Early intervention

In old Khatmia village, nestled beneath the majestic mountains of Kassala, families now face a harsh battle against cholera following the outbreak declared on August 12, 2024. The heavy rains, once welcomed as a source of relief, swept down from the mountains, and contaminated the village’s water sources, spreading waterborne diseases rapidly.

Khatmia, once a safe village, soon became a cholera hotspot, registering alarming numbers of cases and deaths. 

“Six people died in a single day,” recalls Ismail Almanin, a respected community leader and trained medical assistant, reflecting on the devastation that struck his neighbourhood. 

With the sudden influx of internally displaced families fleeing the war, the disease spread even more quickly. The Kassala State Ministry of Health, in partnership with UNICEF, activated an integrated cholera response in affected locations. 

Breaking the silence around cholera 

Despite the growing threat, poor health-seeking behaviours and social stigma surrounding cholera worsened the situation. Many families hid their symptoms, fearful of discrimination, delaying critical treatment and leading to preventable deaths. This stigma created a cycle of fear and silence, allowing the disease to spread unchecked within households. 

To counteract these challenges and reach people with immediate support, oral rehydration points (ORPs) were set up within affected communities, serving both internally displaced people and local residents. 

Oral rehydration points, the lifeline.

Cholera can cause severe diarrhea, which, if left untreated, leads to rapid dehydration and death. A simple yet life-saving solution of water, glucose, sodium, and potassium- known as oral rehydration solution (ORS)- can quickly reverse dehydration. These ORPs were established as critical first-response hubs for administering ORS to those showing symptoms of cholera. 

In Khatmia, the village’s only ORP is hosted in Ismail’s own home. A seasoned medical professional, Ismail didn’t hesitate to offer his space, driven by his deep commitment to serving humanity. 

“This is an act of duty,” he says. “It’s about saving lives.”

On an average day, Ismail treats up to ten people at the ORP, but his work doesn’t stop there. He makes house-to-house visits, ensuring that the most vulnerable, those too weak to reach the ORP, receive timely care. Outside his home, a prominent poster directs people experiencing diarrhea to come for immediate care, a simple but crucial gesture that saves lives. 

UNICEF supplies the essential medical materials needed to keep the ORP running.  Ismail’s role is to provide the initial doses of ORS, guiding patients on how to continue treatment. 

“I start them on oral rehydration salts. In some cases, fluid loss is severe, and this solution helps replace what they’ve lost,” he explains. He hands out additional sachets for subsequent doses and ensures follow-up care for those in need.

If a case is critical, Ismail wastes no time in referring the patient to the nearest health facility. “The goal is to catch it early,” he says. “That’s when we can make a real difference.”

Preventing cholera: a community effort 

Ismail’s success with the ORP is bolstered by a strong community hygiene promotion campaign. Alongside other hygiene promoters, he travels from home to home, teaching villagers about the basic yet essential principles that prevent cholera: clean hands, clean water, clean environments, and early care for suspected cases.

“The community must adhere to the health education we provide,” Ismail urges. His message is clear—Cholera can be prevented, but it requires a collective effort.

As of now, Kassala State has set up 43 ORPs in addition to mobile ones in cholera hotspots, providing life-saving treatment and timely referrals for severe cases. Though the cholera outbreak may seem far from over, the tireless work of people like Ismail gives hope that with early intervention, education, and unity, more lives will be saved.