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UNICEF helps fight cholera outbreak

© UNICEF Angola/2006/Mendonça
This tent is part of the cholera treatment and control centre in the Boavista neighbourhood of Luanda, Angola.

By José Luís Mendonça

LUANDA, Angola, 2 March 2006 – Fifteen-month-old Jorge Rufino smiled when his photo was taken, even though he was still recovering from a bout with cholera. Jorge was lucky: His mother Maria Luísa had brought him in to UNICEF’s cholera centre as soon as he became ill.

Jorge responded well to the attentions of the doctors working in one of two large tents set up by UNICEF. About 72 hours after he was brought in, his appetite had returned and he was attempting to eat small amounts of fish again with help from his mother.

Sanitation conditions for Maria Luísa and the other 10,000 people who live in the Boavista neighbourhood of Luanda are, in a word, appalling. There is no piped water supply and very few houses have latrines. It should have come as little surprise when on 19 February the Angolan Ministry of Health announced that cholera had broken out in the neighbourhood.

So far, ten people have died from the disease and 102 cases have been reported.

© UNICEF Angola/2006/Mendonça
Jorge Rufino 15 months, recuperates in the cholera treatment control centre in Boavista,. Jorge’s mother brought him in at the first sign of illness.

Cholera is spread through poor sanitation and hygiene practices and contaminated drinking water. It causes severe attacks of diarrhoea that, without treatment, can quickly lead to acute dehydration and death.

Social mobilization

In response to the outbreak, government officials in Luanda formed a response team with representatives from the Ministry of Health, the Provincial Government, UNICEF, the World Health Organization (WHO) and the international NGO Médecins Sans Frontières.

They have attacked cholera on four fronts: epidemiological surveillance and water and sanitation, case management, logistics and communication, and social mobilization.

UNICEF’s role in the effort involves supply and logistical support, communication and social mobilization. The organization has set up two large tents for the isolation of patients, and is distributing oral rehydration salts, soap, boots, gloves, essential drugs and chemicals for water purification throughout the affected area.

© UNICEF Angola/2006/Mendonça
Paulo, 18, and his team, building the base for a new water tank in Boavista.

“At this moment, case management is well organized,” says UNICEF Angola Health Officer Dr. Guy Clarysse. “The mortality rate is declining now, because the public is aware of the situation and they quickly run to the cholera centres for good treatment.” Dr. Clarysse says that providing sufficient supply of safe water for daily consumption is essential to the effort against the disease.

Social mobilization helps to disseminate essential knowledge and distribute important supplies. The presidents of the neighbourhood committees in Boavista help gather residents for public meetings, where they listen to health talks and receive printed information. Each family also gets one litre of a chlorinated water solution which they can use to purify their home water supply.

Addressing root causes

UNICEF is helping the neighbourhood committees install plastic water tanks with a capacity of 5,000 litres. Paulo, 18, is among the volunteers who are installing the tanks. “We are pushing to have this platform ready in two days,” he said as he piled up bricks and cement needed for the job.

Dr. Clarysse said that Luanda, Angola’s capital, has some serious challenges related to urbanization. “The current uncontrolled growth of slums doesn’t allow for basic services to cope with hygiene, sanitation, garbage and excreta disposal. In the short term, the interventions are likely to control the current epidemic and possibly stop it.

“But as the basic conditions remain the same and new outbreaks are possible, epidemiologic surveillance will remain very important until the root causes have been more adequately addressed.” Dr. Clarysse says changing the basic conditions will take a long-term effort.



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Common water and sanitation-related diseases

The importance of hygiene

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