Niger

Niger: Cholera Outbreak 2021 - Operation Update Report n° 2 DREF Operation n° MDRNE025

Attachments

Summary of major revisions made to emergency plan of action:

The DREF will be extended with one month until 28 February 2022 to give additional time to National Society to implement and complete some few remaining activities as the first update has allow the completion of most of them. This extension will allow NS to catch up with the backlog caused by two main reasons: the organization of the General assembly and administrative and reporting process.

Since the first Operational Update, Niger National Society has been busy with the preparations for the General Assembly which finally impact the operation agenda by keeping administration, staff and volunteers extremely busy. As General assembly is important for the structure organisation, the planification and to set action and strategy, it can’t be delayed. We should also avoid overlapping between this and the Lesson learn workshop as all the required partner and staff are the same to be part of this general assembly such as the MoH, donors, RCRC Movement partners and humanitarian.

For administrative and reporting concern, the completion of the reporting process has taken more time that initially agreed due to monitoring and discussion needed to complete this task and allow additional transfer to NS. In addition, staff changes within the NS during the same period also had an impact on the respect of the initially approved agenda.

With no change to the budget or strategy, this update allows 01 month to carry out the following activities:

  • Completing the remaining CEA activities which are: organization of community meetings, training of community leaders and completing the ongoing CBS

  • Organize the lesson learn workshop with all the relevant local partner and key staff.

To summarize, the one month no-cost extension enables the NRCS to complete the Cholera DREF with the high quality they have been implementing since the start and to assure sustainability for responses to future cholera outbreaks.

A. SITUATION ANALYSIS

On 9 August 2021, the Minister of Public Health of Niger officially declared the Cholera epidemic outbreak in the country during a press conference. As of 16 August 2021, Niger recorded 845 confirmed cases with 35 deaths. Initially located in two regions of the country, (Zinder and Maradi) and National Society’s response was being supported through the regular IFRC’s Country Support Platform (CSP) project with the Global Taskforce on Cholera Control (GTFCC).

Unfortunately, the epidemic spread rapidly and by 24 August 2021, the number of confirmed cases had increased to 1,904 with 70 deaths (4% lethality rate). In addition, the scope of the outbreak spread significantly, from two regions to six regions by 24 August, including Maradi, Zinder, Tahoua, Dosso, Niamey and Tillabery. A total of 23 Health districts in these regions have so far reported cases out of which 18 are already managing confirmed cases. Below is a summary presentation of data as of 24 August.

In the end of September, the region of Diffa registered its first cases since the 2021 cholera outbreak. This news was alarming for the MoH as the cases raised concern that the outbreak was spreading. The situation in Diffa was closely monitored and MoH called on the support of NRCS to increase community-based activities to prevent further spread of cases. After an internal evaluation of the situation by NRCS and its RCRC movement partners, it was decided that the support of ICRC was sufficient to increase the activities in this region of Diffa. By the end of October, two cases were registered in Dosso region leading the MoH to send a laboratory team to assess the situation. The MoH requested the NRCS to support them by setting up an ORP in case cases would increase. The NRCS prepared for this internally, however when the cases registered in Dosso turned out to be isolated cases it was decided not to proceed with the intervention in Dosso region.

The DREF Operation has been running for almost four months to respond to the epidemy. In this period Niger Red Cross Society (NRCS) has provided an adequate response to the cholera outbreak in Niger and through its interventions it has contributed to reduce cholera cases. The operation is constantly adapting to situational changes and this report presents the next steps since last update.

As of 28 November 2021, a total of 5,572 cases and 166 deaths have been recorded, with a 3% lethality rate. At this stage of the outbreak, Niger, across all eight regions, around 02 new cases daily. In week 47, 14 new cases of cholera were reported, mainly two in Bouza, 11 in Diffa and one in Dosso. This means that even though the outbreak is under control in the regions that were hardest hit in the earlier stages of the endemic, Diffa is now experiencing an increase of cases. The elements that could explain this outbreak are the use of water from the Komadougou Yobé river for consumption (Waragou health district). This river is on the border with Nigeria, and it is in November and December that it floods. It is not unusual for Diffa region to experience cholera cases during this time of the year; insufficient community hygiene (lack of latrines, defecation in nature); low level of community knowledge about cholera; and insufficient training of communities’ relays on community case definitions of cholera.

Since the publication of Operational Update 1 on 13 December 2021, no new cholera cases have been reported and the cholera outbreak is over. The last figures of Cholera epidemiologic situation are as below: