In Lusaka, the capital city of Zambia, Médecins Sans Frontières (MSF) is responding to the worst cholera outbreaks in the country for many years. Over the last five weeks the number of cholera cases has risen dramatically to more than 4,500, while more than 120 people have lost their lives. Despite hopes the previous week that the outbreak has reached its peak and that the number of cholera cases would start decreasing, heavy rains that continue to cause severe floods in the city could potentially worsen the situation in the coming weeks.
MSF teams are working around the clock to treat people affected by cholera and try to contain the spread of the outbreak. Three cholera treatment centres (CTC) have been set up in Matero, Chawama and Kanyama, with a capacity of 567 beds and is also supporting 17 cholera treatment units (CTU). Since 4th March, MSF teams in collaboration with the Ministry of Health have treated 4,020 patients in the three CTCs. “Last week we suffered the peak of the outbreak with a total of 1054 cases admitted. This number of cholera cases is by far the highest recorded in the last decade”, said Luke Arend, head of mission in Zambia. “Due to the severity of this outbreak, we are stepping up our activities, in close collaboration with the Ministry of Health of Zambia.”
MSF medics working with a Ministry of Health clinical officer to put an IV line in a young patient at Kanyama cholera treatment centre. Lusaka, Zambia, March 2010 Photo by Robin Meldrum/MSF
Besides providing direct treatment to cholera patients, MSF is also working intensively for the prevention of the spread of the outbreak in the worst hit areas of the city. MSF water and sanitation staff are providing over 500,000 litres of chlorinated water per day in the affected neighbourhoods of Lusaka, whilst a team of nearly 50 contact tracers is working daily to disinfect the homes of cholera patients, providing chlorine for treating water and teaching safe practices to avoid transmission. MSF is also supporting another team of drainage diggers removing flood waters in the worst affected areas. More than 100 volunteers, with the help of a drama group as well, are conducting outreach activities in the communities with the aim to inform people on how to prevent the spread of the disease. MSF has also produced a television announcement about the prevention of cholera that is aired on the national television channel.
Annie reminds local people how to measure the correct dosage of bottled chlorine during a round of 'contact tracing' in Kuku compound, near Chawama health centre. Zambia, March 2010
Photo by Robin Meldrum/MSF
Cholera is endemic in Zambia. Over the previous years, Lusaka has seen repeated outbreaks during the rainy season. The lack of drainage and clean water and poor hygiene and sanitation conditions are the route causes of the recurrence and severity of outbreaks. “The vast majority of people in Lusaka are living in conditions that make them extremely vulnerable to cholera. What is clear is that much more has to be done by the authorities in the short-term to improve cholera response preparedness and to avert the needless loss of so many lives each year. There is also a need for political commitment to long-term infrastructural investment in drainage, sanitation and water provision in these unplanned peri-urban areas of Lusaka to rid the city of this deadly cholera. For far too long there has been neglect in provision of these basic services,” said Luke Arend.
MSF has been working in Zambia since 1999. In this cholera emergency intervention, 17 international staff are working alongside more than 500 Zambian colleagues in Lusaka.