A public health officer discussing supplies at the oral rehydration therapy corner at the Bayhow cholera treatment centre. Credit: WHO Somalia/Dhal Hassan9 June 2022 – At the cholera treatment centre in the Bayhow General Hospital in Baidoa, Dr Abdirahman Isack Mohamed sighs when he explains some of the gruelling effects of the lingering drought. Between March and April 2022, the hospital was attending to 40–50 cases of cholera a week. Even though the number is down to 5–10 per week this month, the situation is still very severe.
A few weeks ago, late one night, a young man rushed in and admitted a 60-year-old woman with severe dehydration from a camp for internally displaced persons to the hospital. Her caregiver explained she had had a serious bout of diarrhoea and vomiting, and then fainted. He also added that the old lady had been using water from an unprotected shallow well to cook and for hygiene. With the ongoing drought, around 3.5 million people lack sufficient access to water and risk contracting waterborne diseases.
At the cholera treatment centre, after a quick diagnosis and assessment of the dehydration status, Dr Mohamed and his team gave her immediate support, which helped her to gain consciousness. She recovered within a few days, after receiving intravenous (IV) fluids through the bloodstream and then oral rehydration salts (ORS) that she could drink.
WHO supports cholera treatment centres to manage patients with cholera infection
“WHO, the Ministry of Health and other partners have helped us to strengthen and refresh our skills for case management of cholera infections. They trained us to assess dehydration and manage cholera infections, as well as other waterborne diseases. They have also helped us in infection prevention and control, which has enabled us to protect patients and health workers,” said Dr Mohamed.
With support from WHO and partners, medical staff at 3 hospitals – the Bayhow General Hospital in Baidoa and Marka Hospital and Afgoye cholera treatment centres — are able to provide the right treatment and support to patients suffering from acute watery diarrhoea and cholera. The health workers are managing cholera cases and demonstrating to patients proper hygiene practices, including hand washing and safe sanitation practices. They also teach patients how to manage domestic waste within their households, sanitize latrines and use water purification tablets to purify and preserve safe drinking-water at home. All these measures have significantly reduced the spread of waterborne diseases like cholera in the South West state, which has the highest number of cholera infections reported from the country thus far.
Since 2021, WHO has developed the technical capacity through training 45 health workers, including 12 medical staff, such as Dr Mohamed, at these 3 centres in the South West State. WHO has also equipped these major hospitals with essential supplies and medicines for case management of cholera and other waterborne diseases.
Oral rehydration treatment corners offering life-saving measures
Access to clean water is limited during the ongoing drought in Somalia, which increases the risk of cholera and other waterborne infections in camps for internally displaced persons. Credit: WHO Somalia/Mukhtar Sudani Oral rehydration therapy (ORT) corners are an important life-saving strategy that prevent mortality in children due to dehydration from diarrhoeal diseases. WHO is collaborating with health facilities to set up 63 ORT corners across 24 drought-affected districts that WHO is currently supporting for drought response. In Baidoa, so far, WHO has set up ORT corners in 6 health centres to offer life-saving treatment for children with diarrhoea.
ORT corners are equipped with ORS and other useful equipment to assess the dehydration status of children presenting symptoms of diarrhoeal diseases. The early treatment, and follow up offered by trained health workers, is saving children from dying due to severe dehydration. Trained health workers in each corner provide ORS and treatment for children with moderate dehydration, while keeping a watchful eye over them to prevent severe dehydration. When the affected children’s conditions improve, the health workers give their mothers ORS and teach them how to prepare home-made ORS. They advise mothers to visit a health facility nearby if the child’s condition deteriorates and encourage mothers to continue breastfeeding if children are young.
Time is of the essence in curbing cholera spread
“Time is of the essence in our response to the ongoing drought, including in managing diseases like cholera,” said Dr Mamunur Rahman Malik, WHO Representative to Somalia. “WHO has been providing urgent, life-saving support to cholera treatment centres around Somalia to save the lives of patients infected with cholera. We have over 452 community health workers explaining to communities in 6 affected districts of South West State how to prevent the spread of acute diarrhoeal diseases and suspected cholera.”
The Head of Mission at WHO Somalia added, “Furthermore, we are teaming up with the Ministry of Health and Human Services and partners to conduct a cholera vaccination campaign to protect over 900 000 people from cholera. As of May 2022, Somalia has had 4887 suspected cholera cases, including 16 deaths, reported in 21 of 74 drought-affected districts in Somalia. Cholera remains endemic in Somalia with repeated outbreaks occurring in localized areas. Approximately 62% of the cholera cases were among children under 5, while around half of the cases were females.”
An estimated 49% of the population – 7.7 million people – require some form of humanitarian or protection assistance in Somalia. Overall, 6.13 million of these people are estimated to be affected by the current drought.
WHO’s current drought response operations, including its critical life-saving support, is funded by the Central Emergency Response Fund (CERF), the European Union (EU) Delegation to Somalia, and WHO’s Contingency Fund for Emergencies (CFE).
