August 28, 2007
Endemic in West Africa, cholera has once again struck in Guinea. The arrival of the rains at the end of May, notably in the capital, Conakry, has created an ideal breeding ground for the disease to spread. Faced with an increasing number of cases, Doctors Without Borders/Médecins Sans Frontières (MSF) has boosted its direct support of the local health services.
Since January this year, nearly 2,500 cases of cholera have been recorded in and around Conakry. Ninety people have died from the disease. After only a few hours, infected people can become dehydrated and die. Simple medical care consisting of oral rehydration or a perfusion, depending on the state of the patient and in some cases antibiotics, are enough to help patients quickly recover.
Due to the increasing number of cases and the limited treatment capacity in local health facilities in the city, at the end of June, MSF began providing medical support to Donka Hospital. In August, MSF extended its support to two health centers in the towns of Matoto and Ratoma.
"The number of people infected by the disease in Conakry has considerably increased since July," says Sergio Martin Esteso, one of the program heads for MSF in Guinea. "Of the 1260 patients treated in the three centers where MSF works, more than 1,000 have been in the past three weeks."
The sanitary situation in the city only helps to spread the bacteria, Vibrio cholerae, which causes the disease. In many parts of the city, the streets are strewn with household waste, and over-flowing latrines are too close to places where people access drinking water. It is an unhealthy environment which makes it hard for the population to maintain good levels of hygiene. Additionally, in this city of two million people, which lies on a peninsula, the sick are widely dispersed, making it more difficult for them to reach treatment centers.
MSF is part of the Emergency Cholera Unit set up by the Ministry of Health to effectively co-ordinate the approaches of all the organizations involved in the outbreak. While the emergency response is today in place, this year has once again witnessed ill- prepared health facilities and an insufficient medical system. "Without rapid access to treatment, it is well known that cholera victims die quickly and in high numbers," says Esteso. "But once again, health facilities weren't well enough prepared to cope with this emergency."
Trained medical staff in the cholera treatment centers at Dabompa (Matoto area) and the Donka hospital and have been in particularly short supply. "If, as we fear, the number of sick continues to increase over the next few weeks, the local teams in place at the moment will soon be exhausted. As a result we are going to have to offer support to bridge this gap," says Caroline Franco, an MSF coordinator for the operation.
The preventative aspects, such as the distribution of a chlorinated solution called "sur'eau," and public health campaigns telling people to drink clean water and pay greater attention to hygiene practices, are being dealt with by local organizations. However, potable water is still not free, which limits the impact of the messages, as well as encouraging the spread of the disease.
"Regarding the sanitary state in Guinea, we are expecting to face more epidemics of this type in the future. So it is vital that the authorities are better prepared to take care of the sick. It is an essential component in saving a lot of lives," says Esteso.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)