How MSF teams treat cholera patients

Cholera is eminently treatable. The main pathological process it causes is dehydration - thus the treatment we use is simply to replace all the fluid being lost. MSF treats many patients using oral rehydration solution, called ORS. This is a mixture of glucose and electrolytes (such as sodium and potassium) that comes in sachets. Each sachet is stirred into a litre of water and provides the correct balance of electrolytes to rehydrate a cholera patient. It has been said that in global terms ORS is the most important medical discovery since penicillin. However many of our cholera patients vomit so profusely that they cannot drink ORS. MSF therefore treats serious cases by putting in intravenous drips. These IV infusions contain fluid and electrolytes. Some patients lose fluid so quickly that they need two drips, one in each arm. The challenge for an MSF doctor or nurse is to find a vein in a profoundly dehydrated patient - for as the patient loses fluid their veins collapse. Treating serious cases requires a high degree of skill and experience. In most situations MSF teams are able to limit the case fatality rate to less than one per cent.