When cholera strikes: UNICEF’s efforts to stem the tide of global outbreaks
Find out how UNICEF is responding to a worrying spread of the deadly disease.
Cases of cholera, also known as acute watery diarrhoea (AWD), are surging around the world. Since 2021, many countries that had not reported outbreaks in years have been detecting it in their communities.
Cholera is a waterborne disease, spread by eating food or drinking water that is contaminated with the bacteria. Malnourished children are most at risk as it can cause severe dehydration and, if left untreated, can lead to more health complications including death.
The rapid spread of cholera we see today is made worse by weak water and sanitation systems, climate change, conflict and poverty, all of which make access to safe water more challenging. In regions such as East Africa, the Middle East and South Asia, this is particularly troubling as some countries have not experienced large-scale outbreaks in over a decade, highlighting a deteriorating situation for children and families.
Early detection and a quick response to contain outbreaks is vital – work UNICEF is supporting governments to do. This is done by engaging with communities on safe water and sanitation practices, strengthening health systems and rolling out the oral cholera vaccine (OCV), which is a crucial element to prevent recurrence in cholera ‘hotspots’.
Getting supplies to countries
UNICEF is constantly monitoring outbreaks of cholera around the world, coordinating with governments and the Global Task Force on Cholera Control to identify the most urgent supplies required to treat patients and contain the spread of the disease.
UNICEF stocks and delivers two types of AWD kits. The Periphery Kit includes supplies such as medicines, medical devices, water testing kits and personal protective equipment, while the Community Care Kit contains water purification tablets, soap, zinc, oral rehydration salts and other water and sanitation items. This kit is specifically designed for use by affected and at-risk communities, giving them the means to treat water and ensure rehydration, while ensuring those cleaning the water do not contaminate it.
In the first 11 months of 2022 alone – as just one element of the cholera supply response and to meet soaring demand – UNICEF shipped more than 1,900 AWD Community Care kits compared to over 1,500 in the previous three years, with planning already underway to ensure continuous supply into next year.
UNICEF activities on the ground
While the AWD kits can be used to support initial cholera response activities, they are also invaluable in preparation for a potential outbreak. For instance, the kits can be distributed to families ahead of the rainy season so that if flooding restricts their access to clean water, they can take steps to purify any potentially unsafe sources.
UNICEF also takes the lead in engaging with communities to understand people’s perception of risk in a disease outbreak – a crucial activity to inform how preventative measures against it can be adopted and maintained. This is done by training frontline health care workers and engaging with community networks, including local influencers, to improve behaviour change efforts within the most vulnerable populations.
This means talking to people about how to treat sick family members and stop the spread of infection, with an initial aim of identifying the source of the outbreak and preventing it from worsening. In some cases, teams may even disinfect a patient’s home and instruct them on how to maintain safe water and sanitation practices in the future.
In Syria, an outbreak of cholera was declared in September with tens of thousands of suspected cases declared since. UNICEF, alongside the Ministry of Health and the World Health Organization (WHO), are not only distributing critical water, hygiene, sanitation and health supplies but also conducting door-to-door visits to deliver life-saving messages on the causes, symptoms and prevention of cholera.
In response to the recent outbreak in Malawi, UNICEF and partners trained 480 Health Surveillance Assistants and community volunteers to support monitoring and reporting of outbreaks, while hygiene promotion campaigns and hand-washing demonstrations were conducted in public places.
The ability to reach as many people with these messages as quickly as possible following the detection of cholera is of utmost importance. Although community-based outreach is crucial, UNICEF also shares information through text messaging and social media. In fact, since the beginning of the cholera response in Malawi, 2.5 million people have received messages on prevention, treatment and care through national and community radio stations.
While vaccination against cholera is one of the main tools available to respond to cholera outbreaks, current challenges in vaccine availability and the effect of natural disasters, conflict and inadequate sanitation systems mean the impact on countries is growing.
Amid this fast-evolving landscape, UNICEF has stepped up its efforts to reach children and their families with the life-saving supplies and community-based support they urgently need.
Learn more about why cholera outbreaks are occurring and how UNICEF is responding.