Somalia: Cholera Outbreak - Apr 2016Ongoing
Humanitarian partners have stepped up response to the outbreak...Projections of 15,000 severe and 60,000 moderate cases over the coming months have led to plans for a significant and rapid scale up of the response. To help stabilize and contain the outbreak, the CERF rapid response grant of $2 million will strengthen and complement response activities already underway by WASH and Health partners. (OCHA, 30 May 2016)
Since the beginning of , a total of 14165 case of AWD and 497 deaths have been reported in different parts of Somalia. Of these 47.7% are female while 57.9% are children below 5 years. [...] there has been a gradual reduction in number of cases from the peak 1,853 cases and 187 deaths (CFR 10.0%) in week 15 to 194 cases and 0 death in week 46. (WHO, 20 Nov 2016)
Drought conditions have increased the spread of epidemic-prone diseases such as acute watery diarrhoea, cholera and measles. In the first 7 weeks of 2017, more than 6000 cases and 65 deaths by acute watery diarrhoea/ cholera were reported. (WHO, 27 Feb 2017)
The AWD/cholera epidemic in Hiraan, Nugal, Mudug and Bari and Banadir region has been controlled and the cholera treatment centre in Beletweyne has been closed. 2016's outbreak was one of the worst and longest in which the country has experienced in the last five years. (WHO, 5 Mar 2017)
On 15 March 2017, the Government of Somalia, together with humanitarian partners, launched an Oral Cholera Vaccination campaign, the first of its kind in Somalia, targeting over 450,000 people in seven high-risk areas around the country...WASH partners have furthermore scaled up response to AWD/Cholera, reaching 316,000 people in southern and central Somalia through distribution of hygiene kits, chlorination of water points and hygiene promotion campaigns as of end of February. In total, some 568,600 people were assisted with temporary and/or sustainable access to safe water, 36,000 people with safe sanitation and 498,000 people with hygiene promotion activities. (OCHA, 24 Mar 2017)
In 2017, a total of 53,015 AWD/Cholera cases have been reported across 52 districts in 16 regions, including 795 deaths (CFR 1.5 per cent). This represents the worst case scenario with an attack rate (AR) of 5.5 per 1,000 people. 41 per cent of the cases are among children below five years with a slightly higher CFR (1.8%) compared to children above five years (1.4 per cent). The number of AWD/Cholera cases in 2017 is more than three times the 2016 caseload, and 10 times the 2015 caseload. Whilst the cumulative CFR is declining from 2.3 per cent at the beginning of the outbreak to 1.5 per cent as of last week, the reported CFR from inaccessible areas is still four times higher. (UNICEF, 30 Jun 2017)
The month of August has seen a sustained decline in the number of cases of cholera reported from across Somalia. The 917 cases recorded in August 2017 now approximate to the averaged monthly figures recorded in 2015 of 440 cases and during 2016 of 1,300 cases/month. (Health Cluster, 29 Sep 2017)
There have been no reported AWD deaths this month. The 650 AWD cases recorded in the month of September has is part of a sustained decline in the number of cases of cholera reported from across Somalia. In total. 77,783 suspected cases of cholera have been reported since the beginning of 2017 . Due to the reduction in new cases, the focus is currently on cholera preparedness in advance of the forthcoming October rains. (Health Cluster, 19 Oct 2017)
Over the past two months there has been a significant reduction in the number of new AWD/Cholera cases in all regions of Somalia. No AWD/cholera related deaths have been reported since August in any region across Somalia. (Health Cluster, 31 Oct 2017)
Cholera cases and deaths have declined significantly during the month of November 2017 with less districts reporting cases as compared to previous months. (WHO, 30 Nov 2017)
Since the start of the year, a total of 78,560 cumulative cases of AWD/cholera recorded from health facilities across the country and 1,160 deaths have been reported in 55 districts of 16 regions across Somalia. [...] Whilst an overall decline is being reported, new AWD/cholera cases have been reported from Beletweyne district of Hiran region during December. (Health Cluster, 31 Dec 2017)
As of 18 March 2018, a total of 1613 cholera cases, including nine deaths (case fatality rate = 0.6%), have been reported from four regions: Hiraan, Banadir, Lower Juba and Middle Shabelle. The outbreak started in Beletweyne, Hiraan Region; it spread to Banadir Region in early January 2018, to Lower Juba in early February 2018, and to Middle Shabelle in early February 2018. Of the 66 stool samples tested in 2018, 19 were positive for Vibrio cholerae serogroup 01 serotype Ogawa. Banadir Region is one of the regions with the highest concentration of internally displaced persons (IDPs). (WHO, 29 Mar 2018)
Following the heavy rains that have led to the floods in the Juba land and Shabelle basins, there has been an observed increase in the number of new AWD/Cholera cases. The cholera outbreak that started in December 2017 in Beletweyne along river Shabelle has spread to Jowhar, Kismayo, Afgoye and Banadir. The cholera spread is expected to increase due to the floods that have led to contamination of water sources in the flood affected regions. Floods have also led to blockage of access of health services which will contribute to delayed health seeking by the affected populations with... A cumulative total of 3,280 cases including 21 deaths have been reported since December 2017. (WHO, 13 May 2018)
Maps & Infographics
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• 216 health facilities across Somalia submitted weekly reports of epidemic-prone diseases in the electronic early warning disease surveillance (EWARN) system in week 22.
• Total number of consultations decreased from 62,876 in week 21 to 59,673 in week 22.
• A total of 4,231 alerts were received. 159 of these alerts were confirmed as true alerts1 .
