Cholera epidemic - NGO warns worst is yet to come

Describing the cholera outbreak in Angola a "national emergency", an international humanitarian NGO has warned the government that the worst is yet to come. "There are now over 20,000 cases and 941 deaths," said Richard Veerman, head of the Médecins Sans Frontières (MSF) mission in Angola. "Today we have not yet reached the peak of this epidemic. Even based on conservative estimates, the toll of this epidemic will be extremely high. The number of cases at least will double and we will try and contain the deaths. We have told the government to prepare for the worst." Ten weeks after the first case of cholera was confirmed in the capital, Luanda, it has spread throughout the country, from the coastal urban centre of Benguela to interior provinces such as Malange. MSF have upgraded the outbreak to an "epidemic". Tuesday saw the highest daily toll to date, with 929 new cases and 25 deaths. Last week, MSF saw an average of 30 newly infected people and a death every hour. In one of MSF's treatment centres in Luanda alone, 240 new patients came in over a 24-hour period. "By all measures, this outbreak is out of control," said Luis Encinas, MSF emergency coordinator for the cholera outbreak. Earlier this year Angolan health minister Sabastiao Veloso had said that the outbreak was under control. But recent rains have exacerbated the situation, said a UN Children's Fund (UNICEF) official earlier this month. Overcrowding and appalling sanitation are exacerbating the outbreak in the informal townships or 'musseques', mainly inhabited by internally displaced persons who fled the devastating 27-year civil war that ended in 2002. Cholera is a waterborne disease, associated with poor sanitation and lack of access to potable water. This is the first outbreak in Luanda in over a decade. Angola's interior areas have not recorded cholera for an even longer period, as people rarely travelled internally during the war. Angola, sub-Saharan Africa's second largest oil producer after Nigeria, is currently in the middle of a reconstruction boom fuelled by high oil prices. But ironically, as the government tries to rehabilitate infrastructure it also helps the disease to spread faster. "During the war cholera never moved out of Luanda," said Veerman. "But now there are roads [and] people are moving. The disease is following the best roads."