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24 August 2007 |
Endemic in West Africa, Cholera has once again struck in Guinea. The
arrival of the rains at the end of May, notably in the particularly
insalubrious capital city, Conakry, has created an ideal breeding ground
in which the disease can spread. Faced with an increasing number of
cases, MSF has boosted its direct support of the health services.
In Conakry, the old adage that cholera rears its ugly head once every
seven years is long out of date. The sanitary situation in the city
is such that the bacteria which causes the disease, Vibrio cholerae,
finds fertile ground for its rapid and murderous spread every year
during the rainy season. In many parts of the city, the streets are
strewn with household waste, and over-flowing latrines are too close
to water points. It is an unhealthy environment which makes it hard
for the population to maintain good levels of hygiene.
Additionally, in this city of two million people, which is laid out
along a thin peninsula, the sick are widely dispersed, making it more
difficult for them to reach treatment centres.
Since January this year, nearly 2500 cases of Cholera have been recorded,
of whom 90 have succumbed to the disease. Due to the increasing number
of cases and the limited treatment capacity in local health facilities
in the city, at the end of June, MSF began providing medical support
to Donka Hospital. In August, this was followed by two additional centres
in densely populated areas of town called Matoto and Ratoma.
“The number of people infected by the disease in Conakry has
considerably increased since July,” explains Sergio Martin Esteso,
one of the programme heads for MSF in Guinea. “Of the 1260 patients
treated in the three centres where MSF works, more than 1000 have been
in the past three weeks.”
MSF is part of the Emergency Cholera Unit set up by the Ministry of
Health to effectively co-ordinate the approaches of all the organisations
involved in the outbreak.
While the emergency response is today in place, this year has once
again witnessed ill- prepared health facilities and an insufficient
medical system. “Without rapid access to treatment, it is well
known that cholera victims die quickly and in high numbers,” underlines
Esteso. “But once again, health facilities weren’t well
enough prepared to cope with this emergency.”
Trained medical staff in the Cholera treatment centres at Dabompa
(Matoto area) and the Donka hospital and have been in particularly
short supply. “If, as we fear, the number of sick continues to
increase over the next few weeks, the local teams in place at the moment
will soon be exhausted. As a result we are going to have to offer support
to bridge this gap,” adds Caroline Franco, an MSF coordinator
for the operation.
The preventative aspects, such as the distribution of a chlorinated
solution called “sur’eau”, and public health campaigns
telling people to drink clean water and pay greater attention to
their standards of hygiene, are being dealt with by local organizations.
However, potable water is still not free, which limits the impact
of the messages, as well as encouraging the spread of the disease.
“Regarding the sanitary state in Guinea, we are expecting to
face more epidemics of this type in the future. So it is vital that
the authorities are better prepared to take care of the sick. It is
an essential component in saving a lot of lives,” concludes
Esteso.
Extremely contagious, Cholera causes a severe
intestinal infection, marked by uncontrollable diarrhea and vomiting.
After only a few hours, infected people dehydrate and die. Simple
medical care (oral rehydration or a perfusion, depending on the
state of the patient, which if necessary can be followed by an
antibiotic which kills the bacteria) is all that is required
for patients to quickly recover. |
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