• A total of 396 new cases AWD/cholera were reported in week 22 compared to 357 week 21.
• 47% (186) cases were reported from flood affected regions of Lower Shabelle and Lower Jubba regions
• 1 new death were reported in week 22 compared to 4 deaths reported in week 21
• The AWD/Cholera death reported in week 22 occurred in Banadir.
• A cumulative total of 4,300 cases including 28 deaths have been reported since December 2017
The humanitarian situation in Somalia remains challenging in 2018. After a prolonged drought in 2016 and 2017, the above-average Gu rains have had devastating impact in some parts of the country. Flash floods and riverine flooding has been reported in several areas, including the Banadir region, Hirshabelle, Jubaland, Galmuduug, and the South West states. Evictions of IDPs are on the rise, while the benefits of the rainy season are yet to translate into a significantly improved food security situation across the country.
Famine was averted in Somalia in 2017, thanks to the rapid mobilisation of resources and scaled-up response. By the end of 2017, donors had collectively contributed or pledged $1.32 billion, channelled either through the projects included in the 2017 Humanitarian Response Plan (HRP) or projects outside of the HRP.
Norway will provide a further NOK 30 million to alleviate the situation in Somalia. The funds will be channelled through the Somalia Humanitarian Fund, which is administered by the UN, and through Save the Children Norway and Norwegian Church Aid.
'Over the last year, Somalia has been severely affected by drought. Now, the population has been hit by flash floods and river flooding. The authorities and humanitarian actors are doing their best to respond to the situation. It is important that Norway also does its part,' said Minister of Foreign Affairs Ine Eriksen Søreide.
There has been a significant reduction in rainfall levels in the Juba and Shabelle river basins in Somalia and the Ethiopian highlands over the last two weeks, with most areas receiving only light rainfall, if any.
• 228 health facilities across Somalia submitted weekly reports of epidemic-prone diseases in the electronic early warning disease surveillance (EWARN) system in week 21.
• Total number of consultations increased from 50,749 in week 20 to 62,876 in week 21.
• A total of 4,449 alerts were received. 303 of these alerts were confirmed as true alerts1 .
• A total of 357 new cases of suspected AWD/cholera were reported in week 21 compared to 267 and 2 deaths cases in week 20.
• A total of 4 new suspected cholera deaths were reported from Banadir (1) and Lower Jubba (3).
• A cumulative total of 3,904cases including 27 deaths have been reported since December 2017
• The new AWD/cholera cases reported in Beletweyne started in December 2017. All the new outbreaks in Banadir, Kismayo,
Jowhar ,Bulobarde and Afgoye started in 2018
According to FEWSNET, rainfall has been above average over broad areas of Somalia, Eastern and Southern Ethiopia and nearly all of Kenya. The strong performance of seasonal rains has contributed to a continuation of timely and well-distributed rains that had already resulted in seasonal rainfall surpluses across much of the region. Heavy rainfall has persisted across much of East Africa since March, with rainfall totaling more than 200 percent of average in many areas.
After enduring a year of drought and then the heaviest rainfall in over three decades, more than 750,000 Somalis must now figure out how to secure food and shelter and deal with emerging health risks. Last month, Somalia’s government and the UN appealed for $80 million to help people affected by flooding in the south and centre of the country.
When a drought ravaged Fatima Moalim’s village, she left her farmland and home behind. Now, she lives in Sarman camp for internally displaced people in the outskirts of Baidoa. Poor hygiene practices, lack of clean water and absence of proper sanitation all pose a great challenge to many displaced communities in Somalia. Good hygiene and sanitation is critical to keep diseases such as diarrhea and cholera from spreading.
Cyclone Sagar leaves a trail of destruction
Flooding worsens fragile humanitarian situation
Some IDPs in Baidoa return to take advantage of the Gu rains.
Pooled funds boost response but gaps remain
Cyclone Sagar leaves trail of destruction
Over 770,000 people have been affected and 230,000 displaced due to ongoing severe floods along the Juba and Shabelle river basins. The floods have critically impacted crops, shelters and critical service infrastructure, including water, health, nutrition and education facilities. The increased risk of water-borne communicable diseases remains a major threat, especially acute watery diarrhoea (AWD)/cholera.
Heavy rains and flooding have continued to compound an already fragile humanitarian situation in the southern and central parts of Somalia, worsening conditions for communities who recently endured a long period of drought (OCHA 25/05/2018). The floods have resulted in the destruction of homes, critical infrastructure, latrines, and the loss of livestock and crops. There is need for shelter and NFIs, as well as WASH assistance.
Anticipated scope and scale
In 2018, humanitarian organisation in Somalia estimated approximately 6.2M to be need of some kind of protection and humanitarian assistance. This equates to about half the total population of Somalia.
Of this 6.2M, humanitarian actors have targeted to reach 5.4M.
The past week has seen a reduction in rainfall activity across Somalia and in the Ethiopian highlands, according to FAO-managed Somalia Water and Land Information Management (SWALIM). However, river levels remain high with flooding continuing along the Shabelle, while water levels are reducing down the Juba River, according to SWALIM. In Belet Weyne town and surrounding areas in Hirshabelle state, flood waters are receding while in Bulo Burto and Jalalasqi flooding levels have increased.
Thousands of people remain in urgent need of food, clean water, health services and essential household items along the north-western coastline of Somaliland in the wake of last Saturday’s Cyclone Sagar, the strongest storm that has ever made landfall in this part of the country. Hundreds are homeless, 47 deaths have been reported and a massive number of livestock have been killed.