UNICEF helps to protect people in Aleppo from cholera
Curbing the spread of another threat to children’s survival in Syria

Aleppo, Syria – Since the cholera outbreak was declared by the Ministry of Health on 10 September, tens of thousands of suspected acute watery diarrhoea (AWD) cases have been reported in all governorates. Aleppo governorate in northwest Syria has been among the most impacted areas.
UNICEF has supported the efforts of the Ministry of Health (MoH) to curb the spread of the disease through the provision of Oral Cholera Vaccines that arrived in the country in late November 2022. A two-week immunization campaign, supported by UNICEF and WHO, started on 4 December. It aimed to reach vulnerable people in the highly affected governorates: Aleppo, Ar-Raqqa Al-Hassakeh, and Deir ez-Zor.

“I received the cholera vaccine last week. It’s important to prevent the spread of the disease and raise awareness about protection from cholera,” said Aisha, 30, a Department of Health worker at a UNICEF-supported health centre in As-Safira, south rural Aleppo, Syria. “A number of my relatives were infected, and I witnessed how difficult the disease was for them. I screen the children who visit the centre and treat the ones with malnutrition. They are among the groups most prone to cholera, so I’ve advised their families to vaccinate them,” she added.

Fatima, 37, is another worker at the same health centre where Aisha works. She took the vaccine to protect herself from cholera and gave it to her daughter as well. “Both of my parents were infected. It made me even more sure that I need to get vaccinated,” she said.

According to Dr Reem, a Department of Health worker responsible for oral rehydration points in Aleppo, awareness on staying safe from cholera is the ‘first line of defence against the disease’. “Simple hygiene practices can help keep people cholera-free. Also, it is important to highlight these practices for women who are breastfeeding and help them to keep their babies and family members healthy,” she said. Patients with cholera symptoms, including acute watery diarrhoea, are referred to oral rehydration points and provided with oral rehydration salts to ease their symptoms.

“Having oral rehydration points at health centres has been very important during the spread of cholera. For many patients with cholera symptoms the centre was far more accessible - in terms of transportation and financial costs - than hospitals. At the rehydration points, they received the care and treatment they needed to ease their symptoms. For severe cases, we’d refer to hospitals,” explained Fatima, 24. She receives patients with cholera symptoms in an oral rehydration point at the UNICEF -supported Department of Health centre in As-Safira.

“I took the vaccine here and the mobile team visited my daughters at school and vaccinated them. Taking care of one self’s personal hygiene is essential to prevent cholera, and thanks to the vaccine, prevention has become stronger,” said Abdulkarim. He was vaccinated against cholera at the health centre in As-Safira.
To ensure a wider coverage, the health workers reached people with the cholera vaccine both at fixed health centres and in remote and rural areas through mobile teams.

“I hate being sick, and I want to play all the time. I took the vaccine as soon as I heard about it and the lady who gave it to me was very kind!” said Sara, 10. She was vaccinated against cholera by a UNICEF -supported Department of Health mobile team in As-Safira. So did Bayan, 8. “My friends and I were vaccinated on the same day. Some of our friends got cholera earlier. It was painful, so we wanted to avoid that,” she said.

While vaccines are a crucial tool in the fight against cholera, they are not the principal intervention.
As part of the ongoing response, UNICEF is mobilizing critical health; water, hygiene, and sanitation (WASH) supplies, response services and expertise in the affected governorates. UNICEF and its partners also continue to distribute sodium hypochlorite to increase chlorine dosages and concentration to prevent and curb the spread of the disease. UNICEF engages communities through selected media and dialogues, door-to-door visits and key messaging on causes, symptoms, and prevention of cholera.

“Awareness raising is critical in protecting people from cholera. I’ve approached all the women and children who have come to the centre for regular check-ups or for their children’s routine vaccinations. I’ve shared information on how they can stay safe from the disease,” said Ammouneh, 32. She is a Department of Health worker at the health centre in As-Safira.

In November 2022, UNICEF helped to provide the Ministry of Health two million doses of the Oral Cholera Vaccine to bolster efforts to halt the spread of cholera in Syria. A generous contribution from GAVI, The Vaccine Alliance, helped to make it happen.