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Community Cholera Epidemic Preparedness in the Democratic Republic of the Congo and Cameroon: Case Study

Evaluation and Lessons Learned
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Epidemic prevention, preparedness, early action and response is a top priority for the International Federation of Red Cross and Red Crescent Societies (IFRC). Containing an epidemic before it spreads uncontrollably saves lives, protects livelihoods and safeguards long-term development.
National Red Cross and Red Crescent Societies can play a key role in epidemic risk management through their vast network of local branches and volunteers.

This case study examines the experience of the Community Epidemic and Pandemic Preparedness Programme (CP3) in the fight against cholera in Cameroon and the Democratic Republic of the Congo (DRC) in 2019 and 2020. Each country has its own context, specific characteristics, opportunities and challenges that influence the implementation of the programme. The study focuses on the activities carried out, the results achieved and lessons learned that can be applied to cholera programmes implemented in other areas at risk from the disease.

What is cholera?

Cholera is a bacterial infection of the small intestine that can cause acute watery diarrhoea and severe dehydration. Without proper treatment, it is one of the deadliest infectious diseases. People who suffer the rapid loss of fluids and electrolytes as a result of the infection can die in a matter of hours if they do not receive prompt treatment. In addition to rapid access to proper treatment, other factors that contribute to preventing and controlling cholera epidemics are a safe water supply, adequate sanitation facilities, health and hygiene promotion, effective surveillance of the disease and an early warning system. In areas where drinking water is not protected from faecal contamination, cholera can spread rapidly through the population. It is communities themselves, when involved and trained in epidemic preparedness and response, that are best placed to detect and contain cholera epidemics, and their actions can save lives and lessen the adverse impact of the disease.

Role of National Red Cross and Red Crescent Societies

In cholera-endemic countries, preparedness activities implemented by National Red Cross and Red Crescent Societies to combat cholera mainly involve the effective deployment of trained volunteers, the provision of water, sanitation and hygiene (WASH) facilities and the pre-positioning of cholera kits. If cases of acute watery diarrhoea are closely monitored, cholera epidemics can be detected at an early stage, allowing rapid treatment of patients in the community and timely referral of severe cases to health centres. This helps to prevent the spread of cholera and saves lives.

Between 80% and 90% of cholera cases are mild or asymptomatic and can be treated in the community with oral rehydration therapy. This is a task that can be performed by trained, motivated volunteers. Less than 20% of people who become infected will develop typical cholera with moderate to severe dehydration.