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Cholera intervention in South Kivu

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Floods aftermath: cholera emergency in Mozambique — Heavy rains pounded the region in January, provoking severe floods in nearby Malawi. Outbreaks of cholera, a water-borne disease, usually last one to two months and are stopped by the dry season.

Cholera - the water thief

War in Gaza:: find out how we're responding

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Photo Story7 April 2015

There are many ways to steal water. Close a tap. Block access to a river. Drain a well. Or, more viciously: steal life out of it.

This is what cholera does. It creeps into its victims when they drink or eat, and once inside their bodies it keeps on looting: it siphons water, making it gush out, from vomit and from diarrhea, continuously, relentlessly. In the most extreme cholera cases an adult can lose up to twenty liters of water in just one day. Death is quick to follow.

Floods aftermath: cholera emergency in Mozambique — Since early February over 7,400 people have become sick because of cholera in Mozambique. A third have been treated in the Tete city cholera treatment centre (CTC), set up by MSF and co-managed by Mozambican health authorities.

Floods aftermath: cholera emergency in Mozambique — Early in the morning, Jacinta Fernando arrives at the Tete CTC with her one-and-a-half-year-old son, Midio. He started to develop symptoms during the night and is already in critical condition.

Floods aftermath: cholera emergency in Mozambique — A woman arrives at the CTC to visit her husband who is recovering from cholera. Contrary to many other provinces of Mozambique where cholera is endemic, Tete hadn’t had an outbreak since 2009, so many people hadn’t developed resistance to the bacteria and were therefore more susceptible to getting sick. Eighty per cent of the people infected by cholera do not develop symptoms but can still unknowingly spread the disease.

Floods aftermath: cholera emergency in Mozambique — In the most severe cholera cases, thankfully rare, an adult can lose up to 20 litres of water within a day, which leads to death. But with proper rehydration treatment mortality falls to below 1 per cent of the severe cases.

Floods aftermath: cholera emergency in Mozambique — Dr Claudio Machalela is an AIDS paediatric specialist who was on holiday when he responded to MSF’s call for medics to staff the CTC. As Mozambique has one of the lowest ratios of health professionals per person in Africa, there were very few local professionals who could be quickly deployed for an emergency response.

Floods aftermath: cholera emergency in Mozambique — About eight hours after arriving to the CTC, one-and-a-half-year-old Midio stabilised, thanks to the standard rehydration protocol, and was discharged a few days later. Children under five years old are particularly vulnerable to cholera. It can cause such severe dehydration that death can follow as quickly as within six hours. Three-year-old Mauro, who arrived at the CTC at the same time as Midio, succumbed within two hours of his arrival.

Floods aftermath: cholera emergency in Mozambique — MSF’s field coordination manager Renato Souza checks the condition of 18-year-old Manuel Rui who just arrived at the CTC and was given rehydration solution intravenously.

Floods aftermath: cholera emergency in Mozambique — 71-year-old Daniel Bila is recovering from cholera. He comes from Samora Machel bairro, one of the neighbourhoods most affected by the outbreak sweeping through Tete region.

Floods aftermath: cholera emergency in Mozambique — Following the recent mining boom around Tete, tens of thousands of people came looking for jobs, from other provinces of Mozambique as well as neighbouring Malawi and Zimbabwe. But provision of basic services did not keep up with quick population growth.

Floods aftermath: cholera emergency in Mozambique — Cholera is passed on through the ingestion of contaminated water, and it strives where too little has been done to protect the purity of water sources. In Mozambique only 84 per cent of the urban population, and 37 per cent of rural people, have access to improved water sources.

Floods aftermath: cholera emergency in Mozambique — Heavy rains pounded the region in January, provoking severe floods in nearby Malawi. Outbreaks of cholera, a water-borne disease, usually last one to two months and are stopped by the dry season.

Floods aftermath: cholera emergency in Mozambique — “People of Samora Machel! Protect yourselves from cholera!” calls MSF counsellor Ana Maria Jomaze. Sensitisation of vulnerable populations is an essential component of a successful cholera response.

Floods aftermath: cholera emergency in Mozambique — Gabriela Fernando, MSF counsellor, explains to residents of Dégué village how to avoid getting infected by cholera and the procedure to follow when one starts developing symptoms. In the past week five people, all of them children, got sick because of the bacteria. One died, an eight-year-old.

Floods aftermath: cholera emergency in Mozambique — Gabriela is distributing certeza, a chlorine solution used to treat drinking and cooking water to avoid infection. “You know, some people complain that certeza makes water taste bad. But will you use it?” she asks. Everyone agrees.

Floods aftermath: cholera emergency in Mozambique — 77-year-old Francisco Saene is weakened by a finishing bout of malaria. Two of the CTC’s patients live less than 50 meters from his home, but he says he’s not afraid. “I can’t afford to be frightened,” he says. “If I get sick, there would be no one to take care of me. I can’t lose my head.”

Up Next

Mozambique

Cholera - the water thief

Voices from the Field 2 April 2015