The cholera outbreak in Guinea and Sierra Leone that has killed 392 people and infected more than 25,000 others since February is slowing down, say aid groups who also call for sustained measures to wipe out the disease.
Between late August and 16 September, new cholera cases per week have dropped from 2,110 to 1,418 in Sierra Leone and from 1,152 to 346 in neighbouring Guinea, the UN Office for the Coordination of Humanitarian Affairs (OCHA) said in a report.
“The situation is improving faster in Guinea in terms of new cases and in Sierra Leone in terms of lethality. The number of affected districts remains unchanged: 12 out of 13 in Sierra Leone and 11 out of 33 in Guinea,” OCHA said.
In Sierra Leone, updates from 84 health centres in the hardest hit Western Area indicated that there were 112 cases and one death in 32 health centres, and no deaths or cases in the rest on 18 September, according to the UN Children’s Fund (UNICEF).
“I think it doesn’t necessarily mean it [the cases] would not go up. It does seem that things are getting better, but we need to be cautious. It’s certainly a good sign of the huge amount of work we have been doing,” said Nicole Robicheau of the International Federation of Red Cross and Red Crescent Societies.
The outbreak is Sierra Leone’s worst in 15 years. The government declared a national emergency in August. The authorities and aid groups have rallied to treat thousands of infected people, educate the population on basic hygiene practices and sanitize water sources.
“In the long run cholera prevention is a question of hygiene and sanitation, especially in densely populated areas. Access to safe water and sanitation facilities remains very limited in Sierra Leone,” said Angela Griep, UNICEF’s external relations chief in Sierra Leone.
Mohamed Kamara, a resident of Mabella slum in the Sierra Leonean capital whose brother recently died of cholera, decried the poor sanitation in his neighbourhood of congested tin shacks as well as the unhygienic habits of people living there.
“One day I went for prayers and I saw a man coming from the toilet holding the [water] kettle with his wet hands… he left without cleaning his hands or the kettle properly. Another man came to use the same kettle. I feel that such habits increase the spread of cholera in Mabella,” Kamara said.
Torrential rain in August worsened the outbreak, adding to health risks such as poor hygiene, unsafe water sources and improper waste management that are believed to have triggered the disease.
“Cholera is preventable. It is frustrating to see many people infected and dying of cholera. We are emphasizing that people should get help when they get cholera. I think the message is getting across,” Robicheau told IRIN.
Urban slums worst hit
“We are educating people on hygiene. Many people don’t have access to safe water. That’s an issue that should be addressed. People who live in poverty in small villages don’t even have the money to buy soap to wash their hands before eating or after going to the toilet.”
West Africa has some of the world’s lowest access rates to clean water and basic sanitation facilities, according to the UN.
Cholera infections in both Guinea and Sierra Leone tend to hit densely-populated, poorly-serviced urban slums hardest.
“Many of my customers have stopped buying food from me,” said Zainab Conteh, a food vendor in Mabella. “A customer last month ate my food and later started vomiting. He told his friends and relatives that my food which he ate infected him with cholera. I was embarrassed and humiliated. I had to stop selling food for a week because health inspectors came and ordered me to improve on the way I prepare food.”
UNICEF said in an 18 September statement that it was maintaining its efforts in treating and preventing the disease to ensure infections continue to reduce.
“We should not stop fighting cholera before the number of cases has gone down to zero and even then we want to put preventive measures in place so that we increase the chances that one day this disease will disappear in Sierra Leone,” UNICEF’s emergency specialist Moira Fratta said in the statement.