December's Cholera

05 April 2011

Things have been busy. So busy, that I have neglected writing this blog. Since I last wrote, our team has dealt with Cholera in 3 of the 4 states we work in. The cholera happened during the flooding, so that presented us with a double emergency. Testing times...

Extra international staff arrived and set up 2 separate cholera interventions.In total we treated over 20,000 people.

After the peak of the outbreak passed, the extra volunteers departed, some destined for Liberia (where refugees for Ivory Coast were arriving), some Haiti and some for Chad, both of which also had Cholera. Two weeks after they departed, reports came in of a new outbreak in the town of Argungu, Kebbi state. This was a dilemma, our extra international staff had gone (3 of us left in the team) our national staff had just departed and out stocks were low after a prolonged intervention. We had to make a difficult choice, did we throw all resources and stock into treating this outbreak in Argungu and therefore leave us with no resources for any second outbreak? Or did we hold back, expecting a second outbreak?

In the end we decided we had to try and contain the outbreak to Argungu and we sent all our tents, buckets, and essential ringer lactate (intravenous rehydration fluid) which was our real bottle-neck. Being a liquid, it is heavy and therefore expensive to transport by air. If each litre costs about a euro, transportation of each litre costs about 5 Euros. Each patient needs about 7 litres.

In 24 hours, me, my two assistants, a water & sanitation expart and some local helpers built a cholera treatment centre. We had a stock of about 2,000 litres of ringer lactate and about the same due to arrive in a few weeks.

In the end, things worked out. Our team managed to contain the outbreak to Argungu and prevent it spreading to the rest of the state. I gathered all the staff together as we were closing the centre about 6 weeks after opening and thanked them for the work they did. They had treated about 400 patients, half would have died otherwise, but even more importantly, they had stopped the cholera spreading to the rest of the state. We'll never know how big a disaster that might have been. But we avoided it.

Doing so is maybe one of the achievements I am most proud of here.