Floods, legacy of wars drive Africa cholera risk
Pastor Dale Morgan
Floods, legacy of wars drive Africa cholera risk*
By Peter Apps
Reuters
Thursday, March 1, 2007; 4:41 PM
LONDON (Reuters) - Floods, insecurity and war-damaged infrastructure
have combined to raise the risk of cholera in Africa this year and
experts say new methods are needed to fight its spread among the poorest
of the poor.
A bacterial disease that spreads mainly through contaminated water and
causes vomiting, diarrhea and sometimes death, cholera has infected some
12,000 people already in 2007, mainly in a belt spreading through Angola
to Congo.
"The last three years have been particularly bad," Claire-Lise Chaignat,
head of cholera prevention for the World Health Organization (WHO), told
Reuters from Geneva.
"And this year, with all the rains, we are very much concerned about
what is going to happen. We are only in February. Last year in February
we did not have so many cases."
The 2007 cholera death toll already stands at around 320 and WHO
officials fear this year could be worse than 2006, which saw 160,000
cases centering on Angola and Sudan, both countries weakened by decades
of fighting.
The Sudan outbreak spread first from the south into the rest of the
country and into neighbors in the Horn of Africa.
Much of it now appears to have burned itself out but worries persist
about Somalia -- where violence makes surveillance difficult -- and also
Ethiopia, where health officials worry widespread diarrhea might really
be cholera.
"You can definitely draw a direct link between the recent floods in
Somalia and the increased threat of cholera," said CARE International
spokeswoman Amber Meikle in Nairobi.
"Until we have proper humanitarian access it is very difficult to gauge
the extent," she added.
But the real concern for WHO and other agencies remains the ongoing
outbreak in Angola.
HUGE COUNTRY OVERWHELMED
Normally, cholera outbreaks die out after around a year as the immunity
of affected populations increases.
But in Angola -- where two decades of civil war have left the
infrastructure shattered and where sewage and water systems in many
towns have been out of action for years -- it is still reaching
previously unaffected communities.
Aid agencies fear heavy rains might make controlling the outbreak more
difficult still. Already it has crossed the border into parts of
Namibia, the Democratic Republic of Congo and the smaller Republic of Congo.
"It is such a huge country and you get it spreading from province to
province," said Chaignat of Angola. "I think they were overwhelmed by
what happened."
In contrast, aid workers say they have been impressed by Mozambique's
response to the latest floods, which have displaced tens of thousands of
people and raised the risk of disease.
"It is something they have been very aware of. They are trying to get
people out of the camps as soon as possible," said Michael Huggins, U.N.
World Food Program spokesman for southern Africa.
Quick and well-funded responses have often meant success in reducing or
preventing cholera outbreaks. Experts say it is the creeping outbreaks
that attract fewer resources.
QUARANTINE, EDUCATION
"You need a multidisciplinary approach so you deal with the water
sector, the education sector, the health sector and the media," said
WHO's Chaignat.
"They need to practice quarantine and proper health education so people
know where is contaminated and where they can go to get uncontaminated
water.
Health officials should pay more attention to preventing outbreaks
occurring in the first place, she said, possibly using oral vaccines to
immunize populations in areas where it was not immediately possible to
improve sanitation.
But with vaccines costing around $3 a dose and cholera no risk to richer
developing countries, Chaignat said funding is hard to find.
"The sad thing about cholera is that with few means we could make a big
difference," she said. "This affects the poorest of the poor populations."
(Additional reporting by Jeremy Clarke in Nairobi)