Reported by: Asma Awan, Program Coordinator International Medical Corps Eastern DRC
In November Chantal, a 35-year-old mother of seven, was admitted to Swima Health Center in Democratic Republic of Congo (DRC), which is supported by International Medical Corps for emergency cholera treatment. Chantal is just one of the thousands of Congolese who have been affected by the recent cholera outbreak that has already caused 30 deaths.
Cholera, an acute intestinal infection contracted through contaminated food and water sources, causes watery diarrhea that can lead to severe dehydration and – if treatment is not quickly administered – death within the span of a few hours. The disease remains a threat in countries where access to safe drinking water and adequate sanitation is compromised. In 2010 Nundu Health Zone in South Kivu province reported three major outbreaks of cholera. The fear is it will quickly spread to the neighboring territories of Uvira and Baraka.
International Medical Corps has been responding to the cholera epidemic in eastern DRC since April 2010, through the provision of health care services and critical supplies including antibiotics, oral rehydration salts and catheters. We are providing medicines to the 12 health centers we support as well as prepositioning medicines and supplies in Baraka and Uvira in the event the outbreak spreads.
However, due to a lack of funding, only one out of the 12 health centers supported by International Medical Corps in Nundu – Nundu General Hospital – is fully equipped to respond to cholera. We supplied vital cholera medicines to the hospital, which also offers lab facilities for testing and relatively good hygiene conditions to prevent the further spread of disease. But it does not have enough beds to accommodate the growing numbers of patients seeking emergency treatment in Nundu. Currently Chantal is fighting for her life at Swima Health Center where she is forced to lie on the floor because there is not enough space for her. Due to severe anemia and dehydration Chantal is not responding to cholera medicines and requires more advanced care but cannot be transferred to Nundu General due to lack of space.
Based on our findings from a November 2010 assessment, the health centers we support were found to be severely lacking in basic supplies and do not have the means to respond to the increased caseload of cholera patients requiring advanced medical care. Approximately 50 percent of those health centers cannot afford beds, plastic sheets and buckets and ongoing stocks of cholera medicines.
Exacerbating the spread of the disease: minimal access to health centers for isolated populations in eastern DRC; lack of awareness about cholera prevention; and the population’s low-income status. Approximately 30% of the local population is extremely isolated with the nearest health center located as much as 6 km from their homes, making them unable to reach lifesaving treatment in time. Still others do not know to seek treatment as soon as symptoms of cholera are detected. Although International Medical Corps is working to educate isolated communities about using health facilities and taking basic hygiene/sanitation measures at the household level to prevent waterborne disease, additional financial and human resource investment is needed to continue the programs.
International Medical Corps is one of the lead agencies in eastern DRC responding to primary health care needs by facilitating 42 health centers and three general hospitals in Uvira and Baraka territories. While International Medical Corps is actively implementing programs to combat an ongoing epidemic of sexual and gender-based violence, epidemics such as cholera and other waterborne diseases require equal and urgent attention and response.
International Medical Corps has extensive experience in cholera outbreak response, management, and prevention and is currently responding to the large-scale cholera outbreak in Haiti. Other recent cholera responses include Zimbabwe, Mozambique, and Iraq. Clean water, sanitation, and hygiene are likewise top priorities, with water and sanitation programs currently operating in Haiti, Somalia, Kenya, and DRC.