Cholera Still Lingers: Areas of War at High Risk
By Mufuh Ramiro
Cholera is an infectious and often fatal bacterial disease caused by the bacterium vibrio cholerae. It is typically contracted from infected water supplies, food or drinks and causing severe vomiting and diarrhea. Cholera can cause death from severe dehydration (the loss of enormous water and salts from the body) within hours if not treated.
World Health Organisation (WHO) says cholera affects averagely 1.7 million people and kills over 80,000 globally in a year. About 50% of global cholera cases and deaths are recorded in Africa as a result of inadequate water hygiene and sanitation system in most of the continent’s countries. Contaminated water and poor sanitation are likely to transmit water-borne diseases like cholera, diarrhoea, dysentery, hepatitis A, typhoid and polio.
WHO has also reported that congested population areas especially those marked by an influx of refugees and war zones stand a higher risk of degrading in water hygiene and sanitation which often leads to cholera outbreaks.
Recently in June 2018, the Cameroon government declared a cholera outbreak in the Far North, Littoral and Centre Regions of the country. The declarations came after 4 cholera cases were recorded on May 18 in Mayo Oulo, a small town in the Northern Region of Cameroon that borders Nigeria and Cameroon.
The numbers of suspected cholera cases and deaths in Cameroon are rising. In early September 2018, the Ministry of Public Health revealed that there were about 235 suspected cholera cases in the country with 17 deaths which may keep increasing if prevention measures are not intensified.
Reported cholera cases were suspected as being contaminated from among the 90,000 Nigerian refugees fleeing the Boko Haram insurgency to Cameroon.
WHO has reported recurrent cholera outbreaks since February 2018 in the states of Adamawa, Bornu, and Yobe States in Nigeria, with 1,664 suspected cases and 31 deaths.
According to a message from the Infection Prevention and Control Association of Cameroon (IPCA-Cameroon) channeled by the CBC Health Services, the Anglophone Crisis in Cameroon exposes more people to the cholera disease. This is as a result of the increasing number of people fleeing from violence to the bushes and to congested areas like Douala and Yaounde.
Cholera is a major global public health problem, but the burden and impact of the waterborne disease are greatest in sub-Saharan Africa.
In 2017, more than 150,000 cholera cases, including more than 3,000 deaths were reported in 17 African countries. This year, there has been a spike in cholera cases across Africa, with eight countries currently battling outbreaks including Cameroon.
WHO says the region is vulnerable to cholera for a range of reasons. Ninety-two million people in Africa still drink water from unsafe sources. In rural areas, pipe borne water is often unavailable and people practice open defecation. Humanitarian crises, climate change, rapid urbanization, and population growth increase the risk of cholera spreading.
Inadequate management of urban, industrial and agricultural wastewater means that the drinking water of hundreds of millions of people is dangerously contaminated or chemically polluted.
Each year 842,000 people are estimated to die from diarrhoea as a result of unsafe drinking water, sanitation, and hand hygiene. The deaths of 361,000 children below the age of 5 each year could be avoided if these risk factors were addressed.
Where water resources are not readily available, people may decide that hand washing with clean running water and soap is not a priority, and may decide to do that only occasionally, thereby adding to the likelihood of cholera and other diseases.
Maintaining good sanitation and hygienic conditions is the simplest way to prevent cholera. Oral Rehydration Solution (ORS) is approved to be cheap and effective in the treatment of cholera since it prevents dehydration before the patient is rushed to the hospital.
On August 28, 2018, African Health Ministers met in Dakar Senegal and pledged to end causes of Cholera outbreak in Africa by 2030.
During the meeting they agreed to take evidence-based actions which include: Enhancing epidemiological and laboratory surveillance; mapping cholera hotspots; improving access to timely treatment; strengthening cross-border surveillance; promoting community engagement and the use of the Oral Cholera Vaccine (OCV); and increasing investments in clean water and sanitation for the most vulnerable communities.