Nigeria: Five ways to contain the cholera outbreak

12 September, 2017
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The first cholera cases were identified in north-eastern Nigeria’s Borno State on 16 August, despite extensive efforts to improve sanitation conditions in camps and to raise awareness of the importance of best hygiene practices. The insurgency and efforts to quell it have forcibly displaced 1.7 million people in north-eastern Nigeria, many of them living in dire conditions. To date, health partners count more than 1,625 confirmed and/or suspected cases and at least 40 cholera-related deaths. Health workers fear these numbers could rise exponentially because of poor water and sanitation conditions in many camps across the area.

Most of the cholera cases are concentrated in Borno’s capital, Maiduguri, as well as in the local government areas of Dikwa and Monguno.

Here are five ways humanitarian partners have been supporting the Nigerian Government to contain the cholera outbreak.

1. Cholera Treatment Centres

Specialized treatment centres are being set up and opened in all currently identified outbreak hotspots. To date, some 330 beds have been made available to provide urgent care for the most severely affected women, children and men.


Patients in the cholera treatment centre run by the Borno State Ministry of Health and supported by UNICEF and UNFPA. Credit: OCHA/Yasmina Guerda

A new patient is being admitted in the cholera treatment centre. Credit: OCHA/Yasmina Guerda

2. Oral rehydration points

To contain the outbreak, health workers need to be able to quickly re-hydrate patients who are not too severely infected, with oral re-hydration salts. Where possible, suspected cases are monitored in these re-hydration sites for one or two days, before being discharged.


Consultation at the oral re-hydration point run by the International Rescue Committee. Credit: OCHA/Yasmina Guerda

3. Life-saving medicine

Cholera can be treated with oral rehydration salts, antibiotics and nutritional supplements to support patients’ immune systems. Health partners have been stocking clinics with these supplies, but stocks are running low and additional medicines need to be procured. Cholera can also be prevented with a vaccine through an organized campaign – humanitarian agencies, in support of the Ministry of Health will be rolling one out in hardest-hit areas later this month.


A volunteer hands medication to a woman suspected to have cholera. Credit: OCHA/Yasmina Guerda

4. Surveillance and shelter spraying

Crucial for the timely detection and referral of cholera cases, surveillance teams conduct door-to-door investigations. Once a household has been identified as having a member with suspected cholera, the sick family member and anyone else showing symptoms are referred to a nearby treatment or re hydration centre. In addition, teams are deployed to spray shelters and homes with chlorine.


A WHO cholera surveillance team conducts case investigation in an IDP site. Credit: OCHA/Yasmina Guerda

5. Raising awareness

Promoting good hygiene practices among communities is key to prevent further transmission of the disease. Communities are being informed on how to avoid getting infected through door-to-door visits, youth and women's groups, schools, posters, skits, radio broadcasts and other methods. Humanitarian groups have also been undertaking other critical activities such as setting up hand washing stations throughout sites housing internally displaced people in hotspot areas, emptying, cleaning and disinfecting latrines, and training medical workers.

However, much more needs to be done to contain the outbreak should it continue to spread, and aid groups’ capacity in this region is already stretched to the limit. Humanitarian agencies are having to divert resources from other life-saving programmes to rapidly respond to the cholera crisis. Without immediate and adequate action, this outbreak could spread to other areas of the north-east, or even become long-term. Additional funds are urgently required to prevent the worst from happening.


A health worker demonstrates good hygiene practices to a youth group. Credit: UNICEF


Community volunteers go door-to-door to explain the importance of hand-washing. Credit: UNICEF

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