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First cholera outbreak in 50 years in Papua New Guinea moves from small town to provincial capital

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Papua New Guinea's Angau Hospital in Morobe Province, on the northern shore, is on high alert and treating people affected by an already deadly outbreak of cholera. This is one of the first known cholera outbreaks in Papua New Guinea in the last 50 years.

As of Sept 3, 95 cases of cholera were confirmed – including nine deaths – in Wasu, Morobe Province. This is a relatively worrying number as the small community of Wasu has a population of about 12,000. Cholera has also spread to the city of Lae, the provincial capital and the country's second largest metropolitan area.

Eleven suspected cases have been admitted to Angau Hospital, located in the city of Lae, and three patients have died.

Médecins Sans Frontières (MSF) is responding by assisting the Ministry of Health in setting up a cholera treatment centre in the hospital. An isolation ward has been established, which includes disinfection points and footbaths. MSF's emergency team has sent seven additional staff, including three nurses and a water and sanitation specialist, to assist in the urgent response.

Cholera is a highly contagious disease. The bacteria vibrio cholerae is excreted by an infected person in stool and vomit. It can spread directly to other people if they touch the patient and fail to wash their hands. The bacteria can also contaminate food or water supplies. In the latter case this can cause a massive outbreak because many people will ingest the bacteria in a short period of time.

A patient may require up to 10 to 15 litres of intravenous fluid on the first day. A person who is not treated will die of dehydration well before this. Death usually occurs when 10 to 15 per cent of the total body weight is lost. In severe cases, this may take only a couple of hours.

In addition to the cholera outbreak in Wasu and Lae, outbreaks of influenza A and shigella have been identified in Menyama, also in Morobe. MSF is currently assessing the situation.

Papua New Guinea has the worst health indicators in the Pacific region: maternal and infant mortality rates are high. Malaria, pneumonia and tuberculosis are prevalent health problems. HIV/AIDS is a growing health issue (2% of the population is HIV-positive). Violence at all levels of the society presents a huge problem. Physical and sexual violence against women and children in Papua New Guinea is extreme. Two out of three women experience domestic violence and 50 percent of women have experienced forced sex, rape or gang rape. Children too suffer enormously from daily abuse and some men as well.

MSF has worked in Papua New Guinea since 2007 and supports a clinic in the eastern city of Lae. In September 2008, MSF started providing surgical care for victims of violence in the local hospital in Tari, a town in the western part of the island.