The Country’s Devastating Situation
Not as widely broadcasted by the media, Somalia is currently undergoing a significant humanitarian crisis. This crisis is due to a combination of factors: political conflict, food insecurity, displacement of people, and limited access to healthcare (1). Making matters worse, Somalia is also suffering from a severe drought, which began in October 2016 and has contributed to thousands of people contracting cholera and other water-borne diseases (1). This year marks the third consecutive year that Somalia has suffered from failed rains (2). Last year’s El Niño weather phenomenon is partly responsible for the severe drought in Somalia and has also affected other parts of East and South Africa (3).
Due to lack of rainfall and water resources, Somalia is now experiencing a famine along with an alarming increase in water-borne diseases, like cholera (3). Approximately three million people in Somalia currently suffer from food insecurity (3). In early March, over a period of only 48 hours, 110 Somalis died from starvation and drought-related illnesses (4). The WHO has estimated that more than half of the country’s population (about 6.2 million people) are in desperate need of emergency humanitarian assistance (5).
The Cholera Outbreak
Arguably the most concerning part of this humanitarian crisis is the drastic rate at which cholera has been spreading in the country as a result of a lack of clean water (1,6). Somalia has had more than 11,000 cases and 269 deaths from cholera so far in 2017 (1,6). The case fatality rate of this outbreak has reached 2.4% (1). Of the cases reported in February alone, 45.7% were women and 38.8% were children under five years old (7).
What is Cholera?
Cholera is a bacterial disease caused by the bacterium Vibrio cholerae that results in an acute diarrheal illness (8). People acquire the disease through consumption of food or water contaminated with the bacterium, Vibrio cholerae (8). For those who become infected, symptoms can occur anywhere from 12 hours to five days after initial infection (8). Symptoms of cholera include severe watery diarrhea, often leading to severe dehydration. This dehydration can be fatal if not treated within hours of the initial onset of these symptoms (8). Most cases do not exhibit any symptoms but can still shed the bacterium in their feces for one to 10 days after infection (8). This is problematic because the asymptomatic carriers may contamination their environment and can contribute to further spread of the disease (8).
Cholera affects millions of people annually, even though it is a completely treatable and preventable disease. The treatment for cholera includes oral rehydration solution that can be administered through dissolvable tablets or intravenous fluids (8). If administered to the patient quickly and efficiently enough, the case fatality rate for cholera is below 1% (8). In order to prevent the spread of cholera, there must be adequate drinking water and sanitation. Additionally required is hygiene surveillance, social mobilization, quick and sufficient treatment of those already infected, and the use of oral vaccinations (8). Oral vaccinations for cholera involves two doses for full protection against the disease (8). Each vaccination provides about 65% protection against the disease for two to five years depending on the type of vaccination (8). To respond appropriately to cholera emergencies, the World Health Organization established an on-demand supply of approximately two million doses of oral vaccinations (8).
Even though cholera is completely preventable and treatable, it still affects many countries, especially those with poor water and sanitation infrastructure, like Somalia.
What is being done about the crisis in Somalia?
Somalia launched its first oral vaccination campaign from March 15th to March 19th, targeting over 450,000 people in seven different high-risk areas (1). A second round of the vaccinations will take place in April from the 18th to the 22nd (1). Vaccinations will be given in two doses to anyone over the age of one years old (6). These vaccinations will be administered by the Somali government, WHO, UNICEF, and GAVI (6). To date, this campaign is one of the largest oral cholera vaccination campaigns in Africa (1).
Hopefully, this campaign can help prevent the further spread of cholera and save thousands of lives. Nevertheless, this large-scale cholera outbreak serves as a wake up call for better implementation of water and sanitation infrastructure, promotion of adequate hygiene practices, and increased emergency aid to developing countries in times of crisis.