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Syria, Cameroon, Lebanon, Nigeria, Mozambique – In total, some thirty countries have reported cases of cholera since the beginning of the year*. This worrying figure can be explained by a convergence of factors – particularly climate, economic and geopolitical crises – that have led to an increase in the number and intensity of cholera epidemics. They are reappearing in areas that have not been affected by outbreaks for several decades. In seven of these countries, SOLIDARITÉS INTERNATIONAL is working to stop these rampant epidemics.
The Borno region in north-eastern Nigeria is experiencing a major cholera epidemic this year. More than 11,000 cases have been detected since mid-September. This is double the number of cases detected the previous year, which was already one of the largest cholera outbreaks…
Around the same time each year the population of this governorate has to deal with this diarrhoeal disease that can be fatal if not treated quickly. “Cholera is an easy disease to treat, but it requires safe access to water, sanitation and hygiene,” explains Emmanuel Rinck, Director of Operations at SOLIDARITÉS INTERNATIONAL. This region has very limited access to the basic resources needed to treat the disease and maintain hygienic practices that prevent further outbreak. SOLIDARITÉS INTERNATIONAL, with its experience in the prevention of water-borne diseases, is helping the inhabitants by improving water and sanitation services and by providing a rapid and targeted response to epidemic episodes. This response includes the distribution of hygiene kits containing soap, chlorine tablets for water purification, and other items for home disinfection.
This response additionally includes raising awareness about practices that protect against the risks of contamination.
A Crisis Within a Crisis
While Nigeria is among the countries that face cholera outbreaks every year, others – such as Lebanon – have not experienced an outbreak for a very long time. “It’s been 30 years since we’ve seen cases of cholera in Lebanon. This epidemic is very worrying because it affects a country whose healthcare infrastructure and public health systems have been greatly weakened in recent years,” says Olivier Leconte, Country Director of SOLIDARITÉS INTERNATIONAL in Lebanon.
The economic crisis that has shaken the country for several years, and the consequent deterioration of services (access to water, healthcare, etc.), are some of the major contributors to the reappearance of this disease. As the population finds it more difficult to access clean water, residents must turn to less secure sources of water that are more likely to be contaminated.
“As soon as the first cases appeared, we carried out disinfection campaigns and transported drinking water by trucks, as well as hygiene awareness sessions. All of these activities are part of the chain that needs to be put in place to curb this epidemic,” explains Olivier Leconte.
When Climate Change gets Involved in Cholera
Climate change and rising global temperatures are also strongly linked to the increase in cholera outbreaks. This bacterium, like many others, thrives in warm temperatures.
“The increase in droughts leading to a scarcity of water and therefore a greater risk that the population will resort to contaminated water sources, followed by episodes of intense rainfall: this is a perfect recipe for the spread of cases during epidemics,” explains Baptiste Lecuyot, Head of the Water, Sanitation and Hygiene Unit at SOLIDARITÉS INTERNATIONAL.
Syria, for example, is now facing a new disaster: a water crisis. Due to the drought that has been raging for several months, the level of the Euphrates – the country’s main river – is falling and its pollution is increasing. Residents have difficulty accessing water to meet their basic needs (drinking, washing, cooking, etc.), as well as for agriculture and livestock. Inhabitants are thus often forced to rely on water sources with a high risk of contamination, such as the river. As a result, cholera has reappeared throughout the north-east of the country after having disappeared for over 10 years. To try to limit the spread of the disease, SOLIDARITÉS INTERNATIONAL is distributing drinking water, organizing hygiene promotion sessions and disinfecting infrastructures.
Fleeing War, Finding Cholera
Climate change and economic crises are two of several factors that are leading to an expansion and aggravation of cholera epidemics around the world. International geopolitics, and the deterioration of security due to war or conflict, have a significant impact on the development of this disease in a growing number of countries. To flee from war or conflict, refugees seek shelter in nearby towns or villages that do not have the health infrastructure or water resources to cope with their growing populations. The destruction of healthcare buildings during armed conflict, as well as the destruction of water sources such as wells or irrigation canals, only aggravates the situation. This is compounded by the lack of resources to maintain good hygiene practices throughout the region. All of the aforementioned circumstances present a significant risk of propagation of pathogenic strains of the Vibrio cholerae bacillus.
In view of the increasing number of cholera epidemics in the world, immediate short-term responses, such as those implemented by SOLIDARITÉS INTERNATIONAL, are necessary. However, it is also essential to devise long-term solutions and set up sustainable water supply and sanitation services. This can be accomplished, for example, through the rehabilitation or construction of infrastructure, or by working with local institutions to strengthen sustainable hygiene practices that enable people to protect themselves from this disease.
“It is the combination of these short-, medium- and long-term solutions that will enable affected countries to overcome this disease. Unfortunately, succeeding in containing these epidemics is often a question of means…” concludes Baptiste Lecuyot.
*Cholera vaccine shortage leads to temporary suspension of two-dose strategy as number of cases increases worldwide, Relief Web
© Ralph Tedy Erol