Published Date: 2011-11-29 11:30:45
Subject: PRO/EAFR> Cholera - Cameroon (09): (Douala)
Archive Number: 20111129.235947

CHOLERA - CAMEROON (09): (DOUALA)
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Mon 28 Nov 2011
Source: Medecins Sans Frontieres (MSF) [edited]
http://www.doctorswithoutborders.org/news/article.cfm?id=5633&cat=field-news&ref=news-index


Cholera has now spread to all districts of Cameroon's largest city,
Douala, home to 2.1 million people. The outbreak was officially
declared an epidemic in September 2010 and since then it has spiked
and declined a number of times. During a rainy period in March and
April 2011, the numbers of cases peaked with an average of 120 per
week; and numbers have steadily risen again with another rainy period
beginning in September 2011. By mid-October 2011, there were more
than 400 cases per week.

"The existing health structures were no longer able to care for
patients adequately," said Dr Narcisse Wega, MSF's emergency
coordinator in Cameroon. "We found 2 to 3 patients per bed, some
lying on the ground or on benches, in appalling conditions. Health
facilities had reached their limit and were no longer able to cope
with the influx of patients."

MSF teams carried out an assessment and within days opened a cholera
treatment center in Laquintinie Hospital in order to relieve pressure
on local health facilities. The center is easy to access from all
parts of the city, and Doctors Without Borders/Medecins Sans
Frontieres (MSF) teams treated more than 350 patients in the 1st 2
weeks of its opening. "We transferred the overflow of patients from
existing health facilities to the cholera treatment center and
established a referral system with an ambulance service," Dr Wega
said.

In early November 2011, national stocks of oral rehydration solution
(ORS) were depleted and health workers had to treat patients with a
homemade solution. MSF has provided the Ministry of Health with more
than 120 000 sachets of ORS. "This is enough to treat around 12 000
patients -- a figure beyond the number of expected cases," Dr Wega
said. Each of the city's 11 existing cholera treatment units now
includes an oral rehydration point, where patients are provided with
rehydration solution.

MSF's emergency teams are also conducting prevention activities by
purifying water with chlorine and carrying out health promotion
activities in communities and through the media.

There has been a gradual decrease in registered cases of cholera in
the past few days, raising hopes that the current peak is over.
During the 3rd week of November 2011, 15 new admissions were
registered every day in the treatment center at Laquintinie Hospital,
compared to 40 admissions during the previous week. "This corresponds
to the rain having stopped in the past 10 days," said Dr Wega.

Cholera is endemic in Cameroon, and is linked to the poor conditions
in which many people live. "The majority of patients come from areas
where living conditions are precarious," said Dr Wega, "where houses
have been built in flood-prone areas and where hygiene conditions are
poor. There is a lack of latrines and access to drinking water. Faced
with these structural problems that help the spread of the disease,
the problem can't be solved through medical intervention alone.

"We treat patients, we raise awareness about hygiene precautions, but
we must be prepared to start all over again in March or April 2012
when the next rainy season is expected," he said. As a result of the
recent decrease in case numbers, MSF is preparing the end of its
emergency response in collaboration with the Douala health
authorities. MSF teams are training local health staff on cholera
treatment and hygiene management. "Our objective is to provide them
with the tools to be able to respond to the next epidemic," Dr Wega
said.

--
Communicated by:
ProMED-EAFR
<promed-eafr@promedmail.org>

[From the last sentence in the report, it appears that prevention of
the outbreaks altogether is not being accorded a serious
consideration and hence the focus is on equipping local authorities
to respond to the next cholera epidemic. There is need for a paradigm
shift to ensure that efforts are made towards preventing cholera
outbreaks.

An interactive map showing the regions of Cameroon can be accessed at
http://www.lib.utexas.edu/maps/africa/cameroon_pol98.jpg. The
HealthMap/ProMED-mail interactive map of Cameroon can be accessed at
http://healthmap.org/r/1tC0. - Mod.JFW]

See Also

Cholera - Democratic Republic of Congo (12): 20111126.235805
Cholera - Kenya: (North Eastern) Dadaab Camp 20111126.235802
Cholera, diarrhea and dysentery - Djibouti: (Djibouti) 20111123.235604
Cholera - Uganda (02): (Kasese) 20111108.234963
Cholera - Zambia (03): (Northern) 20111105.234621
Cholera - Somalia (10) 20111102.234212
Cholera - Ghana (16): (Accra) 20111102.234201
Cholera - Cameroon (08) 20111030.233871
Cholera - Nigeria (22): (Adamawa) 20111014.232631
Cholera - Central& West Africa (02) 20111012.232348
Cholera - Central African Republic 20111011.232257
Cholera - Chad (04) 20111009.232089
Cholera - Burundi (03) 20110915.229413
Cholera - Zimbabwe (09) 20110912.229043
Cholera - Lake Chad basin: Chad, Cameroon, Niger, Nigeria 20110902.228566
Cholera - Congo Republic (02) 20110830.228408
Cholera - Cameroon (07): Far North 20110817.227283
Cholera - Mali (03) 20110808.226795
Cholera - Africa: 2010 update, WHO 20110801.226491
Cholera - Ethiopia: susp. 20110717.225753
Cholera - Cameroon (06) 20110710.225350
Cholera - Cameroon (05) 20110630.224867
Cholera - Cameroon (04): (North) 20110623.224466
Cholera - Cote d'Ivoire (04): (Abidjan) 20110621.224295
Cholera - Niger: (Tillaberi) 20110620.224197
Cholera - Cameroon (03): nationwide update 20110611.223478
Cholera - Uganda: (Hoima) susp, RFI 20110607.223117
Cholera - Cameroon (02): nationwide update 20110529.222455
Cholera - Mozambique: (Maputo) 20110503.221703
Cholera - Cameroon: nationwide update 20110502.221659
Cholera - Zambia (02): (Southern) 20110203.217836
Cholera - Tanzania 2011 (01): Dar es Salaam 20110108.216933
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