Cholera, the poor man's disease, maintains its grip on the DRC mining town of Likasi

Likasi - On the 100 kilometers of tarmac road connecting Lubumbashi and Likasi, the flow of heavy trucks from mining companies is incessant, their skips filled with freshly extracted minerals. In stark contrast to the flourishing mining sector, tens of thousands of people who fled war or misery to settle in Likasi struggle to survive in overpopulated districts wracked by poverty. A few hundred metres away from the elegant colonial buildings that, in the past, earned Likasi its reputation of being "the most beautiful town in the country", the working class district of Kikula has been struggling with a cholera epidemic since early January. The "poor man's disease", which thrives where people live in bad hygiene conditions and without access to drinking water, can kill in up to 50 percent of those infected if it is not treated. Cholera is common in this area, but this year's outbreak is significantly larger than in an average year. "When we responded to the cholera alert on January 24, the hospital in Likasi was completely overwhelmed," Lucia Canziani, the medical manager of MSF's Congo Emergency Pool, recalls. "There was no isolation unit set up for the patients, no chlorine disinfectant, too few means for treating patients properly. The number of patients was rising constantly, and there were three people per bed. We started treating the patients immediately, and at the same time set up temporary structures for taking some pressure off the hospital. We also trained the medical personnel in treating cholera." MSF has set up a cholera treatment centre at the entrance of Kikula district, a poor neighbourhood where most of the patients originate. The risk of contagion is very high and everyone must stick to strict protection measures, both at the entrance and exit of the treatment centre. Moreover, access is restricted and only relatives of children and old people are allowed into the centre. Outside the treatment centre, often several dozens of people are waiting anxiously for news of their relatives admitted into the centre. "We try to reassure family members," explains Dieudonné Bokwala, in charge of community education. "We also take the opportunity to explain some basic rules for protection against cholera: boiling water, cleaning food, washing hands thoroughly before eating, etcetera." Dieudonné has trained a team of 30 in the town's various districts in order to deliver the awareness-raising messages to the heart of the communities. "They are my community intermediaries. They gather families together and circulate the messages on cholera prevention," says Dieudonné. "They also draw attention to the symptoms of the disease and the importance of bringing patients to the centre quickly." At present, too many patients are still arriving in the treatment centre too late. As recently as the beginning of February, 21 people died in one week. The treatment and isolation of patients is now secured, but the epidemic has its roots in the heart of the Kikula community. "The public system of water distribution is out of order," explains MSF's logistician, Azaad Alocco. "With the rainy season, the rubbish and excrement contaminate the water sources and wells. This is where the people get water for drinking, cooking and washing. They have no choice, because they haven't had access to clean water for years." MSF is putting into place a system of safe water supply in response to the outbreak. However, water supply is a major problem which can only be addressed by investment in infrastructure in the long run, in Likasi and other cities of Katanga. The latest figures for the outbreaks in Likasi and Lubumbashi is of 4,623 patients, including over 110 deaths. In Likasi and Lubumbashi, 40 members of MSF's emergency team work alongside more than 200 locally recruited people to stem the cholera outbreak and treat infected people.