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Cholera creates a new danger for children after Idai

05 April 2019, Emergencies

There will be another disaster if cholera spreads

Save the Children has deployed its Emergency Health Unit (a global pool of public health and medical experts) into Mozambique to supplement the efforts of the government. 

A threat to survivors

Cyclone Idai, which made landfall in Mozambique over two weeks ago, is one of the worst weather-related catastrophes in Africa in recent times. It left a long trail of death and destruction in Mozambique, Zimbabwe and Malawi, and the flooding and contaminated water caused by the storm pose a huge threat to survivors, including thousands and thousands of children. In addition to cholera, floodwater also poses the risk of mosquito and other vector-borne diseases like malaria.

Cholera is an acute diarrhoeal disease that can kill within hours if left untreated. Cholera, or any disease outbreak, complicates relief efforts and stretches health systems. If not contained quickly, it can spread like wildfire. The World Health Organization says up to 80 percent of cases can be successfully treated with oral rehydration solution in normal settings.
However, the best way to predict the future of a cholera outbreak is to prevent it. Based on our experience of working in cholera settings, there are seven essential steps to fight a deadly cholera outbreak and stop it in its tracks.

Fatima, 5, received a family kit from Save the Children after her home was destroyed by Cyclone Idai.

Seven steps to stopping a cholera outbreak

  1. Quick decisions and strong leadership 

    This can make or break relief operations. Once contracted, dehydration from cholera can kill children in a few hours, so the battle against cholera is a race against time. The test of true leadership in such humanitarian settings is the ability to prioritise actions. Cholera should remain a priority, as slow decisions or inaction may cost lives. In Mozambique’s case, the Government is leading on the cholera response and has triggered the cholera response protocols.

  2. Acknowledge

    Being open about the prevalence of cholera is a key step to fight it. It is good to note the Government of Mozambique has quickly acknowledged the problem and is setting up a mass vaccination campaign together with partners in the Sofala province. This will help to shift gears quickly and instil trust and confidence in the system. Continuous surveillance remains key. 

  3. Clean water and soap 

    Access to safe, clean water and sanitation is critical to control the transmission of cholera and other waterborne diseases. The Centres for Disease Control and Prevention lists clean water (to drink) and washing hands with soap and clean water as two of the five basic cholera prevention steps. Severe cholera cases need rapid treatment with intravenous fluids and antibiotics. Cholera vaccination can be complementary to these activities, but not a replacement for the prevention through clean water, sanitation, hygiene and other control measures.

  4. Children first

    Cholera affects all age groups but it has a bias against children - half the cholera-deaths worldwide are among children under five. Children, pregnant women and nursing mothers are particularly vulnerable. Undernutrition and cholera make a deadly combination. Reaching people in remote places is vital.

  5. Collaboration and funding

    Health is a first casualty in disaster zones. Cyclone and cholera are putting pressure on an already stretched health system and it is important to maximise collective efforts.

  6. Media and public broadcasting

    Fighting cholera is not just about medical prescriptions – social and other media can play a vital role in urging the public to take preventive measures and mobilise communities. Singers, artists and radio programmes can help to demystify health messages and reach a wider audience.

  7. People’s power

    The success of the fight against cholera is directly proportional to the mobilisation of the impacted communities. Everyone has a role to play and it is vital to recognise the power of ordinary people. The Sphere Humanitarian Standards says treating disaster survivors with dignity and creating space for them to be involved, are critical in battle against cholera.  

Rachael Cummings is Director of Save the Children’s Humanitarian Public Health Team.
Dr Unni Krishnan is the Director of the Emergency Health Unit, Save the Children Australia.  

Images: Sacha Myers/Save the Children

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