Cholera outbreak challenges relief efforts in Malawi's flood-affected communities

GENEVA, Switzerland, February 26, 2015/African Press Organization (APO)/ -- A cholera outbreak is further jeopardizing the health of 230,000 people recently displaced by floods in Malawi. The majority of those affected are living in temporary camps where access to safe water and improved sanitation, both essential for the prevention of an epidemic, is an immediate challenge. The Red Cross, through its solid network of volunteers, is on the ground, constructing new latrines and repairing damaged boreholes, however, without an influx of resources, there is concern that the caseload will increase, increasing the vulnerability of already fragile families.

“The Red Cross is extremely worried that this cholera outbreak will put flood-affected communities at further risk,” said Erin Law, regional health delegate, International Federation of Red Cross and Red Crescent Societies (IFRC). “This outbreak makes it essential that we secure safe water and sanitation facilities for everyone who was left homeless by the floods as soon as possible. It is also vital that we establish detection and referral mechanisms for cholera patients and promote proper hygienic behaviour.”

The Ministry of Health has confirmed 24 cases of cholera in Nsanje district, with one death attributed to the outbreak. Nsanje has been the region hardest by the recent floods which began in early January. Flash flooding and storm damage have destroyed crops, buildings, latrines and water sources, leaving over 146,000 people in the district, homeless.

Displaced communities have gathered in makeshift camps where the high water table has made it almost impossible to excavate latrine pits which are also liable to collapse given the saturated state of the soil. Because the latrines are not always safe or are not available, open defecation has become commonplace in flood-affected areas.

This, combined with rising flood waters, provides an environment rich for the spread of cholera. It is extremely difficult for affected people to ensure their waste water is kept separate from water used for drinking and cooking.

“Basic hygiene practices, such as hand washing, become essential life-saving measures in an emergency like this,” said Law. “The administration of simple oral rehydration therapy to those infected with cholera becomes more important than any other medical intervention.”

Through an emergency appeal, volunteers with the Malawi Red Cross Society, supported by IFRC, have been carrying out hygiene promotion activities in temporary camps in Nsanje. Five cholera kits have been sent to camps in the region. Each kit provides sufficient oral rehydration solution to treat 30 patients suffering from cholera-related dehydration per day. Further community mobilization and sensitization activities focusing on the basics of cholera prevention are also planned.

Malawi Red Cross Society is also working to improve the water and sanitation situation in the camps and surrounding areas, by desludging flooded latrines, constructing new latrines and repairing boreholes. To date, no cases of cholera have been reported inside the camps where the Red Cross is working.

“A lot of work is happening at the grassroots level to prevent this outbreak from growing,” said Michael Charles, acting regional representative, IFRC. “To ensure all flood-affected families receive the emergency life-saving support they so desperately need, we are going to need to scale up our response efforts. We cannot afford to turn a blind eye and let this become another silent disaster.”

In neighbouring Mozambique, also affected by the Zambezi flood crisis, 3,478 cholera cases have been recorded with a death toll of 37. “Cholera is endemic in Mozambique and, while the number of cases is higher than last year, the outbreak is currently being controlled in flood-affected areas,” said Law. “However, there is great concern, due to the relatively easy transmission of the disease and the current flood environment, that the outbreak could spread.”

The Mozambique Red Cross Society, together with Movement partners and through an emergency appeal, is supporting cholera prevention and referral activities, including health education and prevention activities for over 6,000 people, support to the Ministry of Health at cholera treatment centres, and the provision of soap and chlorine water treatment.

Cholera is a bacterial disease which is transmitted via water polluted with human waste, unwashed hands, and contaminated food. Once infected, cholera causes diarrhoea and vomiting that can lead to severe dehydration and death in some cases. Children under five, pregnant and lactating women, and the elderly are most at risk.