Managing a diarrhoea epidemic

An epidemic of diarrhoeal disease is always a risk in an emergency situation. Refugees are often crowded together in conditions of poor hygiene and sanitation. There are almost always high numbers of cases of diarrhoea. And if cholera breaks out, it may spread like wildfire. The key to managing an outbreak of diarrhoea is being prepared and setting up a sound system of logistics. MSF teams generally assume that they will have to deal with large numbers of dehydrated people, and prepare themselves accordingly. The MSF response to an outbreak of diarrhoea includes the following elements:
  • setting up decentralised oral rehydration corners where community health workers can treat mild cases as they occur;
  • educating mothers on how to use oral rehydration solution;
  • having trained field volunteers on standby for rapid deployment; use of MSF cholera kits that contain all the equipment and supplies that a team needs in order to be able to start work immediately;
  • prepositioning of kits and supplies in a cholera-prone region; building cholera treatment centres according to a tested MSF design, and centralising here staff-intensive activities such as IV rehydration;
  • training community health workers to identify new serious cases and bring them in for treatment;
  • setting up adequate water supplies and sanitation facilities to limit contagion.