Ghana: Cholera DREF operation Final Report n° MDRGH007

Situation Report
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Summary: CHF 122,571 was allocated from the IFRC’s Disaster Relief Emergency Fund (DREF) on 7 May 2012 to support the national society in delivering assistance to some 300,000 beneficiaries in the Greater Accra and the Eastern Regions of the country.

In April 2012, the Ministry of Health declared a cholera outbreak in the Greater Accra Region. According to the Ghana health service, in the second week of April 2012 there were 684 reported cases of cholera with 17 deaths. This figure doubled after only one week with the cause of the outbreak associated with poor sanitary conditions in the affected communities. In Eastern region, the situation was further exacerbated by irregular piped water supply that made the residents depend on stream water for their daily use. The cholera cases and deaths increased steadily with nationwide figures from Ghana Health Service (GHS) of about 6,000 cholera cases with 69 deaths reported at the end of August 2012.

The operation lasted for three months, during which time community assessments were carried out, volunteers were trained, health education and cholera awareness and prevention activities were carried out, water and sanitation activities performed, and cholera prevention items distributed to vulnerable households, by the Ghana Red Cross Society (GRCS).

The community assessments done determined risk factors and gaps in cholera control in the selected communities and also revealed that the main reason for the spread of cholera cases was poor sanitation.

GRCS trained 200 locally recruited volunteers who carried out activities on health preventive measures on cholera and diarrhea in their communities. These trained volunteers reached over 50,000 households with health messages on cholera and its prevention. House to house visits were performed, and community gatherings, focus group discussions, role plays and community sessions were organized in markets, schools, religious places, etc. Radio jingles were broadcasted and posters put up in the community on cholera prevention and personal hygiene.

As part of the cholera prevention activities, the GRCS volunteers also met with traditional and religious leaders as well as with headmasters of schools, to advocate for communal activities promoting community clean-up exercises and personal hygiene messages. The GRCS volunteers engaged the schools in awareness raising campaigns through their teachers, and with support from traditional, community and religious leaders, the GRCS volunteers mobilized communities for mass clean–up exercises. Advocacy efforts towards the government on the importance of addressing sanitary problems, rendered positive results through agreement on joint community mobilization and clean up campaigns.

The DREF operation proved to be very timely for social mobilization for cholera vaccination performed by the government, as well as for the introduction of two new vaccines (Pneumococcal and Rotavirus). While the Ministry of Health (MoH) rolled out the vaccination campaigns, GRCS volunteers were trained to include these messages in the cholera preventive messages, community sensitization and house to house education.

To improve the quality of the water for households, cholera related non-food items (NFIs) were distributed to 12,000 most vulnerable households (that took their drinking water from wells and river sources). The NFIs provided by the DREF was insufficient to cover the increasing number of vulnerable households therefore the NS backed it up with extra NFIs reserve from the DM stock. These items were donated to the families in the most affected communities, to contribute to safer water and improved sanitation for households. Additionally, household water treatment demonstrations were provided by community volunteers.

Although, there were still cases being reported at the end of the intervention, it is believed that the cholera response and prevention activities performed by the GRCS contributed positively to behavioral change and decreased sanitary risks among the targeted population. This in turn decreased cholera cases transmissions in the targeted communities. The fact that GRCS could extend the scope of the operation to also include newly affected regions with information, education and communication (IEC) material on cholera prevention reflect their ability for rapid response towards these kinds of epidemics, and also contributed to reduce the community’s risky behavior.

The spread of the cholera epidemic to new regions during the course of the DREF operation, posed a challenge for the actors involved. Other challenges involved the attitudes among some of the community members that preferred self-medication at the early signs of diarrhea, which mostly did not prove effective against the cholera.

A total of CHF 785 that was unspent at the close of the operation has been returned to DREF.
Contributions from ECHO replenished 80% of the allocation made for this operation. The major donors and partners of DREF include the Australian, American and Belgian governments, the Austrian Red Cross, the Canadian Red Cross and government, Danish Red Cross and government, the European Commission Humanitarian Aid and Civil Protection (ECHO), the Irish and the Italian governments, the Japanese Red Cross Society, the Luxembourg government, the Monaco Red Cross and government, the Netherlands Red Cross and government, the Norwegian Red Cross and government, the Spanish Government, the Swedish Red Cross and government, the United Kingdom Department for International Development (DFID), the Medtronic and Z Zurich Foundations, and other corporate and private donors. The IFRC, on behalf of the National Society, would like to extend thanks to all for their generous contributions. Details of DREF contributions can be found on: