Guinea Bissau hit by a severe cholera outbreak

Over 6,000 cases have already been reported

22 September 2008

Doctors Without Borders/Médecins Sans Frontières (MSF) has just launched an emergency intervention in Guinea Bissau to face a severe cholera outbreak. The first cases were reported in May, but the epidemic has only soared in August. Over 6,000 people have already been infected and nearly 120 have died. On average, 70 new cases are admitted daily in the treatment centre opened in Bissau town. The capital is the most affected area, but cases have also been reported in the other 11 regions of the country. The disease mainly hits the most crowded environments such as markets and their surrounding areas.

“Several factors can explain this rapid spread,” says Daniel Remartínez, the coordinator of the MSF teams, “… rites at burials – where relatives drink the water used to clean the corpses – have increased transmission, as well as the fact that most of the population lacks basic hygienic measures. In addition, this lack of hygiene turns health centres into sources of infection. Another factor is that 80% of the population in Bissau do not have access to drinking water. They depend on very basic wells that may be infected by nearby latrines.”

MSF supports the Cholera Treatment Centre (CTC) that has been opened in Bissau and other 17 rehydration centres in the country. The teams have focused their efforts on supporting local health authorities in places where their capacities were inadequate: they have helped to set up the CTCs, they supply medicines and material and they participate in the implementation and supervision of hygiene and infection control measures. They also offer medical support in patient management in some cases.

The organisation has also organised mobile teams in charge of implementing water and sanitation measures, disinfecting the patients´ houses and actively searching for new cases in order to prevent the disease from spreading further.

Despite the fact that cholera is endemic in the country (MSF already responded to another epidemic in 2005), the country lacks response capacity to fight the disease. “The water distribution system has not undergone any improvement in the past few years. We can see that the centres where we intervened in 2005 are better prepared, but globally local response capacity is still poor,” adds Remartínez.

Although enormous efforts have been made by the authorities to inform about the disease, means are not available. “People know what cholera is and we can see that medical staff has already managed cases, yet stemming the epidemic is still difficult because access to the hygiene measures needed is nonexistent,” concludes the MSF coordinator.