Fighting cholera in Cameroon

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Posted by Unni Krishnan

The clock is ticking on dealing with the deadly cholera outbreak that has swept through Cameroon. Public health officials say that the outbreak this year has claimed 135 lives. Almost three-quarters of the total 4,122 cases have occurred in areas close to the capital, Yaounde, and the main port, Douala. Cholera has now spread to 6 of the 10 regions.

The seasonal rains start next month and this will only exasperate the outbreak and bring the already stretched health system to breaking point.

Time is of the essence

If left untreated, cholera and the ensuing dehydration could kill a patient in 6 hours. Sufficient rehydration and timely assistance can save 90% of lives. Unlike an earthquake or hurricane that has already come and gone, in the case of cholera, it is possible to stop deaths. Timely action, to rephrase Gabriel Garcia Marquez, can help to foretell the chronicle and outcome of a cholera outbreak. Action and inaction make the difference.

Dealing with cholera is not rocket science. Public health experts cracked the code of this killer disease long back. Rehydration, oral rehydration therapy and case management of the severely affected are key in saving lives.

It is equally important to stop the spread through provision of clean drinking water, sanitation, public health and hygiene promotion. Radios, televisions and social media have a role to play in stopping the spread of disease. The battle for cholera is to be fought not just in hospitals and cholera treatment centres, it also needs to be fought on the airwaves.

Protecting the vulnerable

Children - especially the malnourished, people living with HIV and AIDS whose defences are already weakened, and people living in remote areas where health services can be almost non-existent, are more vulnerable. Children dehydrate quickly.

It is necessary to place vulnerable groups like malnourished children at the centre of the cholera response strategy in Cameroon. Measures are needed to profile their plight and amplify their voices.

Setting up health surveillance mechanisms is crucial in monitoring the outbreak. Frontline community health workers are a key alley for a robust surveillance mechanism. Children and young people could also play a key role in the battle against cholera. It is necessary to include public health issues as part of the school curricula.

Lessons from the past

Poverty, lack of clean water and adequate sanitation and most importantly absence of a vibrant public health system multiply the impact. Plan’s experience of working in previous cholera outbreaks, such as that in Haiti, show that ensuring care and support for the most vulnerable and targeted public health measures and messaging can save lives.

The World Health Organization estimates that between 100,000 to 120,000 people die because of cholera every year. Each day, 4,000 children die from diarrhoea. How to stop these preventable deaths? They should serve as a wake-up call for governments to invest in public health and donors to commit sufficient resources.