In a small classroom in Mogadishu, over twenty qualified Somali nurses, men and women are gathering tools to fight cholera and acute watery diarrhoea.
Report by Eva Gilliam. MOGADISHU, Somalia.
UNICEF reports on the organization’s efforts to contain the rising threat of cholera in the Somali capital of Mogadishu. Watch in RealPlayer
“There are many different causes of diarrhoea,” explained Dr. P. Pk Burdhan of the International Centre for Diarrhoeal Diseases Research (icddr,b) in Bangladesh. “There are many different types of germs that can cause diarrhoea.”
Dr. Burdhan and his team are passionate about their work, teaching others how to treat cholera and other diarrheal diseases around the world.
“Just start ORS [Oral Rehydration Salts] as soon as a person has diarrhoea, don’t wait!” advised Dr. Burdhan.
Dr. Burdhan and his team were brought in by UNICEF in an effort to keep the cases of cholera and acute watery diarrhoea (AWD) from becoming an epidemic.
A constant threat
Conflict and famine in Somalia have forced hundreds of thousands of Somalis to come to Mogadishu seeking food and safety, often arriving in a state of extreme malnutrition. The influx of such high numbers into congested urban areas and Internally Displaced Persons (IDP) camps, in an endemic cholera area can have potentially devastating consequences.
Since January 2011, over 43,000 cases of AWD/cholera have been reported, resulting in over 710 deaths. The worst affected areas are Banadir, Lower Shabelle and Lower Juba, which account for 57 per cent of the reported cases and 76 per cent of the related deaths.
“Usually the diarrhoea is caused by very poor sanitation and contaminated water,” said Dr. Osamu Okunii, Chief of Child Survival and Development with UNICEF Somalia. “But also it is facilitated by acute malnutrition and improper infant and young child feeding.”
In a country with little infrastructure and extreme insecurity due to conflict and famine, training health workers is imperative. This is particularly true when other health concerns such as malnutrition are prevalent.
Minimizing the risk
“In a situation like Somalia, treating cholera [or acute watery diarrhoea] should go hand-in-hand with knowing and understanding the other underlying illnesses and diseases that can exacerbate any illness – like malnutrition, TB, and malaria,” said Dr. Burdhan.
Health, nutrition and water and sanitation partners are currently working with the local and newly arrived populations to minimize the disease risk and subsequent deaths. These partners are helping to chlorinate water sources, build latrines, and carry out basic hygiene and sanitation education campaigns.
“Even though we had received medical training, this kind of training is a model,” said training participant Hanad Abdi Gariae from Mogadishu. “It’s a model whereby you are taught how to do things step-by-step.”
Millions of people in southern Somalia are currently at risk of cholera and AWD due to a lack of access to clean water, sanitation and hygiene, population movements and overcrowding in urban areas. If only 0.5-3 per cent of the ‘at risk’ population were to actually fall ill, it would result in an approximate 80,000-100,000 cases of cholera/AWD region-wide.
“The difference between working in Somalia and elsewhere is that, first, there has been no formal training or capacity building in 20 years,” said Dr. Burdhan. “Second, the security situation is bleak. And these things make a huge difference in having an organised response to cholera.”