Ghana is a Cholera Endemic Country, Deputy Health Minister Declares (News Brief)

Spread of cholera in Ghana, photo courtesy of myjoyonline(HN, March 22, 2011) -- Deputy Health Minister Rojo Mettle Nunoo says the government in Ghana is rolling out a comprehensive strategy to fight the spread of cholera in the country.

The Ghana Health Service says over 4,000 cholera cases with 61 deaths have been recorded since the outbreak of the epidemic in the latter part of 2010.

Officials of the Disease Surveillance Unit at the Ghana Health Service say the situation is worrying and needs urgent attention.

Cholera cases reported at various health facilities across the country particularly in the Accra Metropolis keeps increasing by the day.

Speaking to Joy News the Deputy Health Minister said Ghana has over the years been known to be a cholera endemic country, owing largely to the attitudinal and lifestyle of some Ghanaians.

He said the recent outbreak was triggered by the early rains, adding, the Interior Ministry in collaboration with the National Disaster Management Organization is tracking the cholera endemic areas in the country to provide the needed health support.

The Director of Public Health at the Ghana Health Service, Dr. Joseph Amankwa says poor sanitary conditions coupled with the non-adherence to personal hygiene practices are contributory factors to the outbreak.

“Some of the shell fish, and sea foods are some of the causes of cholera. If you pick sea food that is contaminated and not properly prepared you will get cholera.

"People are disposing waste anyhow on main roads, highways and close to rivers. The waste is supposed to be dumped at landfill sites but where are the landfill sites in Accra and other districts?

"We don’t have them and until we address that, it is going to be a major problem for us and every year we are going to have cholera,” he cautioned.

The Ghana Health Service has set up receptive centers at various clinics in the Accra metropolis to deal with the increasing cases.

Deputy Health Minister Rojo Mettle Nunoo says his outfit will embark on a comprehensive education and media outreach program to inform people on the incidence of cholera, the mode of transmission and its prevention.

- HUMNews staff

New Study Estimates Cholera Cases in Haiti Expected to Double Original Predictions (News Brief)

Patients being treated for Cholera in Haiti - photo courtesy of TopNews(HN March 18, 2011) -- Haiti could be facing nearly twice as many cases of cholera this year than what the United Nations originally estimated, say researchers from Harvard Medical School and the University of California, San Fancisco.

Haiti had been free of cholera for almost a century until last October, when the first cases of disease were reported.

Jason Andrews of Harvard Medical School and colleagues have just published a new study projecting the course of the epidemic over the next year. 

The new study suggests  that nearly 780,000 cholera cases could develop in 2011, with the disease killing about 11,000 people. The UN had estimated 400,000 cases of the diarrheal disease for the country.

The new study uses a more sophisticated mathematical model of the likely course of the outbreak than the U.N. used for its estimates.

Andrews' projection includes assumptions about improving water supplies, vaccination, and the use of antibiotics. He says his model indicates that those interventions can make a real difference in the ultimate impact of the epidemic.

"Certainly, if more aggressive interventions were done, such as vaccinating a larger proportion of the population or a faster rollout of clean water, the impact of interventions could be greater," he says. "But what we found was by doing all three of these interventions, you could avert a substantial burden of cholera and a substantial burden of deaths over the coming year, and that's one of the main messages of my analysis."

So far, 231,070 cholera cases and 4,549 deaths have been reported by the Haitian government.

UCSF medical resident Sanjay Basu, MD, has warned that the “epidemic is not likely to be short-term.”

“It is going to be larger than predicted in terms of sheer numbers and will last far longer than the initial projections,” Basu added.

Public health experts continue to debate the best way to control cholera - vaccination versus antibiotics versus sanitation. But Andrews says his model shows that even modest use of all three can have a significant impact in reducing cholera illness and death.

The model in Andrews' study projects the course of the epidemic for the next year, but it doesn't indicate when Haiti will again be free of cholera.

-HUMNews Staff 

Displaced in Haiti Drops Below One Million, A Year After Earthquake - IOM

(HN. January 11, 2011) - Close to 1-million people are still living in temporary shelters in Haiti one year after a major earthquake struck.Temporary shelter in Haiti CREDIT: IOM

However, according to the International Organization on Migration (IOM), this represents a "significant drop" in the number of Haitians living in displacement camps and is a welcome sign of progress in recovery efforts.

The UN agency said at a media briefing in Geneva today that still remaining is the massive task of finding durable housing solutions in the most challenging aspect of the humanitarian response.

An IOM country-wide assessment conducted between last November and January 2011 found 810,000 people are still living in informal sites in Port-au-Prince and provinces. This is nearly half the figure last July of an estimated 1.5 million internally displaced Haitians. It is also the first time that the camp population in Haiti has dropped to well below one million.

"While these figures seem a positive development, there is a long way to go. The displacement crisis in Haiti is the most visible and intractable issue. Getting people out of camps and into durable housing is key to long term recovery. However, there are many obstacles to doing this quickly and for Haitians, solutions can't come quickly enough," says IOM Director General William Lacy Swing.

