1. EXECUTIVE SUMMARY
The United Nations Children’s Fund (UNICEF), the World Health Organization (WHO) and their national government partners, primarily the ministries of health as well as engaged Non-Governmental Organisations (NGO) in the region are acutely aware of how cholera kills and threatens the already fragile health situation of men, women and children in the affected countries. The current wave of cholera outbreaks in the West and Central Africa region started in June 2005 and has so far affected the ten countries of Burkina Faso, Gambia, Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Senegal and Sao Tome & Principe. This appeal covers needs that continue to be of concern in The Gambia, Guinea Bissau, Mali, Mauritania, Senegal and Sao Tome & Principe where a total of 51,976 cases and 814 deaths have been registered this year as of 20 October (1). In addition to the human suffering, cholera outbreaks cause panic, disrupt the social and economic structure of affected communities, put tremendous strain on already precarious health systems and impede the development process. The situation in Burkina Faso, Guinea, Liberia and Niger is under control. There is no need for additional support to address the current situation. The response to the cholera epidemic in Niger has been incorporated into the response to the Niger crisis (Food, Nutrition and Health).
The latest data of UNICEF/WHO on the epidemiological curve by country (see country profiles below) show a general trend towards continued reduction of weekly cholera cases and deaths except for Guinea Bissau. The threat of continued suffering, however, remains very high, as the situation in many countries has worsened by extremely tense humanitarian situations and the current rainy season. Without action, populations face a vicious circle of continued suffering, with inadequate preparedness for a similar outbreak next year.
The various country situations can be summarised as follows:
The Gambia: 17 Cases with 4 deaths occurred between 8 and 23 September representing a high case fatality rate (CFR= 24%). 11 out of the 17 cases are females (65%) between the ages of 22 - 60 years. All the reported cases are from Western Division mostly Brikama Santo Su.
Guinea-Bissau: 21,278 cases including 343 deaths (CFR 1.6%) occurred between 6 June and 26 October in the country. The regions of Bissau and Bimbo account for 77% of cases; cholera has spread to all 11 regions of the country, 82% of the cases have occurred in Bissau, Bjombo and Bijagos. A WHO expert is currently providing technical support to the Ministry of Health for the implementation of the recommendations issued by an earlier WHO mission.
Mali: 158 cases including 20 deaths (CFR 12.65%) have occurred between 20 June and 24 July. Recently there has been a resurgence of cholera cases with 40 cases and 1 death reported from Kayes between 3 and 16 October. Heightened awareness and intensified prevention and preparedness activities are recommended.
Mauritania: A total of 2,930 cases including 49 deaths (CFR 1.7%) have been reported from 6 districts between 20 July and 27 September 2005. Nouakchott accounts for 89% of all the cases. A technical support team is being dispatched by WHO to adapt ongoing control measures.
Senegal: A resurgence of the cholera outbreak, which started early this year, has recently occurred. The capital city, Dakar, is most affected, due to the unusually heavy rains. To date, a total of 27,461 cases including 394 deaths (CFR 1%) have been reported during the outbreak, which began in January and peaked at the end of March.
Sao Tomé & Principe: A resurgence of cholera, which started on 15 April, has occurred in 5 districts (Agua grande, Cantogalo, Lemba, Lobata, MeZochi) due to water and sanitation problems. A total of 132 cases including 4 deaths (CFR 3.3%) have been reported during the outbreak.
This appeal covers needs for the following countries: The Gambia, Guinea Bissau, Mali, Mauritania, Sao Tome & Principe and Senegal. Further, it will cover the needs for providing WHO and UNICEF technical support and coordination, as well as for an inter-country meeting to analyse the response provided and to get prepared for the forthcoming cholera season. A total amount of US$ 3,241,637 is requested to assist the governments of The Gambia, Guinea-Bissau, Mali, Mauritania, Sao Tomé and Senegal to prevent the epidemic to spread further across countries and within the region.
TABLE OF CONTENTS
1. EXECUTIVE SUMMARY
Table I: Summary of Requirements – By Sector
2. CONTEXT AND HUMANITARIAN CONSEQUENCES
2.1 THE GAMBIA
2.2 GUINEA BISSAU
2.4 SAO TOME & PRINCIPE
3. RESPONSE PLANS
Table II: List of Projects – By Sector
Table III: List of Projects – By Appealing Organisation
Annex I. ACRONYMS AND ABBREVIATIONS
This appeal covers the needs of the vulnerable population in The Gambia, Guinea Bissau, Mali, Mauritania, Sao Tome & Principe and Senegal for a period of 6 months following the outbreak of cholera in the West Africa region.
Note: The full text of this revised appeal is available on-line in Adobe Acrobat (pdf) format and may also be downloaded in zipped MS Word format.
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(1) WHO Global Task Force on Cholera Control 20 October 2005 and UNICEF / WHO AFRO update 26 october 2005
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