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© MSF/Awad Abdulsebur
25 Apr 17 25 Apr 17

Ethiopia: Acute watery diarrhoea outbreak sparks health crisis

A massive outbreak of acute watery diarrhoea is sweeping through Doolo zone, in Ethiopia’s Somali region, exacerbated by one of the worst droughts in 30 years.

In response, Médecins Sans Frontières/Doctors Without Borders (MSF) is working alongside Ethiopian health authorities to bring the outbreak under control.

We warn that more external funding and resources are urgently needed to stop the disease from spreading further. 

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Acute watery diarrhoea

The outbreak was officially declared on 7 April, affecting more than 16,000 people (WHO) in the whole region since the start of the year. There have been about 3,500 new cases per month, according to local authorities.

The government has so far deployed over 1,200 health professionals, including nurses and doctors, and set up 100 treatment centres.

Even if an overall decline in acute watery diarrhoea numbers is registered in the region, the risk of re-infection remains high.

Despite efforts to contain the outbreak, MSF teams say there are still serious shortages of infrastructure in the Doolo zone – such as boreholes, pumps, trucks to transport water, and storage tanks for safe drinking water – and a lack of international organisations responding to the emergency in Ethiopia

Less rain, less clean water

People in this region (who are mostly nomadic) use the rainy season to store water for the rest of the year. However, little rain has fallen in the past two years.

This has resulted in a severe drought. People are now surviving on less than two litres of water per day.

Without sufficient clean water, many have been forced to use untreated water sources, often resulting in the spread of acute watery diarrhoea. 

For health staff, treating patients with acute watery diarrhoea without sufficient supplies of water is a major challenge.

Many health centres have been overwhelmed by the suddenness of the outbreak. MSF has worked with several partners to support the government’s health centres, and increase the rapid response to temporary sites during outbreaks. 

"All of our animals died"

The outbreak is the latest in a series of crises brought on by the drought.

The drought has already caused the cost of food to rise sharply. Large numbers of people – women and children in particular – are being forced to travel in search of water, to keep themselves and their remaining livestock alive.

“All of our animals died,” is a common sentence heard in many of the informal settlement camps.

"Drought, malnutrition and disease are a lethal combination."
oliver schulzmsf country manager in ethiopia

One woman, whose child recovered from severe malnutrition after being treated at MSF’s inpatient therapeutic feeding centre, told a similar tale: “Before, we moved around with our animals.

"But our last camel has just died, and now we have to settle closer to a place where we can find a remaining source of water.”

These camps are scattered throughout the Doolo zone, which makes a rapid response to an outbreak more challenging.

Severe malnutrition

Some 5.7 million people are in need of food aid in Ethiopia, according to the UN.

Before the current outbreak was declared, MSF and the Ethiopian government had already reported an alarming increase in the number of children suffering from severe malnutrition in Doolo zone. 

In the first three months of 2017 alone, our teams in the region treated 2,352 patients for severe acute malnutrition in MSF-supported centres, compared to 1,230 in the whole of 2016.

Severe acute malnutrition is life-threatening, particularly for young children. Our teams have seen large numbers of children under five with clear signs of malnutrition. 

“Drought, malnutrition and disease are a lethal combination,” says Oliver Schulz, MSF’s country manager in Ethiopia. “More help is urgently needed to provide clean water, infrastructure and funding.

"Unless this happens soon, many more lives will be at risk.” 

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