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Aid agencies working to control cholera in southern Somalia


Aid agencies are working to control this year's cholera outbreak in parts of Somalia, and to date, far fewer cases have been reported this season than during the same period last year.

Between mid-January and mid-April this year, 1,307 cases of cholera were reported overall, and out of those, 83 deaths have occurred, according to the UN World Health Organization (WHO).

Those figures are much lower than last year during a similar period, when some 6,000 cases were reported, many of them due to a severe outbreak in Bardera, Gedo region, during February 1999. On average, over 70 percent of all cholera cases each year are reported from the capital Mogadishu.

International NGOs Action Internationale Contre la Faim (ACF) in south Mogadishu and Medicins Sans Frontieres (MSF) Spain - in north Mogadishu have established cholera treatment centres in collaboration with Somalia counterparts.

They have reported 388 cases in the city's south, and 529 cases in the city's north so far this season, with a total of 19 deaths in both areas, yielding a low 2 percent case fatality rate city-wide. Other cases were reported from Bur Hakaba, Bay region (146 cases, 23 deaths), Qoryoley, Lower Shabelle region (86 cases, 23 deaths) and Merka/Afgoi, Lower Shabelle region (97 cases, 16 deaths).

Recent outbreaks have reportedly occurred in Dinsoor and Qansax Dheere (Bay region), Bardera (Gedo region), Jilib (Middle Juba region), and Kismayo (Lower Juba region).

However, it is too early to ensure a proper collection of accurate statistics for analysis, or to confirm data which can initially be inflated.

Cholera, which is endemic in central and southern Somalia, normally surges from November through May during any given year, and improves at the onset of the long Gu rains.

"The outbreak is there, it is going on, cases are occurring, and deaths are occurring", says Manuel Fontaine, Senior Programme Officer, UNICEF Somalia. "And where there is cholera, children are early victims of the outbreak".

But he points out that where aid agencies are working, the case fatality rate - that is, the ratio of deaths per cholera case - has drastically dropped. This year the case fatality rate is down to 6.4 percent overall.

Because of security concerns and lack of funding, some parts of cholera-prone Bay and Lower Shabelle regions do not have cholera treatment centres run by international aid agencies.

As a result, the UN World Health Organization (WHO), the UN Children's Fund (UNICEF), the International Medical Corps (IMC), Coordinating Committee of the Organization for Voluntary Services (COSV) and local Somali aid agencies such as the Somali Red Crescent Society have formed Regional Cholera Task Forces to meet the needs of the local population.

The WHO analyses stool samples which have been collected and transported by implementing agencies (both local and international), provides intravenous solution, and coordinates on-site training in case management and cholera control, while UNICEF provides medical kits, Oral Rehydration solution (ORS) for dehydrated children and chlorine to purify water sources.

Cholera preventive messages (30,000 leaflets) have been provided by UNICEF to partners for distribution in the main towns in heatlh and education facilities, while training of 224 social mobilisers has taken place in Baidoa, Bardera, Jowhar and Kismayo.

In addition, UNICEF is sending a public health and a water sanitation specialist to help coordinate the response to cholera in several locations where outbreaks have been reported by local authorities.

In Bardera, UNICEF staff are undertaking activities in collaboration with partners to stem the outbreak.

With this technical assistance, local Somali aid agencies are able to set up, wherever possible, cholera treatment centres and water chlorination activities in areas of need.


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