The assessment, part of IOM's work in leading and coordinating camp management efforts in post-earthquake Haiti and regularly carried out, suggests a downward trend in the camp population of about 100,000 people a month. The largest declines are being witnessed in the south of the country in rural or semi-urban areas where housing options are more easily available.

Although an estimated 200,000 people have left the camps for transitional shelters, returned to damaged or rebuilt homes or simply left to live elsewhere, issues over land tenure, rubble, the lack of land preparation for construction as well as environmental concerns and risk mapping, are blocking more significant progress in resolving the displacement crisis.

"We have to acknowledge that life in camps will continue to be a reality for hundreds of thousands of people in the near future. In the meantime, the greatest possible efforts are being made to ensure that the displaced get the continued assistance and protection they need. As more camps continue to close down, this includes helping people without homes or livelihoods into more durable accommodation and into jobs," adds Swing.

Until more permanent houses can be built, transitional shelters which can last up to five years are the best option. IOM is complementing its work to assist the displaced by building 8110 shelters in the most affected areas. To date, 3000 shelters have been completed by IOM.

Although camp management activities have been the least funded of any humanitarian response in Haiti (43%), IOM and partners are regularly monitoring 100 per cent of all spontaneous settlements to track levels of service and to raise awareness on difficulties that the displaced face. For 2011, the camp management cluster of humanitarian agencies has appealed for $93 million.

According to UNICEF, the 12 January earthquake affected 1.5 million children and 63,000 pregnant women. As of 29 December, 3,481 people had died of cholera -- including 210 children below the age of five -- and over 157,000 cases of cholera had been reported, according to statistics from the Ministry of Health.

Also today, Nigel Fisher, the United Nations’ Humanitarian Coordinator, will present a UN report on 11 January in Port-au-Prince, along with the Haitian authorities. And tomorrow, various commemorative ceremonies such as the unveiling of a statue will be held in the capital in memory of the Haitians and the UN staff who had perished in the earthquake.

The UN response is still hobbled by lack of funding. According to UN-OCHA, the $1.5 billion appeal launched in 2010 has been funded to 72 per cent at the end of 2010. The $174 million cholera emergency appeal launched in late 2010, for its part, is only funded to 25 per cent.

- HUM staff, IOM

Cholera Cases in Haiti Set to Rise; Fears of Instability (NEWS BRIEF)

(HN, November 17, 2010) - The number of cholera cases in Haiti is expected to rise significantly beyond the latest figure of 11,000 as case monitoring improves and as health officials try to get ahead of an epidemic that is already causing political instability ahead of the November 28 presidential elections.

Cholera cases have now been found in every Haiti province, known as departments, as well as the capital Port-au-Prince. So far in Haiti, more than 11,000 cases have been cited and about 1000 people have died from the disease.

UN officials said as data collection improves, numbers will inevitably rise.

"We expect to have, once that data comes in, a significant increase in recorded cases. So people should not be surprised at that," said Nigel Fisher, the U.N. humanitarian coordinator in Haiti.Canadian Nigel Fisher leads the UN response in Haiti

Fisher said emphasis is continuing on educating the public about the disease and making sure they have access to oral rehydration salts and tablets to chlorinate their water. Plans are also being made to increase the number of cholera treatment centers across the country. 'It is [cholera] spreading and we have to contain, if not [the] number of cases, we have to try to contain the number of deaths," he said.

Today, Médecins Sans Frontières (MSF) said there are "acute deficiencies" in the well-established preventative actions that are essential to controlling the spread of the epidemic. It said activities such as the distribution of clean drinking water, positioning of oral rehydration points in affected communities, waste removal, and safe burial of victims of the epidemic, all remain far below the needs.

UN officials fear the outbreak may be used by some faction to increase instability: on Monday protestors directed their anger at UN peacekeeping forces - claiming UN personnel were responsible for importing cholera into the country.

Separately, health officials have confirmed the first case of cholera in Haiti's neighbour, the Dominican Republic.

In Geneva yesterday Fadéla Chaib of the World Health Organization (WHO) said there was a scientific consensus that cholera will remain an issue in Haiti for several years to come. WHO is preparing for more cases, mostly in remote areas, opening new treatment centers. Several levels of assistance are being offered to cholera-affected people, Chaib said, underscoring that mild cases are being treated at the community level and serious ones referred to cholera treatment centers. Social mobilization and education efforts are now very important, given that many Haitians were very scared and know little about cholera. 

Last week, the UN launched a new $163.8 million appeal for Haiti. Elisabeth Byrs of the Office for the Coordination of Humanitarian Affairs (OCHA) said it is intended for the purchase water purification tablets and rehydration salts, to increase the number of medical staff and to train medical personnel.

