In Lusaka, the capital city of Zambia, Médecins Sans Frontières (MSF) is responding to the worst cholera outbreak in the country for many years. Over the last five weeks the number of cholera cases has risen dramatically to more than 4,500, while more than 120 people have lost their lives.

Despite hopes that the outbreak had reached its peak and the number of cholera cases would start decreasing, continuing heavy rains have caused severe floods in the city and could potentially worsen the situation in the coming weeks.

MSF teams are working around the clock to treat people affected by cholera and try to contain the spread of the outbreak. MSF satff have set up three cholera treatment centres (CTC) in Matero, Chawama and Kanyama, with a capacity of 567 beds, and is also supporting 17 cholera treatment units (CTU).

Since March 4, MSF teams in collaboration with the Ministry of Health have treated 4,020 patients in the three CTCs.

“Last week we suffered the peak of the outbreak with a total of 1054 cases admitted.  This number of cholera cases is by far the highest recorded in the last decade,” said Luke Arend, Head of Mission of MSF in Zambia. “Due to the severity of this outbreak, we are stepping up our intervention, in close collaboration with the Ministry of Health of Zambia.”

Besides providing direct treatment to cholera patients, MSF is also working intensely to prevent the spread of cholera in the worst hit areas of the city. MSF water and sanitation staff are providing over 500,000 litres of chlorinated water per day in the affected neighbourhoods of Lusaka, while nearly 50 contact tracers are working every day to disinfect the homes of cholera patients, providing people chlorine for treating their water and teaching them of safe practices to avoid transmission.

MSF is also supporting another team of drainage diggers to remove flood waters in the worst affected areas.

More than 100 volunteers, with the help of a drama group, are conducting outreach activities in the communitiesto inform people on how to prevent the spread of the disease. MSF has also produced a television announcement about the prevention of cholera that is being aired on the national television channel.

Cholera is endemic in Zambia. Over the previous years, Lusaka has seen repeated outbreaks during the rainy season. The lack of provision of drainage, access to clean water and poor hygiene and sanitation conditions are the route causes of the recurrence and severity of outbreaks.

“The vast majority of the population in Lusaka is living in such conditions that make them extremely vulnerable to cholera due to the lack of access to safe water, drainage and good sanitation facilities,” said Arend. “What is clear is that much more has to be done by the authorities in the short-term to improve cholera response preparedness and to avert the needless loss of so many lives each year.

“There is also a need for political commitment to long-term infrastructural investment in drainage, sanitation and water provision in these unplanned peri-urban areas of Lusaka to rid the city of this deadly cholera. For far too long there has been neglect in provision of these basic services.”

MSF has been working in Zambia since 1999. In this cholera emergency intervention, 17 international staff are working alongside more than 500 Zambian colleagues in Lusaka.