Cholera every year if water and sanitation not improved

The cholera epidemic in Angola has peaked and new cases are on the decline, but if water and sanitation issues are not addressed, aid agencies expect to be back for another outbreak within a year.

"The government needs to improve water and sanitation - Angola has not seen a cholera outbreak since 1995 and now we expect it to reappear every year, becoming endemic," Karen Godley, the Medecins Sans Frontieres (MSF)-Switzerland head of mission in Angola, told IRIN.

According to the latest World Health Organisation update, Angola has reported 2,003 deaths and 48,817 cases in 14 of the country's 18 provinces since mid-February.

The outbreak started in the capital, Luanda. The first cases were reported in the Boa Vista slum, located on landfills, where people have no access to municipal water supplies or a proper sewerage system.

Cholera is an acute intestinal infection spread by drinking contaminated water or eating contaminated food. Symptoms include vomiting, cramps and diarrhoea, which can lead to severe dehydration and death.

Godley attributes the spread of the disease to the water delivery system that 80 percent of Luandans depend on: water is pumped from heavily used rivers flowing through densely populated urban areas into ancient, broken tankers for distribution throughout the city.

Originally designed to accommodate 200,000 people, the capital's population has exploded to between 4 and 7 million as a result of displacement caused by the 27-year civil war, which ended in 2002.

"A great majority of people have no access to government water supply. People have to purchase water at very high prices - it is a very profitable activity," said Godley.

MSF has been collaborating with the Ministry of Health since the onset of the epidemic and has brought in over 100 doctors, nurses, water and sanitation experts, and information and education specialists to get the disease under control.