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UNICEF helps respond to cholera outbreak in Congo

Wednesday, 4 February 1998: UNICEF today dispatched emergency medical supplies to help contain a cholera outbreak in the city of Pointe Noire, the Republic of Congo. As of 27 January, 445 cases had been reported in Pointe Noire since November 1997, with 83 deaths attributed to the disease. About 10 new cases are reported every day. Children are among the victims of the outbreak, but more specific information on the numbers of children affected is under investigation.

Cases of severe diarrhoea were first reported in the area of Mvouti, 150 km northeast of Pointe Noire, as early as June 1997 -- the month that a brutal civil war started in the country's capital city, Brazzaville. The outbreak moved to Madingo-Kayes and then further south, with the first case of severe diarrhoea reported in Pointe Noire on 7 November 1997. A total of 1,019 cases and 36 deaths were reported from the earlier outbreaks in Mvouti and Madingo-Kayes.

The Ministry of Health and the World Health Organization (WHO) undertook an assessment mission to Pointe Noire on 24 January, and two hospitals in the city were designated as cholera centres for the isolation and treatment of patients. Laboratory analysis carried out by WHO has confirmed the presence of cholera in the area. A coordination committee has been formed in Brazzaville, with a unit in Pointe Noire, to guide the fight against the disease. The committee is chaired by the Ministry of Health and includes UNICEF, WHO, Médecins sans frontières (MSF) and national water authorities.

Supplies sent by UNICEF to assist in combatting the disease include ringer lactate solution and oral rehydration salts (ORS). These supplies, sufficient for the treatment of about 100 patients, are being provided to regional health authorities in Pointe Noire and will be supplemented with additional cholera supplies to be sent from Brazzaville in the coming days. UNICEF is also organizing activities to raise the local population's awareness of ways to prevent the spread of the disease, including through proper hygiene behaviour and safe water practices.

The effects of the five-month civil war in the Republic of Congo, although fought for the most part in the capital, aggravated an already deteriorating health situation throughout the country. In October 1997, it was estimated that about 150,000-200,000 people displaced from Brazzaville were still staying with friends or family members in Pointe Noire, increasing the city's population by about 50 per cent. Overcrowded and inadequate living conditions, lack of potable water and the weak capacity of local health structures are among the factors contributing to the outbreak and spread of cholera in the area.

In addition, the overall health and nutritional status of the population has been weakened by the impact of the conflict, making people more susceptible to catching and succumbing to diseases such as cholera and measles.

"It is dangerously inaccurate to believe that the scarred buildings of Brazzaville are the only remnants of the war. The conflict has virtually incapacitated the entire country's primary health care system, on which depends the well-being and survival of the population, especially the children and other vulnerable groups," said Eric Laroche, UNICEF Representative for the Republic of the Congo.

"Recent findings and assessments indicate that there is still a serious lack of essential drugs and vaccines in many areas of the country, including the southern regions, and a lingering risk of the complete collapse of the health care system unless adequate assistance and support is rapidly provided," he added.

As part of efforts to help reactivate basic health care services in the area, UNICEF this week is also planning to send essential drugs and vaccine doses to Pointe Noire as well as to Dolisie, which is located about 170 km to the northeast.

In Brazzaville, a six-week vaccination and vitamin A supplementation campaign that started on 12 January 1998 has so far immunized 112,000 children to help prevent an outbreak of measles in the war-ravaged city. The campaign is being undertaken by the Government, UNICEF and MERLIN, with support from OFDA, the U.S. Agency for International Development's Office of Foreign Disaster Assistance. A similar vaccination campaign is being planned by UNICEF and its partners in Pointe Noire.

Insufficient donor response to the United Nations Consolidated Inter-Agency Flash Appeal for the Republic of Congo (Brazzaville) for the period November 1997-January 1998 hindered the capacity of UNICEF and other UN agencies to address the humanitarian needs in war-affected areas of the country. As of the end of January, UNICEF had received only 22 per cent of the funds it had requested in the Appeal. "Lack of response to the Flash Appeal is worrying, as it is an indication of scarce donor interest in the plight of the country and its people," Mr. Laroche said.

Please email with comments or requests for more information, quoting CF/DOC/PR/1998/04.

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