DRC: Trying To Contain A Cholera Epidemic

A cholera epidemic is rapidly spreading along the Congo River in western Democratic Republic of Congo. The disease is affecting towns and villages along the waterway, which is the population's main mode of transportation. More than 250 people had died as a result of the disease by July 21, and the epidemic is expected to soon reach the country's crowded capital, Kinshasa.

Doctors Without Borders/Médecins Sans Frontières (MSF) emergency medical teams are running a free cholera treatment center (CTC) in the city of Mbandaka that has been receiving around 20 new patients a day.

Photos by Robin Meldrum/MSF

Mbandaka, the capital of Equateur Province, is a major port city on the Congo River; its population has been hit by a regional cholera epidemic.

DRC 2011 © Robin Meldrum/MSF

A team of MSF emergency logisticians set up a cholera treatment center (CTC) in Mbandaka in just 48 hours.

DRC 2011 © Robin Meldrum/MSF

As cholera is extremely infectious, the CTC is enclosed by a high fence made of plastic sheeting. There are slits at regular intervals in the sheets to allow wind to pass through and passers-by to look in.

DRC 2011 © Robin Meldrum/MSF

Infection control is essential in the CTC. Regularly washing hands and spraying feet with a chlorine solution helps to prevent the spread of the disease.

DRC 2011 © Robin Meldrum/MSF

Jonathan Mbosenge, 10, was brought to the the MSF CTC by his mother because he had the main symptoms of the disease—profuse diarrhea and vomiting.

DRC 2011 © Robin Meldrum/MSF

Mbosenge was in a state of severe dehydration with the weak pulse and sunken eyes typical of a seriously ill cholera patient. MSF staff gave him an intravenous drip of Ringers lactate solution that rehydrated him and helped rebalance the essential electrolytes in his body.

DRC 2011 © Robin Meldrum/MSF

Twenty-four hours later, Mbosenge had regained much of his strength and was alert. He was still ill, but his mother was much less worried.

DRC 2011 © Robin Meldrum/MSF

Seven-year-old Eliezer Wetchi was brought by his father to MSF’s CTC. “We spent all night traveling down the Congo River to get here,” Wetchi’s father said. “I had no choice. My youngest son Eliezer was going out like a candle.”

DRC 2011 © Robin Meldrum/MSF

“Late in the evening I held Eliezer in my arms and and we got a place on the last boat to Mbandaka," his father said. "I watched over him all night—I didn’t dare close my eyes for a second. As soon as we got here they started treating him and now he’s much better—they say he can go home soon.”

DRC 2011 © Robin Meldrum/MSF

Dieudonne Bokwala is an MSF health promotion specialist. Every day, he goes to cholera-afflicted neighborhoods to spread the word about what cholera is, how to avoid catching it, and what to do if someone shows the symptoms.

DRC 2011 © Robin Meldrum/MSF

DRC 2011 © Robin Meldrum/MSF

People are generally very interested to hear the messages and learn how to avoid catching cholera.

Nurse Joel NyimiNyimi is in charge of the CTC’s medical operations. He has come to check on the night shift, which starts at 3 a.m., and to assist staff from the Ministry of Health, who have less experience treating cholera, with potentially difficult cases.

An extremely dehydrated child has just been admitted, and it is hard to for the medical staff to find a vein and start an IV drip, especially with such little light.

A staff member uses a flashlight built into his cellphone to help him find a vein.

Cholera can be deadly if left untreated, but treatment is straightforward if patients seek it early enough. Seven-year-old Ebengo was in the recovery ward with his mother after 24 hours of treatment. ”Ebengo loves playing—he is always trying to sneak away to meet up with his friends,” his mother said. “So when I got back from the market, I was surprised to find him already in bed at 5 p.m.”

”Just as I approached the bed, he started violently throwing up. His eyes were sunken and he was pale and weak. I got very frightened and I started crying and praying. I started thinking he might die. I had lost control of the situation. I heard the radio messages about cholera, so I came immediately to the center. I think that if I had waited half a day more at home, my son would now be dead. All it took was a day of treatment and Ebengo is back to himself.”

DRC: Trying To Contain A Cholera Epidemic

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DRC: Trying To Contain A Cholera Epidemic

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