Cholera epidemic hits mining city of Lubumbashi

A team from MSF's Congo Emergency Pool provide treatment to cholera patients in the city of Lubumbashi - ©Bertrand Perrochet /MSF

Since the start of 2008, 767 people suffering from cholera have required treatment in the city of Lubumbashi, the capital of Katanga province and the economic capital of the Democratic Republic of Congo (DRC). Médecins Sans Frontières is supporting a Cholera Treatment Centre (CTC) and has set up a second. Thirty to forty new patients are being admitted every day.

A team of fifteen people from Médecins Sans Frontières' Congo Emergency Pool (PUC; Pool d’Urgence Congo) is currently working to fight the cholera epidemic that has been raging since the start of the year in the heart of Lubumbashi, a mining city in the south east of DRC, with a population of 1.3 million.

To date, 767 cholera patients have been treated in the Cholera Treatment Centre (CTC) supported by Médecins Sans Frontières. And the number of patients is rising slightly, with 278 new patients admitted over the course of last week - an average of thirty to forty new patients every day.

"Patients lying on the bare ground"

The Médecins Sans Frontières team comprises a coordinator, three doctors, six nurses, five logistics specialists and a water sanitation and disinfection expert. Highly contagious, cholera is a bacterium that is easily transmitted via stools and vomit and by drinking contaminated water. Two additional members of the Médecins Sans Frontières team are taking care of raising awareness among the population on the ways in which they can protect themselves from contracting the illness. On the 10 January 2008, while the PUC was working in the city's only CTC, located in one of the general referral hospitals in the Kenya district, the number of patients rose so rapidly that hospital staff were completely unable to cope. "On site, the result was people lying on the bare ground due to the lack of space, dangerous proximity between patients and those accompanying them, non-compliance with standards for disinfection with chlorinated water between the interior and exterior of the CTC," explains Bertrand Perrochet.

The Médecins Sans Frontières team first reorganised patient care by placing the entry and exit disinfection areas outside of the hospital, thereby also increasing the capacity of the centre. The severely ill, those suffering from severe dehydration due to vomiting and diarrhoea caused by the 'vibrio' bacteria, are placed in an isolated room and put on a drip. Following the changes in their health, they then go through various phases of treatment until the convalescence area. In all, patients undergo four phases of treatment before full recovery. "Normally, each phase of treatment is separated from the others." explains Bertrand Perrochet. "At the Kenya CTC, we have had to divide the patients between the three rooms available to us. Given the significant number of hospitalised patients, 79 at present, we have increased the capacity of each room to 35 beds."

Nevertheless, it was necessary to open a second treatment centre. On Saturday, 19 January, Médecins Sans Frontières opened a CTC in the Katuba district, 8 km from the Kenya district. Twenty-four patients have already been admitted. Over several days, community awareness raisers informed the population about the imminent opening of the centre. "We were able to reduce the overload on the Kenya centre and provide closer care to a greater number of patients," explains Elke Frans, Médecins Sans Frontières nurse. Indeed, the Katuba district is one of the biggest focuses of cholera in the city. 

Until now, due to the lack of a centre, patients had been crossing Lubumbashi before receiving treatment. "This can have very serious consequences," continues Elke Frans. "Not treated in time, cholera results in fatal dehydration in 50% of cases, but the quicker the sick are treated, the more easily and rapidly they recover. The risk of contagion is also reduced and this is important in a big city like Lubumbashi, where a great number of people live in precarious and overcrowded conditions."

Illness of ‘the poor’

Médecins Sans Frontières is now focusing its efforts in order to limit the spread of the epidemic, while lamenting the fact that it could not be contained in time due to the lack of adequate resources deployed for the poorest population of this rich mining city. "The situation was entirely manageable for the health authorities," insists Bertrand Perrochet. "But neither adequate tools nor sufficient resources were deployed to contain the cholera epidemic and prevent it spreading.” A serious epidemic previously hit the capital of Katanga in 2003 and Médecins Sans Frontières also provided assistance on that occasion. Once again, it is the people living in difficult hygiene conditions and without access to drinking water that are affected by this illness of ‘the poor’.

The PUC is an emergency support team that was created in 1995 by Médecins Sans Frontières Belgium. It provides medical support throughout the DRC. Its aim is to reduce mortality and morbidity resulting from medical emergencies through their early detection and treatment. The PUC assists in caring for victims of epidemics, malnutrition, natural disasters and population displacements through enhanced surveillance, rapid assessments and a quick and effective response. Médecins Sans Frontières has been working in the DRC since 1981.