Greeting!  Chantelle here, reporting live from my first ever cholera outbreak.  Infection control is paramount in cholera epidemics, and where there is chlorine, there is always a watsan nearby!  So, myself and my national staff counterpart were sent to Fianga, where MSF has been intervening for the past few weeks.

I wish I could search the internet an tell you how many people unnecessarily die from cholera every year, corresponding directly to how many people have no access to clean water or a shitter of some sort; but alas, those are hoop dreams in an imperfectly connected wireless world and I am left only quoting from the MSF cholera guidelines and reporting what I see here.  If you have followed the events in Haiti or previously in Zimbabwe, you have a sense of the potential scale of mortality if conditions permit.

I quote:

“Cholera is an acute enteric disease characterized by the sudden onset of profuse painless watery diarrhoea or rice-water like diarrhoea, often accompanied by vomiting…”

Yup – I can vouch for that.  “Rice-water” is pretty accurate.

“…which can rapidly lead to severe dehydration and cardiovascular collapse.” “In severe forms (a patient can lose) more than 10 to 20 litres/ day”

Wow!  Didn’t measure, but I can believe it.

Cholera can cause as high as 20 to 50% mortality if case management is not adequate. Conversely, the death rate can be less than 2% if well treated.”

Easy to get, easy to cure.  Simple oral and IV rehydration for the majority of cases, with antibiotics for the most severe cases.  Really just a matter of pumping them with fluids.  IF they can get to a health centre and IF that health centre has supplies. Therein lays the kicker.

WHO cholera information brochure. Don't be fooled though, the discharged body fluids are rather white than red.