

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