Sierra Leone: Slum environment worsens spread of cholera

© Florence Demeulin/MSF Cholera patients at the Marcauley cholera treatment unit in Freetown, Sierra Leone

Sierra Leone’s capital Freetown is currently struggling to contain a cholera outbreak, which has affected over 1500 people and claimed at least 17 lives in the city. Médecins Sans Frontières (MSF), in collaboration with the Ministry of Health, is already running three cholera treatment units in the city, and has treated over 500 patients. The number of people infected is increasing each day, and MSF aims to have two additional treatment facilities up and running in the next ten days.

“We are moving quickly to increase our capacity to handle all the new patients that will arrive,” says Karen Van den Brande, MSF’s Head of Mission in Sierra Leone. “Our present cholera treatment facilities are stretched to the limit with patients. The patients that we see are of all ages, so it’s not just children or people who are already weak that are at risk.”

Many patients come from slum settlements, where proper drainage and waste disposal systems are almost inexistent, leaving people vulnerable to the spread of water-borne diseases like cholera. The city is densely populated, and lies between high mountains and the sea. Many slums are right by the seafront, where waste water is flushed out by the shoreline.

“The living conditions in the slums are a breeding ground for disease. You see children playing with rubbish and bathing in polluted waste water. The central water supply system is dysfunctional and many water points are contaminated. The risk of disease spreading in such places is really high - unless strict precautions are taken.” says Van den Brande.

MSF, in collaboration with the Ministry of Health, is disseminating health promotion messages to the public on how to protect themselves and others against the spread of cholera. This includes washing their hands properly, using only boiled water and making sure that food is cooked or washed before consumption, as well as information on how and where to seek help if needed. 

“It is crucial that people know how to seek help immediately if they are experiencing symptoms. Without help, people can die within twenty hours. Some patients are so dehydrated that they are in a coma when they arrive to us.” says Van den Brande.

MSF has also responded to cholera outbreaks in Freetown in 2006-2007, 1995 and 1986. In 2011, MSF admitted over 130,000 patients to its cholera treatment facilities across the world.

With the opening of two additional cholera treatment facilities in Freetown, the total number of beds will rise from 90 to a maximum of 200. MSF is also planning to open a cholera treatment unit in the town of Bo, where MSF has been managing a hospital since 2003.