The first cholera cases were identified in Borno State, north-east Nigeria, 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 the efforts to quell it, have forcibly displaced 1.7 million people in north-east Nigeria, many of whom are living in dire conditions. To date, health partners have counted 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, and in the local government areas of Dikwa and Monguno.
Here are five ways humanitarian partners are supporting the Nigerian Government to contain the cholera outbreak.
1. Cholera Treatment Centres
Specialized treatment centres are being set up 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 use oral rehydration salts to rehydrate patients who are not too severely infected. Where possible, suspected cases are monitored in these rehydration 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 roll out a campaign in the 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. Door-to-door visits, youth and women's groups, schools, posters, skits, radio broadcasts are some of the methods being used to inform communities about how to avoid infection. Humanitarian groups have also been undertaking other critical activities, such as setting up hand-washing stations throughout sites that house internally displaced people in hotspot areas; emptying, cleaning and disinfecting latrines; and training medical workers.
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
Much more needs to be done to contain the outbreak should it continue to spread, but aid groups’ capacity in this region is already stretched to the limit. Humanitarian agencies are forced 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 Cholera Response and Prevention Plan has been developed to address the immediate needs of 3.7 million people that could be affected by the outbreak. “We need a holistic and comprehensive response to this outbreak and a clear prevention strategy,” Mr. Lundberg, Deputy Humanitarian Coordinator for Nigeria, said launching the Plan. “The implications of not responding in a timely manner could be absolutely devastating for millions of conflict-affected women, children and men who are already living in very dire conditions.”