On Thursday we rose with the sun and headed out to the surface water treatment site to see if we could get the system to produce clean water. A day earlier, the pumps at the Bamtiko borehole — the main source of water for Jamam refugee camp — had failed. The NGO that was responsible for water supply in the camp had made an urgent request to MSF to set up emergency water treatment capacity. Waterborne disease had always been one of the primary threats for the refugee population in this place, but with hepatitis E now also spreading in the camp, ensuring safe water supply was more critical than ever. MSF agreed to do what we could to fill the gap.
But then we hear a message on the radio. Rink, one of our star Water/Sanitation guys has gone up to K18 to check that the water supply can be reactivated. He’s discovered about 100 families that must have arrived in recent days from the border. He asks for medical support and Erna, our top medic that has been here since the start of this refugee crisis, from the initial discovery of weak, exhausted refugees that were beyond medical care to the erection of a clinic at K18 to the transfer of all refugees to T3 and finally Batil, grabs her kit and jumps in a car, cancelling the first day off she’s had in a month.
We could continue treating children suffering from diarrhea induced malnutrition, or we could choose to treat the diarrhea at the community level before the child became malnourished. The answer seemed obvious – and Project ORS (Oral Rehydration Salts) was conceived.
And the situation here is desperate. The water is running out, and when it’s gone, that’s it—you’re going to have 35,000 people without water. People are right on the borderline now. We’ve managed to provide 2.5 liters (a little over half a gallon) per person yesterday and we’re hoping to get that up to 3 liters today, but that’s nowhere near enough, and the pond where we are treating and distributing water is running out.
People are arriving in such an emaciated state that our medical staff are struggling to revive them. They have gone too long without food and water. My role as an epidemiologist is to get a handle on how big the emergency is. We measure this through the mortality rate…