(News Brief) Cholera in Haiti and Nigeria

Photo UNICEF – A baby in Haiti suffers from diarrhea (HN, October 27, 2010) --- Over 3000 cases of cholera have been reported in Haiti this week resulting in over 250 deaths so far. More than 1,500 people have been hospitalized with a variety of diarrhea-related side effects, including dehydration, vomiting and abdominal pain. The confirmed cases are clustered around the Artibonite River in a region two hours north of the capital, Port-au-Prince. Additional cases of watery diarrhea in Port-au-Prince are worrying health officials who are working to prevent the spread of the disease into the crowded camps of displaced.

The United Nations Children’s Fund (UNICEF)  Haiti's Chief of Health, Dr. Jean-Claude Mubalama, said the situation was hectic and the local hospital in Saint-Marc was overwhelmed with sick people.

"The people here—the medical [staff] and the nurses—are not very familiar with this kind of disease," said Mr. Mubalama. As a result, UNICEF is managing the available resources, as well as coordinating with government and local partners, to try to treat people as quickly as possible, he added.

North of St. Marc, additional cases have appeared in the small community of Dessalines.

Photo: An MSF staff member attends to patients receiving treatment at the St. Nicholas Hospital in St. Marc"We have 35 hospitals beds, but we now have 61 patients spread throughout the hospital," says Dr. John Fequier, director of Claire Heureuse in Dessalines. Only 5 years out of medical school, Dr. Fequier is quick to admit he has never seen anything like this.

Dr. David Olson of Doctors without Borders/ Médecins Sans Frontières (MSF) medical advisor and cholera specialist in Haiti says “The best way to contain the spread of cholera is through prevention, and ensuring people have access to clean drinking water” . He adds that “ in refugee settings in conflict areas, people are forced to seek water wherever they can find it. By contrast, in many of the displacement camps in Port-au-Prince, people are provided with water that is less likely to be contaminated. This will hopefully mitigate the threat."

Nigeria
In Nigeria a cholera outbreak has led to 40,000 cases and resulted in 1,555 deaths, the United Nations confirmed yesterday.

According to the United Nations Children’s Fund (UNICEF) the number of cases is three times higher than last year and seven times higher and in 2008. The disease’s spread seems to be largely contained in Nigeria, where new cases are still being reported in the country, particularly in the northeast.

Women and children account for 80 percent of the cases, according to the UN report.

Two-thirds of rural Nigerians do not have access to safe drinking water or proper sanitation.

In the African nations of Cameroon, Chad and Niger there have been far more cases of cholera than usual this year according to the United Nations

The statistics from the World Health Organization (WHO) are that the disease kills about 120,000 people per year.

Causes

Cholera is caused by a bacterial infection of the intestine and, in severe cases, is characterized by diarrhea, vomiting and leg cramps, according to the Centers for Disease Control (CDC) . In such cases, rapid loss of body fluids can lead to dehydration and shock. Without treatment death can occur within hours.

A person can get cholera by drinking water or eating food contaminated with the bacteria. During epidemics, the source of the contamination is often the feces of an infected person, and infections can spread rapidly in areas where there is poor sewage treatment and a lack of clean drinking water.

Treatment

According to the World Health Organization (WHO) Cholera is an easily treatable disease. The prompt administration of oral rehydration salts to replace lost fluids nearly always results in cure. In especially severe cases, intravenous administration of fluids may be required to save the patient's life.

- HUM News Staff

(REPORT) Benin suffering from the worst floods since 1963

(Photo UN News) 

(HN, October 25, 2010) -- Nearly 700,000 people have been affected by severe flooding in the West African country of Benin and at least 60 people have been killed, according to the United Nations.

“Seasonal heavy rains have been hitting West Africa for several months and normally last until November,” said Adrian Edwards, a spokesman for the UN High Commissioner for Refugees (UNHCR) in a statement. “However, what has happened this year goes well beyond normal flooding for Benin.”

The deluge – the most extreme since 1963 – has had an impact on 51 out of 77 communes in the last five weeks. Along rivers and lakes, fragile huts have been submerged in up to two meters of water.

The UN High Commissioner for Refugees (UNHCR) will begin airlifting supplies, including some 3000 tents, from its emergency stockpiles in Copenhagen.

Edwards said that while the UNHCR's normal work in Benin was with the refugee and asylum-seeking population of some 7,300, "we have been called upon to help with the emergency shelter needs of some of the homeless people in southern parts of the country where we have a presence.”  

Food production has also been badly hit by the floods. Elisabeth Byrs of the UN's Office for the Co-ordination of Humanitarian Affairs (OCHA) said an appeal for funds and aid is being planned.
  
Experts had assessed needs for fresh water and purification measures, food and shelter, she added.

Earlier this month the U.N. reported that the floods affected 1.5 million people in regions in West and Central Africa with Benin being hit the worst. The floods have destroyed entire villages, killing more than 100 people in Nigeria alone. There have been 377 flood related deaths according to the report.

A cholera outbreak has added to the misery, with over 800 cases counted across Benin. In the aftermath of the flooding, Chad, Northern Cameroon, Niger, and Nigeria are also facing serious cholera epidemics, according to the U.N.

The heavy floods are caused by torrential rains and high water level waters of the Niger and other rivers.

- HUM News Staff