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Congo, Democratic Republic of the

Fighting cholera, a deadly threat to child survival in DR Congo

© UNICEF DR Congo/2011/Walther
Yesifa Kaonda, 13, and his mother are visibly shaken after five days at a cholera treatment centre in DR Congo, where the boy was hovering between life and death.

By Cornelia Walther

KINSHASA, Democratic Republic of the Congo, 13 July 2011 – “I have never been as worried as during the past three days,” sighs Maman Vombi Sidania. After a night of continuous vomiting and diarrhoea, her granddaughter Mimi, 11, was taken to the health centre in Maluku. There, the girl was diagnosed with cholera – and a potential death sentence from dehydration.

Yet following treatment with oral rehydration salts at the cholera treatment centre set-up by UNICEF partner COOPI in Kinshasa, Mimi can smile anew.

The current cholera outbreak has sickened thousands in DR Congo, It began in March in the city of Kisangani, located in the eastern part of the country, where it affected over 1,400 people and caused 74 deaths. Along the river, it spread via water, boats and travellers into Equateur, Bandundu and the capital, Kinshasa – home to 10 million people.

Crowded conditions

Modern sewage and water treatment have virtually eliminated cholera in industrialized countries. But the disease persists in some places, including DR Congo, where cholera epidemics are endemically recurring in North Kivu, South Kivu and North Katanga provinces.

The risk of cholera is highest when poverty or disaster forces people to live in crowded conditions without adequate sanitation.

© UNICEF DR Congo/2011/Walther
Precautions for health workers leaving a cholera treatment centre in DR Congo include handwashing with diluted chlorine solution and disinfection of shoes.

Today, less than one in seven Congolese lives in acceptable hygienic conditions, and barely half of the population has access to safe drinking water. This situation has hardly changed over the past 10 years. Defecation in the open air and consumption of water from unprotected sources are common practices all across the country, particularly in rural areas.

Need for rehydration

Causing a loss of up to 10 per cent of body fluids, cholera can be fatal in a matter of hours. Yet in most cases, the disease can be treated successfully with oral rehydration therapy. In severe cases, intravenous rehydration may be necessary; Ringer's lactate solution is preferred for this.

Since the beginning of the current outbreak in DR Congo, UNICEF has provided 2,700 litres of Ringer’s lactate solution and 20,000 sachets of oral rehydration salts to health centres in the three affected provinces.

One cholera sufferer, Yesifa Kaonda, 13, received 11 litres of Ringer’s lactate over three days to quickly replace lost fluids. Now he is able to eat again. “I felt so bad, I thought I would die. But now I start to feel okay,” he says.

Children highly susceptible

About 100 million bacteria must typically be ingested to cause cholera in a healthy adult. This quantity is found in one glass of contaminated water. Children are more susceptible, and two- to four-year-olds have the highest rates of infection. While only 1 in 10 infected people develop the typical symptoms of cholera, they can infect others through contaminated water by shedding cholera bacteria in their stool for up to 14 days.

© UNICEF DR Congo/2011/Walther
Mimi Vombi, 11, seen here with her grandmother, is now out of immediate danger but still under observation following a cholera diagnosis and treatement in DR Congo.

To prevent a massive spread of the epidemic the two main concerns in DR Congo today are access to safe drinking water, a governmental responsibility, and hygiene measures, which can be taken by each individual.

"Health starts in every family,” Dr. Victor Makwenge Kaput, Minister of Public Health, said at a press conference held in Kinshasa on 8 July. “Five actions must become a routine for all of us: handwashing with soap before eating and after using the toilet, using appropriate latrines, eating only thoroughly cooked food, boiling water before consumption, and not handling the corpses of the deceased."

Safe water and hygiene

To ensure safe drinking water supplies, UNICEF has provided 460,000 Aquatab water-purification tablets for the disinfection of potentially contaminated water. And water-treatment points have been established along the river in the affected areas.

"It is important that people understand the importance of washing their hands and cleaning their immediate living environment,” said UNICEF Representative in DR Congo Pierrette Vu Thi. “Yet these precautionary actions will not fulfil their full potential without the provision of clean water. We have a shared and individual responsibility to protect all children from disease.”

Together with its partners, UNICEF is organizing a mass communication campaign to sensitize families in Equateur, Bandundu and Kinshasa about hygiene practices. Building on the community networks that have been established for the fight against polio, religious and traditional leaders, parents and authorities are being mobilized on a large scale for a shared purpose: protecting their communities from suffering.



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