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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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