Trying to halt cholera in Angola

Access to safe and free water needs to be guaranteed, says MSF

The disastrous state of the water supply and sanitation infrastructure in Luanda and other big cities is the principal reason for the rapid spread of the cholera outbreak in Angola. Up until 14th of May, more than 34,000 people had fallen ill (17,500 in Luanda alone) with cholera and over 1,200 have died. Though the Angola authorities have now taken some initiative for limiting the spread of the disease, the international humanitarian organization Médecins Sans Frontières (MSF), calls for a dramatically stepped up emergency intervention from the Government of Angola and international agencies.

Crucial to the containment of the outbreak is the provision of large amounts of free-of-charge water to cholera-affected areas, particularly in the shantytowns of Angola's capital. More than 4.5 million people live in Luanda, over two-thirds of them in shantytowns without access to running water. In these areas, over 70 percent of the people are paying high prices for water from private suppliers. This water is transported in trucks to water vendors who sell it by the bucket to families. As a result, people make do with insufficient quantities of water. Combined with poor sanitation facilities and the virtual absence of sewage and rubbish collection, this creates perfect conditions for waterborne diseases like cholera to spread through the slums like wildfire.

"Cholera is right in its element in the shantytowns of Luanda," says David Noguera, emergency coordinator for MSF in Angola. "Concurrent to our efforts to provide treatment, preventive measures such as a massive emergency intervention to provide free of charge water in the affected areas are needed. This must be done immediately in order to prevent many more people from becoming infected. If nothing is done to improve water supply and sanitation, this outbreak could continue on this scale for months to come."

The first cases of cholera were found in February in Boa Vista shantytown. Since, the outbreak has spread to other parts of the country, with cases reported now in 11 of Angola's 18 provinces. But Luanda has been hit particularly hard: more than half of the infected people live in the capital city and 20 % of the deaths occurred here. Not a single corner of the vast city has been spared from the epidemic.

As the outbreak is far from over, more needs to be done to achieve the dual strategy of ensuring early detection and treatment of patients and limiting the spread of the outbreak. Every day sees between 500 and 700 new cases and an average of ten deaths. In response to the epidemic, MSF is today running ten cholera centres in Luanda, with a total capacity of 700 beds. The organisation has also set up cholera centres in Benguela, Bengo, Malanje, Biè, Huila, Huambo, Kuanza Norte and Uige.

Thus far, more than 400 tons of medical and logistical supplies have been sent to Angola in response to the outbreak. The MSF teams total more than 70 international and 1000 national staff.