Luanda, Angola, joins list of African capitals with cholera outbreaks this year
Mar 08, 2006
In the outbreak area, the only way people have to get drinkable water is to buy it from private sellers. No drains system exists and latrines are very rare. People in many other slums in Luanda live in similar conditions and the outbreak could easily spread out to other areas, especially when heavy rains start to fall.
Médecins Sans Frontières (MSF) is once again responding to a cholera outbreak and, once again, the outbreak is in one of Africa's capital cities.
In less than a year Monrovia (Liberia), Conakry (Guinea), Bissau (Guinea Bissau), Nouakchott (Mauritania), Ouagadougou (Burkina Faso), Lusaka (Zambia) and now Luanda in Angola have had to deal with cholera outbreaks.
It is the first outbreak in Luanda in over a decade.
On February 13, the first case of cholera was reported. The outbreak started in Boa Vista, one of the poorest and most overcrowded slums that surround the city centre. Within 10 days, the Angolan Ministry of Health officially declared the outbreak. By early morning on the March 2, 128 cases had been identified - ten died.
"Overcrowded areas with poor sanitation and hygiene conditions are key factors for an epidemic disease like cholera," says Joachim Delville, Médecins Sans Frontières (MSF) head of mission in Angola. "Our immediate priorities are to reduce the mortality and to limit the spread of the disease."
MSF, in cooperation with the Ministry of Health, decided to set up a cholera treatment centre (CTC) in Boa Vista, where around 50,000 people live, and where, so far, 75% of cases were notified. The centre has been set up on an area of 900 square meters and it has 50 beds to admit cholera patients. Capacity of the site can be extended to a maximum of 100 beds. As the number of infected people is increasing in surrounding areas, assessments are also being done in other slums, to allow oral rehydration points and additional cholera treatment units to be quickly set up.
"In Boa Vista there is no access to safe water and wells are infected," explains Delville. "The only way people have to get drinkable water is to buy it from private sellers. No drains system exists and latrines are very rare. And in these respects Boa Vista is not an exception. People in many other slums in Luanda live in similar conditions and the outbreak could easily spread out to other areas, especially when heavy rains start to fall."
The authorities have started water distribution to the communities in Boa Vista, but the number of people benefiting from this potable water is still limited, and the outbreak will not be contained until basic hygiene and sanitation conditions are followed.
Cholera is most often transmitted through water and food contaminated by the vibrio cholerae carried in stools and vomit. It can then be spread directly to other people if they touch the patient and then fail to wash their hands before eating. If untreated, the mortality rate is between 25% and 50%: people usually die because of dehydration.
Infected persons (whether symptomatic or not) can carry and transmit the vibrio cholerae, the bacterium that causes cholera in humans, during one to four weeks. A small number of individuals can even remain healthy carriers for several months. A number of factors conspire to a cholera outbreak: bad hygiene conditions, overcrowding and a lack of safe drinking water.
"At the moment the situation is still controllable, but the expected peak is still to come. Priorities now are: to extend the capacity to admit more cases; to carry out massive sensitisation actions while it is still time; to develop a proper mapping of cases to better identify the clusters in the communities and directly act in those places", concludes Delville.
From 1987 to 1995, Angola - with Luanda and the coastal areas in particular - was affected by a recurrent seasonal epidemics of cholera which resulted in an estimated 90,000 cases and over 4,500 deaths. Since 1995 there have been no major epidemics in Angola and only occasional reporting of unconfirmed cholera within Luanda. In 1999, MSF worked on the preparation of an extensive cholera preparedness plan for the city of Luanda.
Over 30 years, during and after the 23 years civil war, Luanda reported a fast increase of its urban population and especially in slum areas such as Cacuaco, Cazenga, Maianga, Sambizanga and Viana.
Médecins Sans Frontières (MSF) is once again responding to a cholera outbreak and, once again, the outbreak is in one of Africa's capital cities.
In less than a year Monrovia (Liberia), Conakry (Guinea), Bissau (Guinea Bissau), Nouakchott (Mauritania), Ouagadougou (Burkina Faso), Lusaka (Zambia) and now Luanda in Angola have had to deal with cholera outbreaks.
It is the first outbreak in Luanda in over a decade.
On February 13, the first case of cholera was reported. The outbreak started in Boa Vista, one of the poorest and most overcrowded slums that surround the city centre. Within 10 days, the Angolan Ministry of Health officially declared the outbreak. By early morning on the March 2, 128 cases had been identified - ten died.
"Overcrowded areas with poor sanitation and hygiene conditions are key factors for an epidemic disease like cholera," says Joachim Delville, Médecins Sans Frontières (MSF) head of mission in Angola. "Our immediate priorities are to reduce the mortality and to limit the spread of the disease."
MSF, in cooperation with the Ministry of Health, decided to set up a cholera treatment centre (CTC) in Boa Vista, where around 50,000 people live, and where, so far, 75% of cases were notified. The centre has been set up on an area of 900 square meters and it has 50 beds to admit cholera patients. Capacity of the site can be extended to a maximum of 100 beds. As the number of infected people is increasing in surrounding areas, assessments are also being done in other slums, to allow oral rehydration points and additional cholera treatment units to be quickly set up.
"In Boa Vista there is no access to safe water and wells are infected," explains Delville. "The only way people have to get drinkable water is to buy it from private sellers. No drains system exists and latrines are very rare. And in these respects Boa Vista is not an exception. People in many other slums in Luanda live in similar conditions and the outbreak could easily spread out to other areas, especially when heavy rains start to fall."
The authorities have started water distribution to the communities in Boa Vista, but the number of people benefiting from this potable water is still limited, and the outbreak will not be contained until basic hygiene and sanitation conditions are followed.
Cholera is most often transmitted through water and food contaminated by the vibrio cholerae carried in stools and vomit. It can then be spread directly to other people if they touch the patient and then fail to wash their hands before eating. If untreated, the mortality rate is between 25% and 50%: people usually die because of dehydration.
Infected persons (whether symptomatic or not) can carry and transmit the vibrio cholerae, the bacterium that causes cholera in humans, during one to four weeks. A small number of individuals can even remain healthy carriers for several months. A number of factors conspire to a cholera outbreak: bad hygiene conditions, overcrowding and a lack of safe drinking water.
"At the moment the situation is still controllable, but the expected peak is still to come. Priorities now are: to extend the capacity to admit more cases; to carry out massive sensitisation actions while it is still time; to develop a proper mapping of cases to better identify the clusters in the communities and directly act in those places", concludes Delville.
From 1987 to 1995, Angola - with Luanda and the coastal areas in particular - was affected by a recurrent seasonal epidemics of cholera which resulted in an estimated 90,000 cases and over 4,500 deaths. Since 1995 there have been no major epidemics in Angola and only occasional reporting of unconfirmed cholera within Luanda. In 1999, MSF worked on the preparation of an extensive cholera preparedness plan for the city of Luanda.
Over 30 years, during and after the 23 years civil war, Luanda reported a fast increase of its urban population and especially in slum areas such as Cacuaco, Cazenga, Maianga, Sambizanga and Viana.
Leave a Comment