01 Jun 17 04 Jan 18

Cholera outbreak in Yemen worsens as conflict escalates across the country

Armed conflict escalated into a full-scale war in Yemen in 2015, exacerbating already massive medical and humanitarian needs and severely restricting access to healthcare. MSF calls for urgent response as recent cholera outbreak threatens to get out of control.

By May 29th, the number of cholera cases reported by World Health Organization (WHO) has reached more than 50,000. If the morbidity remains low (1.1 per cent), the number of cases is way higher compared to the previous outbreak (23,506 suspected cases in total between October 2016 and March 21 2017, according to WHO) as well as its spread all over the country. Cases are now reported from 19 governorates out of 22 governorates (the previous outbreak had reached a maximum of 15 governorates).

The poor level of sanitation and lack of safe drinking water, consequences of the conflict, are increasing the vulnerability of the population. Caused by war, the community is more susceptible to cholera (particularly if suffering from chronic and acute malnutrition), and the difficulty to access health facilities on time increases the risk. The outbreak is spreading to the more remote and poor communities so they have further to travel and less money for transport.

MSF’s Cholera Treatment Centres and outreach activities

Since March 30th, Doctors Without Borders/Médecins Sans Frontières (MSF) has treated more than 12,181 patients in eight Cholera Treatment Centres (CTC), six Cholera Treatment Unit (CTU) and two stabilization units in seven governorates (Amran, Hajja, Al-Dhale, Hodaidah, Ibb, Taiz and Sana’a. MSF also supports the Ministry of Public Health and Population (MoPHP) like in Aden governorate (Cholera response training for staffs, donations).

MSF first cases of cholera were identified in its supported Abs Rural hospital in Hajja governorate on March 30. Due to the quick growing number of cases, MSF continues to expand the capacity of some of its CTC, opening new ones, supporting other locations through donations and evaluating the needs.

Apart from the treatment of patients, the next step is to focus on outreach activities. In Yemen, many households have individuals well which makes the detection of corrupted water sources a very long process. Even though, MSF will focus on hygiene promotion in hard-to-reach areas as well as chlorination of the wells.

Chlorination of all the water-trucking in Sana’a by UNICEF has been in this regard an important factor to the stabilization of the outbreak in the capital. Humanitarian actors need to multiply similar efforts in the various affected governorates.

MSF calls authorities to join efforts

  • The collapsed health system all over the country because of the war and the extremely limited financial capacity of the MOPHP are some of the reasons why the outbreak has spread so widely.
  • Due to bad hygiene conditions in local communities, tens of thousands of people are exposed to the risk.
  • Humanitarian Assistance needs to be scaled up urgently and outreach activities, apart from the treatment of patients will be key to limit the spread of the disease.
  • A smooth collaboration between health actors and all relevant authorities is needed to control the epidemic.

MSF Figures at glance

MSF has treated 12,181patients (cholera & acute watery diarrhea):

  • 3,091 patients in Amran governorate (between April 25 & May 29)
  • 3,670 patients in Hajja governorate (between March 30 & May 29)
  • 2,392 patients in Al-Dhale governorate (between April 23 & May 30)
  • 1,122 patients in Hodaida since (between May 19 & May 30)
  • 1,245 patients in Taiz governorate (between May 7 & May 30)
  • 318 patients in Ibb governorate (between May 3 & May 30)
  • 343 patients in Sana’a in one day (between May 23 & 30)

Where is MSF treating Cholera?

The treatment of patients by MSF is taking place in seven governorates now and is organized as follows:

  • 99 bed-CTC at a public school in Khamer- 5 deaths
  • 25 bed-CTU at Huth hospital
  • 10 bed-Cholera Stabilization Unit at Al-Qafla
  • 10 bed- Cholera Stabilization Unit Harf- Sufyan

MSF has been sharing awareness messages to local mosques in all districts of the governorate, and have now developed a comprehensive outreach strategy to target the most affected areas, in order to stop the chain of transmission.

Hajja governorate:

60 bed-CTC at a public school near ABS Rural Hospital in ABS town

79 bed-CTC at a public school near Al-Jomhouri Hospital in Hajja city

MSF CTC’s are receiving around 200 patients per day from more than 14 different districts which are located tens of miles away. To complement the MOH/WHO response plan, MSF will provide its direct support such as training, supply, supervision, and incentives to nine local health facilities in the most affected rural areas. And, MSF will send awareness messages to the local populations through radios and in collaboration with mosques. For WASH, MSF will provide hygiene kits and disinfection kits to the patients and their families who come to our CTC’s with clear instruction on how to use at their homes.

Al-Dhale’ governorate:

  • 20 bed-CTU at Al-Salam Hospital, Qatabah – since 28 April 940 cases, 0 deaths
  • 16 bed-CTU at Al-Nasr Hospital, Addhale – since 24 April 557 cases 2 deaths
  • 14 bed-CTU at Damt Health center – since 14 May 475 cases, 0 deaths

Hodaida governorate

  • 20 bed-CTU at Al-Olfy Hospital- since 19 May, 1122 cases, 3 deaths

Taiz governorate:

  • 30 bed-CTC at a school in Al-Houban, since 07 May, 1245 cases, 2 deaths
  • 4 bed-CTU at MSF Mother & Child Hospital

Ibb governorate:

  • 40 bed-CTC at Thi As Sufal General Rural hospital. Since 3 of May 1601 suspected cases, 291 admissions, 5 deaths. MSF is still supporting 3 hospitals (Al-Nasser hospital, MCH hospital in IBB city and Jibla hospital one of the district in IBB governorate
  • MSF new CTC is open since May 30th in the city of IBB with 100 beds capacity. We already had 12 consultations and 2 admissions in the afternoon around 5.30 PM ; we are expecting more patients for the coming days.

Sana’a governorate:

  • MSF has opened a 50-bed-cholera treatment center in Al-Kuwait hospital, Sana’a, on May 23rd
  • MSF has been donating drugs for cholera management to 3 hospitals (22th May Hospital, Al-Jomhouri, and Azal medical compound).

Aden governorate

MSF is providing logistic support to Al-Sadaqa hospital that has received 960 and Lawdar hospital in Abyan that received 400 patients since beginning of May. The Cases Al-Sadaqa hospital are increasing in the last couple of days with 100+ cases per day. More CTC is needed in Aden. We are working with the hospital to open new rooms and increase the capacity from 82 beds to 96 beds. Lawdar is stable with 20 new cases/day

The support also includes training to the staff and donations). Al-Jumhouri hospital in Aden has requested MSF support for WATSAN& infection controle. Our team will go there next week; hand wash, buckets, training on chlorine solution is to start.

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