Nigeria

Cholera in Nigeria: an outbreak hits IDP camps

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Northeastern Nigeria's Borno State has been suffering from an outbreak of cholera since August 16, 2017

The most affected area is on the outskirts of the state capital, Maiduguri, in the Muna Garage camp, which home to some 32,000 internally displaced people (IDPs). The town of Maiduguri, and the communes of Dikwa, Mafa and Monguno, are also affected by the outbreak. More than 4,800 suspected cases and 61 deaths (as of Oct. 12, 2017) have been recorded in the country since the outbreak began.

AN ALARMING SITUATION IN THE CAMPS

Cholera is an infection caused by ingesting food or water that has been contaminated with the Vibrio cholerae bacteria. It can cause acute watery diarrhea and dehydration.

Cholera spreads most easily in crowded places where hygiene and sanitation conditions are poor and access to drinking water is limited. This is the case in many of Borno State's IDP camps, where people have taken refuge after fleeing the ongoing conflict between Boko Haram and the Nigerian army.

“The situation is quite critical, given the poor living conditions of the people and the apparent rapid spread of the outbreak.” -Doctor Max Yvon Mbangui, project coordinator for ALIMA’s rapid emergency response team in Nigeria

"Many people live in makeshift homes and do not have access to clean water. During the rainy season, parts of the camp are flooded, and the sewage systems are blocked, causing stagnation of dirty water and contaminating clean water sources." - Jean-Paul Mushenvula, ALIMA’s Head of Mission in Nigeria

HEALTH PROMOTION TO STOP THE SPREAD

Health promotion teams traverse the camps to explain how cholera spreads. People are also reminded of good hygiene measures. In particular, it is advisable to wash your hands frequently with soap and clean water, to thoroughly clean and cook food, and to use the latrines or toilets.

"Raising awareness about cholera within these communities is crucial." -Hamman Usman, assistant nurse

REHYDRATE AS QUICKLY AS POSSIBLE

Most cases of cholera can be treated with oral rehydration salts. In severe cases, without treatment, cholera can lead to a patient’s death within a few hours.

In order to treat infected patients as soon as possible, ALIMA installed oral rehydration points in Muna Garage, Muna Customs and two sites in Monguno. ALIMA has also set up four observation sites in Monguno.

20 TO 30 NEW PATIENTS PER DAY DURING THE PEAK

During the peak of the outbreak in Muna Garage, our teams received an average of 100 patients per week.

When a patient enters the center, after washing their hands with chlorinated water, the teams first determine whether this is a suspected case of cholera, and then the severity of disease. Non-severe cases may stay at the center, where they are kept under observation and treated with oral rehydration salts.

Since September 6, ALIMA teams have cared for more than 1,000 patients within our 4 oral rehydration points. After their treatment, patients return home with packets of oral rehydration salts, and continue their treatment for a few more days.

NANA’S STORY

Nana Bukar is 8 years old. She now lives with her mother, Falmata, in the Customs House IDP camp, but is from the village of Dole in Dikwa commune.

"Nana has been vomiting for a week.She has received an infusion, but she isn’t getting better." -Falmata, Nana's mother

Nana's case is diagnosed as severe. The ALIMA teams decide to refer her by ambulance to the nearby cholera treatment center, where she will be hospitalized and receive complementary care.

Like Nana, more than 269 other patients have been referred by ALIMA to cholera treatment centers since the start of operations in September.

DISINFECTING CONTAMINATION SOURCES

“The best way to stop the spread of the outbreak is by reducing person-to-person transmission through individual hygiene and the disinfection of potential sources of contamination, such as dirty water or in marketplaces.” - Dr Max Yvon Mbangui, project coordinator for ALIMA’s rapid emergency response team in Nigeria