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Rainy season deepens fears of cholera spreading in Yemen

13 Jun 2017
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A young boy lies in the emergency room awaiting treatment for suspected cholera. Credit: Giles Clarke/OCHA

As the cholera outbreak reaches unprecedented levels in Yemen, humanitarian partners have expressed fears of the epidemic spreading over the course of the rainy season.

The conflict-ravaged country's broken health and the water and sanitation systems have been unable to cope as waste piles up in the streets amid the rainy season. Congested urban centers where garbage remains uncollected and overcrowded displaced people's settlements with precarious sanitation are at high risk of contagion.

As of 12 June, some 124,002 suspected cases of cholera and 923 related deaths, had been reported, according to the World Health Organisation (WHO). Most of the deaths are of children under 15 and the elderly (those over 60) .Humanitarian partners fear the actual number of people affected may be much higher, as only 45 per cent of the health facilities are effectively functioning.

"The health system is a shell of what it once was, with half of all health facilities now closed. People are dying because even basic medical treatment, that we would take for granted, is no longer available," said the Emergency Relief Coordinator Stephen O'Brien in a recent statement to the UN Security Council.

Humanitarian partners have been responding to the cholera outbreak since October 2016. At the national level, two emergency centres have been established in Aden and the capital, Sana’a, where the health ministry has declared a state of emergency.

Amanat Al Asimah, Hajjah, Amran and Al Hudeideh governorates represent more than half of the suspected cholera cases. Rapid Response Teams at the governorate level investigate suspected cases and treat contaminated water sources. Health partners have also established Oral Rehydration Corners in the 12 most affected governorates and 99 Diarrhoea Treatment Centres (DTCs) in 17 governorates. Some 4,000 rapid diagnostic tests have been distributed in the most affected governorates to enhance early detection.

Nearly 3.5 million people across the country have been reached with clean drinking water and hygiene kits (soaps and washing powders). Some 14.8 million people lack access to safe drinking water and sanitation services in Yemen.

WHO has airlifted 67 tons of supplies (IV fluids and cholera kits). Health awareness information is being broadcast through 17 radio stations across Yemen with some eight million people being reached through SMS.

Humanitarian partners urgently require funds for health, water and sanitation activities to contain the epidemic. As of 12 June, the Yemen Humanitarian Response Plan was only 28.5 per cent funded with the health, water and sanitation sectors just 13 and 15 per cent funded, respectively.

Hospitals are short of medicines with only 30 per cent of required medical supplies being imported into the country. The salaries of doctors and nurses have not been paid regularly for over six months.

"The debilitated health system took longer to detect cholera warning signs as health workers, who would have been maintaining disease surveillance systems, were not paid. Water and sanitation systems were not functioning due to lack of fuel and basic maintenance... And the rainy season, coupled with uncollected rubbish piling up in the streets of large cities, created the perfect conditions for the rapid spread of communicable and water-borne diseases," added Mr. O'Brien.

The humanitarian community continues to call on all parties to the conflict to uphold their responsibilities and allow humanitarian workers unhindered humanitarian access to all people in need, and allow the importation of critical commodities, including urgently needed medical supplies.

Over two years of escalating conflict in Yemen and import restrictions on basic commodities such as fuel and medicine have devastated livelihoods and led to a collapse of key health, water and sanitation institutions.