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Appeal No. 35/02; Launched on: 17 December 2002 for 3 months for CHF 160,000 (USD 111,901 or EUR 108,862) to assist 250,000 beneficiaries. Programme was extended by three months to end of May 2003. Appeal coverage: 65.7% Disaster Relief Emergency Fund (DREF) Allocated: CHF 10,000 (reimbursed)
Summary
Since 19 September 2002, the Democratic Republic of the Congo (DRC) experienced a particularly long epidemic of cholera - more than 6 months -- affecting most of the territory in the province of Eastern Kasaï. The epidemic involved 5,008 cases and resulted in 263 deaths, a case fatality rate of 7.77%.
Table 1 below summarizes the evolution of the epidemic from its inception on 19 September 2002 up to 31 May 2003. This table emphasizes the fact that this epidemic was particularly long, extending to nine months whereas such epidemics rarely exceed three months. Two reasons for this have been repeatedly advanced:
i. Insufficient family latrines, due to the high rock composition of the soil making it difficult to dig. Based on a survey performed by the Red Cross of the Democratic Republic of Congo (RCDRC) in January 2003, only 17.37% of the plots visited have toilets or latrines;
ii. Low rate of access to quality water: 21.3% of the plots visited have access to water from the Regideso (water distribution company), and the rest drink water from unprotected wells or springs and placed downstream from inhabited areas, where the few existing latrines have a depth of less than 1 metre.
In week 21, the epidemic flared up in a further spurt and the number of cases increased exponentially, rising from 45 cases (26 May) to 64 cases (27 May) and then to 84 cases (29 May) in the two mining areas of Luamuela and Bakua Tshimuna. In the last week of May, the total number of cases for the province was 125, with 6 deaths (source: Meeting of the Crisis Committee on 30 May 2003).
In terms of geographical distribution, 68.32% of recorded cases came from the town of Mbujimayi and only 31.68% from the interior of the province, in particular the diamond mines where the diggers relieve themselves in the open.
Table 1: Distribution and localization of cases and deaths by week
|
WEEKS OF THE EPIDEMIC
|
TOTAL NUMBER OF CASES
|
TOTAL NUMBER OF DEATHS
|
Case fatality (%)
|
||||
|
Mbujimayi
|
Interior province
|
Total cases
|
Mbujimayi
|
Interior province
|
Total deaths
|
||
|
Week 1
|
3
|
3
|
2
|
2
|
0.00
|
||
|
Week 2
|
9
|
10
|
19
|
5
|
4
|
9
|
54.17
|
|
Week 3
|
11
|
48
|
59
|
9
|
9
|
30.51
|
|
|
Week 4
|
33
|
81
|
114
|
9
|
9
|
15.79
|
|
|
Week 5
|
32
|
97
|
129
|
17
|
17
|
26.36
|
|
|
Week 6
|
36
|
119
|
155
|
3
|
3
|
6
|
5.70
|
|
Week 7
|
123
|
72
|
195
|
11
|
2
|
13
|
7.77
|
|
Week 8
|
129
|
56
|
185
|
6
|
6
|
12
|
9.42
|
|
Week 9
|
156
|
29
|
185
|
5
|
3
|
8
|
5.79
|
|
Week 10
|
124
|
77
|
201
|
10
|
8
|
18
|
12.32
|
|
Week 11
|
151
|
77
|
228
|
10
|
5
|
15
|
8.40
|
|
Week 12
|
159
|
73
|
232
|
12
|
6
|
18
|
9.84
|
|
Week 13
|
144
|
55
|
199
|
4
|
9
|
13
|
10.84
|
|
Week 14
|
130
|
46
|
176
|
8
|
7
|
15
|
11.96
|
|
Week 15
|
176
|
51
|
227
|
10
|
2
|
12
|
5.91
|
|
Week 16
|
198
|
64
|
262
|
1
|
7
|
8
|
5.70
|
|
Week 17
|
194
|
35
|
229
|
7
|
4
|
11
|
6.36
|
|
Week 18
|
242
|
21
|
263
|
12
|
3
|
15
|
6.55
|
|
Week 19
|
220
|
32
|
252
|
11
|
1
|
12
|
4.94
|
|
Week 20
|
196
|
35
|
231
|
2
|
2
|
1.73
|
|
|
Week 21
|
136
|
42
|
178
|
3
|
5
|
8
|
7.18
|
|
Week 22
|
99
|
65
|
164
|
1
|
4
|
5
|
5.45
|
|
Week 23
|
122
|
39
|
161
|
2
|
2
|
1.23
|
|
|
Week 24
|
63
|
38
|
101
|
3
|
3
|
5.94
|
|
|
Week 25
|
40
|
33
|
73
|
1
|
1
|
1.35
|
|
|
Week 26
|
43
|
45
|
88
|
1
|
1
|
2
|
3.37
|
|
Week 27
|
19
|
41
|
60
|
2
|
1
|
3
|
6.45
|
|
Week 28
|
23
|
39
|
62
|
1
|
1
|
1.59
|
|
|
Week 29
|
52
|
31
|
83
|
1
|
1
|
2.41
|
|
|
Week 30
|
69
|
38
|
107
|
3
|
3
|
5.61
|
|
|
Week 31
|
57
|
24
|
81
|
1
|
1
|
2.47
|
|
|
Week 32
|
41
|
17
|
58
|
1
|
1
|
2
|
5.08
|
|
Week 33
|
42
|
12
|
54
|
0.00
|
|||
|
Week 34
|
33
|
15
|
48
|
1
|
1
|
4.17
|
|
|
Week 35
|
11
|
12
|
23
|
0.00
|
|||
|
Week 36
|
32
|
91
|
123
|
6
|
6
|
9.76
|
|
|
TOTAL
|
3,345
|
1,663
|
5,008
|
127
|
136
|
263
|
7.77
|
Source: "Stop Cholera" Crisis Committee
Once the Government officially declared the epidemic on 25 September 2002, the RCDRC Provincial Committee became immediately and actively involved in efforts to combat this epidemic. This committee is a member of the "Stop Cholera" Crisis Committee set up by the Ministry of Health; other members include Médecins Sans Frontières (MSF), Oxfam, Health Net, COOPI and several other organizations. Three main lines of action were pursued:
- Social mobilization;
- Disinfection and burial;
- Water and sanitation.
The operation, originally planned for three months, was extended to allow for the construction of public toilets and family latrines. This operation was coordinated by a team from the Provincial Committee and was supported by a regional resource person, a member of Central Africa Regional Disaster Response Team (ERDAC); it was carried out with financing from the Swedish Red Cross, the Netherlands Red Cross and the Canadian International Development Agency (CIDA).
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