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Cholera is endemic in Zambia. On average, Zambia had 4,449 cases a year between 1990 and 2010. The largest outbreaks happened in 1999 (13,511 cases), 1990 (13,154 cases) and 2004 (12,149 cases). However, the situation improved between 2011 and today most years did not see an outbreak. Only in 2016 and 2017 outbreaks were registered and the number of cases were 1,434 and 1,900 respectively. The most recent outbreak was declared on 6 October 2017. As of 10 January 2018, a total of 2,905 confirmed cases and 67 deaths were reported countrywide, including 2,755 cases and 62 deaths recorded in Lusaka. Cases have also been recorded in the districts of Chilanga, Chibombo, Mumbwa, Ndola, Chikankata, Sinazongwe and Monze.

To support the efforts to contain the spread of cholera, the World Health Organization (WHO) facilitated the import of two million oral cholera vaccines, enough to immunize one million people. On 10 January 2018, the Government with the support of the UN and health partners, commenced oral cholera vaccination in Lusaka’s Kanyama area and other cholera-prone areas. Some two million doses of chlorine plus other mobilization incentives and supplies were provided by the UN to help fight the epidemic. The Government escalated the burying of shallow wells and created fresh water points as a preventative measure. A second round of vaccinations was administered in February covering more than 700,000 people.

Intensified violence in the Haut-Katanga and Tanganyika provinces of the Democratic Republic of the Congo (DRC) has forced people to flee into northern Zambia through the Chiengi border area in Luapula Province. Before 30 August 2017, the Chiengi border crossing had not registered refugees; since then, 12,765 people had entered as of 31 December 2017 at an average rate of 110 persons per day. As of January 2018, the new arrivals are hosted in an overcrowded temporary transit centre (Kenani, Nchelenge District) posing serious health, sexual and gender-based violence, and protection risks. Over 80 per cent of the refugees are women and children, and about 22 per cent are under age 5. The transit centre has exceeded its initial maximum capacity of 10,000, although work to expand it has started. The Government identified land for a new refugee settlement at Mantapala, some 50 kilometres from the DRC border and 30 kilometres from the Kenani transit centre. The growing number of new arrivals has overstretched the capacity of the humanitarian community, which is already struggling to provide life-saving assistance at the Kenani transit centre.