Situation as of 30th October
A virulent outbreak has been claiming victims since mid -May.
The outbreak has proved exceptionally difficult to control. It has now spread to the whole of the country.
As of 28th of October, a total of 12,950 cases have been recorded, with 216 deaths (which makes fatality rate at 1.7%). There have been 165 new cases with 3 deaths during the past two days. For the first time since the beginning of the epidemic, the trend in number of cases is declining for three consecutive weeks.
Although a number of rural areas are affected, most cases have been in the capital, Bissau (8,573 cases and 72 deaths). From 23 August to the 21 October, there have been 4,871 cases in Bissau. Of these, 915 were children, 0 to 14 years of age.
During 27-28 Oct., 37 cases of cholera with a total of 6 children (from 1-14 years old) and no death were recorded at the Re-hydration Centre of the National Hospital Simão Mendes of Bissau. The six pperipheral Re-hydration Centers in the Autonomous Sector of Bissau recorded 42 cases and no death.
With the start of the electoral campaign for the legislative elections that will take place on November 16th - there are concerns of new increase in cases, a people gather in large numbers and travel in absence of adequate hygiene conditions.
A survey conducted in Bairro Militar, one of the most affected neighborhoods of the capital Bissau, reveals that, among families surveyed: 59% washed their hands with soap, 41% protected their food, 35% are desinfecting and storing water in a container, 35% use latrnes.
From the beginning UNICEF has been actively engaged with the Ministry of Health to combat the outbreak, to train government officials, including teachers and hundreds of volunteers on cholera prevention practices. UNICEF also brings in supplies, inclding re-hydration salts, medicines, tents, cholera beds, bleach, sodium hypochlorite, soap, sprayers and communication materal.
The agency has also been mobilizing donors and calling for assistance from qualified organisations not currently active in the country.
A medical health staff member from the UNICEF office in neighbouring Guinea has been drafted in to assist the UNICEF Bissau Cholera Crisis Team. He is supporting the training of partners in the control of the cholera outbreak, with a special focus on appropriate treatment at health centres, implementation of hygienic measures in health centres, while following up on new cases and promoting hygienic practices. On 27-28 September, a training on clinical aspects, health education and sanitation was organized to benefit 114 health staff and community members in the region of Gabu.
A Water and Sanitation Consultant from the UNICEF Regional Office is supporting the reorganization of the strategy for active search and sanitation of the markets in Bissau town by dully trained brigades.
Additional communication materials (posters, brochures) have been printed and are being released to the partners (Government and NGOs) for distribution. Also UNICEF staffs are involved in distribution in their respective areas, near churches, mosques, markets and other public places where large numbers of people assemble. They are working with media to broadcast prevention messages (handwashing, stigma). Since Oct. 12th, RTP-Africa (Portuguese television section broadcasting in Guinea-Bissau) broadcasts spots about prevention (handwashing, water/food treatment). The State television will start on the week of Oct. 20th an information and sensitization campaign with traditional and religious leaders.
An advocacy meeting with the main religious leaders took place on Sept. 11th to seek their involvement in the fight against cholera at family and community levels.
The Minisrty of Education and UNICEF agreed on a plan to implement prevention activities in selected schools in the most affected areas in Bissau and Biombo regions. UNICEF will partner with NGOs to implement the plans in schools. On Oct. 15th, UNICEF supported the celebration of the First Global Hand-washing day in Guinea Bissau, linking this celebration to the fight against cholera, and launching in collaboration with the Ministry of Education the school campaign against cholera, as the new school year 2008-2009 is starting. The school campaign against cholera will focus on promoting hand-washing with soap or ash among school children, and will be facilitated by teachers, with the support of local NGOs.
UNICEF is discussing with the Ministry of Health on ways to ensure that the traditional funeral ceremonies "toca shoro" stop being a majoy way of contamination. An anthropological study will be needed to implement medium- and long-term behavioral change and prevent future epidemics.
In the run up to the elections, following recommendations from the National Inter-agency Technical Committee, the political parties are using the electoral campaign to convey prevention messages on cholera prevention.
To date, the regional breakdown of NGOs (national and international) involved in controlling the cholera epidemic is as follows: MSF Spain (Bissau, Biombo and Oio); MSF Switzerland (Cacheu, Quinara, Tombali, Bijagos, Bolama and starting from next week also Bafata and Gabu); Plan International Guinea Bissau (Bafata and Gabu); MdM Portugal and Spain (Biombo); Nadel (Bissau); Guinea Bissau Red Cross (Quinara, Bolama, Bijagos, Cacheu).
Cholera killed 400 people and infected 25,000 across the country in 2005.
Water and sanitation infrastructures in the capital date from the colonial time, and are totally deteriorated.
In the capital only one in five people have access to tap water, which is not potable.
Cholera is transmitted through contaminated water and human waste.
Young children are particularly vulnerable when struck by cholera and the dehydration it causes.