Cholera in the Far North of Cameroon

Apologies to anybody who has already read my blog of 30th October. I have split it in two and added a little to this part.

Maroua is referred to as the epicentre of the cholera outbreak, which extends to Nigeria to the west, Niger to the north, Chad to the east and to North Cameroon, which includes Garoua, to Maroua’s south. Cholera is endemic in the Far North of Cameroon but this year’s outbreak is the worst for over 20 years. The most recent figures which I could find from the health ministry are from 26th September when 7,247 cases had been recorded in Cameroon (6,000 of these in the Far North), including 483 deaths. Local people believe that the real numbers are higher than these.

The Far North has a population of 5,000,000 and its outbreak is probably bigger than the Haitian outbreak which is currently getting much media attention. While the Far North has not had the scale of devastation of the Haitian earthquake, the severe rainy season there has brought its own destruction, as mentioned in a previous post, and has created conditions conducive to the spread of cholera. The mortality rate of cholera sufferers in the Far North is much higher than in most affected areas due to the poor infrastructure and health services in the area. Less than 30% of people have access to safe drinking water and there is one latrine per 4,000 people.

Médecins sans Frontières has set up treatment centres in Maroua and in Mokolo, a village around 60 kilometers to the west. The government has launched a campaign, mainly in schools, to promote awareness of good practices to avoid transmission of the disease and this appears to be working well. It also has a phase two plan aimed at providing infrastructure to reduce the risks in the future by building 50 new deep wells and repairing 200 which are broken. However, to put this in context, Maga is one of around 30 counties in the Far North and it needs 190 new wells and needs more than this number of existing wells repaired. Because of the lack of infrastructure here, I am very keen to work on the preparation of Maga’s development plan, for which state funding came through while I was away.

Lest it should appear that I am suggesting that I am at serious risk from cholera, this is not the case. While admitting that firm information is very hard to come by, I have the impression that the outbreak is under control. There appear to have been very few cases in Maga. The villages of some other volunteers have had serious outbreaks but the volunteers remain in place. I drink only water which I have filtered and keep large stocks of water in my house. I wash my hands all the time, in filtered water if I am touching food. After buying lettuce, tomatoes, apples and other food that is eaten raw I steep it in bleach for half an hour and I always wash it again in filtered water before eating it. I am very selective about eating or drinking anything that either I or Aicha has not prepared. Cholera is easy to treat. Deaths from cholera tend to be due to dehydration and I have stocks of Dioralyte which I can take should the need arise. Aicha and I had a vaccination against cholera before coming here. It is only around 40% effective but should reduce the intensity of the disease should it strike.

13/11/2010:  I spoke too soon last week when I said that the outbreak appears to be under control.  During the week there were new cases in at least three Maga villages, including seven cases in Maga itself.

01/09/2011:  There is a very serious outbreak of cholera in Maga this year which appears to be more severe than last year's.  I have not been able to get any statistics.