Posts tagged Diarrheal disease

An Escalating Health Crisis in South Sudan

Women and children wait in line to gather water at an MSF-run tap point in Doro camp. Supplying refugees with safe water has been a challenge since they started arriving. Heavy rains have further jeopardizing the supply of clean water and caused widespread flooding in the camps.

Since November 2011, MSF has been operating emergency programs in South Sudan for tens of thousands of refugees who fled violence in Sudan’s South Kordofan and Blue Nile States. MSF has field hospitals in five refugee camps in Unity and Upper Nile states in South Sudan (Batil, Doro, Jamam, Yida, and Gendrassa). However, resources in the camps are stretched extremely thin, and the humanitarian crisis is only worsening as more refugees arrive. Heavy rains have exacerbated the situation, flooding camps and leaving refugees—many of whom have already endured the journey from Sudan on foot—vulnerable to diseases like diarrhea, malaria, and cholera.

Photo: South Sudan 2012 © Nichole Sobecki

Battling Cholera in Freetown, Sierra Leone

Sierra Leone’s capital. Freetown, is currently struggling to contain a cholera outbreak that has affected over 1,500 people and killed at least 17 to date. MSF, in collaboration with the Ministry of Health, is already running three cholera treatment units in the city and has treated more than 500 patients. Because the number of people infected continues to grow, however, MSF plans to open two additional treatment facilities up in the next 10 days.

“We are moving quickly to increase our capacity to handle all the new patients that will arrive,” says Karen Van den Brande, MSF head of mission in Sierra Leone. “Our present cholera treatment facilities are stretched to the limit with patients. The patients that we see are of all ages, so it’s not just children or already weak people that are at risk.”

Photo: Cholera patients at Marcauley cholera treatment unit in Freetown, Sierra Leone.
Sierra Leone © Florence Demeulin/MSF

Voice From the Field: Tackling Haiti’s Cholera Epidemic

Joan Arnan, MSF Head of Mission in Haiti, has been working in Haiti for five months, coordinating MSF’s response to the cholera epidemic that has been sweeping the country since October 2010. Here, Arnan explains the response and discusses the difficulties faced by the Haitian Ministry of Health and its international partners in responding to the epidemic.

Failures in the epidemiological surveillance system make it impossible to deploy an adequate response in strategic locations, and the dearth of cholera treatment services in national health facilities—along with the withdrawal of several nongovernmental organizations (NGOs) following a decrease in international funding—are hampering the national response to the epidemic. An MSF staff member educates outpatients about cholera at Léogâne hospital

Haiti 2011 © Yann Libessart/MSF

Somalia: Responding to Diarrhea in Kismayo

MSF is responding to increased cases of acute watery diarrhea among children and adults in the city of Kismayo in southern Somalia. More patients are being admitted every day. Acute watery diarrhea is highly infectious and can be deadly if not treated in time. Kismayo’s dense population means that a widespread outbreak could easily occur if urgent prevention measures are not taken.

A rapid test among a sample of ten patients indicated that six tested positive for cholera. Of the 65 patients treated so far, 40 suffered severe dehydration and needed immediate hospitalization. The majority of the cases were children under the age of eight.

The most effective way to prevent such outbreaks is chlorination of drinking water sources and adherence to basic hygienic measures. Unfortunately, the use of chlorine is not allowed in the Kismayo area, so MSF community health workers are advising people to strain water through clean cotton fabric and boil it before drinking it, in addition to regularly washing their hands with soap.

Photo: Mothers and young children—who are especially vulnerable to diarrhea—wait to be seen in an MSF facility.

Somalia 2011 © Peter Casaer

Vaccinating Against Cholera in Guinea

More than 170,000 people in the Boffa region of Guinea recently became the first in Africa to receive a new two-dose oral vaccine for cholera, said MSF, which led the vaccination campaign.

The initiative, MSF said, could spur an improved response to cholera epidemics worldwide. In collaboration with the Guinean Ministry of Health, MSF focused its response on Boffa, a coastal region near Conakry, which was considered a hotspot of the epidemic.

“We were faced with an outbreak and we wanted first to protect people by vaccinating them, and to limit the spread of cholera,” said Dr. Dominique Legros, MSF’s innovation initiative manager in Geneva. “MSF is regularly involved in responding to cholera outbreaks and it is always difficult to control the disease. Because cholera evolves quickly, oral vaccination provides us with a new tool to try to contain [it]. If we can control the most active spots, we can reduce the spread of cholera.”

Photo: An MSF patient takes a dose of the new oral cholera vaccine in Guinea. Guinea 2012 © David Di Lorenzo

Haiti’s Rainy Season Brings Cholera Back to Port-au-Prince and Léogâne

With the rainy season now underway in Haiti, MSF has seen an increase in the number of cholera patients. Admissions to MSF’s treatment centers in Port-au-Prince and Léogâne have more than tripled in less than one month.

New patients arrive daily at MSF’s cholera treatment centers (CTCs). A woman named Marie was admitted to the Martissant CTC on April 16. “I had diarrhea and was vomiting a lot, then I fainted,” she recounted. “A relative brought me here because it is the center closest to where I live. The doctors told me that I had cholera and was dehydrated.” One hundred thirty-four other people like Marie arrived at the MSF center in Martissant between April 16 and 23 and nearly 400 more went to MSF’s other CTCs in Port-au-Prince and Léogâne.

“Cholera is easy to treat but specialized treatment centers must be accessible and patients must be brought there as soon as possible once symptoms appear,” says Dr. Sophie Duterne, MSF’s medical coordinator in Haiti. “If left untreated, this disease can kill within a few hours. Treatment involves simple oral or intravenous rehydration, with antibiotics for the most severe cases. However, taking additional hygiene precautions and drinking disinfected water is still the best protection.” Since the first cases were identified in October 2010, more than 500,000 Haitians have contracted cholera.

Photo: Haiti 2012 © Mathieu Fortoul/MSF Cholera patients recover in MSF’s Martissant CTC.