Stop the spread

In addition to decreasing mortality amongst the affected people, stopping the spread of the epidemic by taking disinfection and preventative measures is crucial. Cholera is mainly spread by drinking contaminated water or eating contaminated food and is linked to the lack of garbage and human waste management as well as the lack of hygienic measures such as hand-washing. This is the reason why crowded places such as markets, where sanitation and hygiene measures are inadequate, are more prone to it. “The overall water and sanitation situation in the country continues to be very limited,” states Agustín López, who is in charge of logistics in the project. “This facilitates the spread of cholera. Prevention depends on access to drinking water and proper sanitation systems to prevent exposure to the bacteria and stop transmission.”

In many areas of Guinea-Bissau, basic infrastructures are inadequate: drainage is non-existent, the electricity network is poor and, based on estimates, less than 20% of the population has access to drinking water. Most of them get the water they need from wells.

In addition, the bodies of those who die of cholera need to be treated with extreme caution and properly disinfected before being buried in order to prevent further contamination. According to local customs, a dead body can be kept at home for several days, so that family members and friends are able to pay their last respects. They usually touch the body. The government forbids these rituals when there is an epidemic. Their houses, as well as the houses of the patients admitted to the centres, have to be disinfected. This task is carried out by the brigades in charge of actively tracing cases and disinfecting, that Médecins Sans Frontières coordinates together with the government seeking to stop the spread. A special team disinfects houses using a chlorinated solution. They also deliver soap and bleach to the population and explain to them how to treat water and the hygiene measures needed to prevent the bacteria from re-infecting them.

Médecins Sans Frontières has also worked in Guinea-Bissau in 2005 fighting another cholera epidemic.