Cholera outbreak in Yemen

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Yemen finds itself in the midst of the worst cholera outbreak in the world. Since it was declared on April 27th this year, over 430,000 citizens have been diagnosed and 2,000 have died from the bacterial infection.

No outbreak has ever affected as many people in such a short period of time. The collapse of basic public services, armed conflict and famine was described by the head of the UN’s relief organization Stephen O’Brien last week as a “triple threat… that has already killed, injured, displaced or otherwise affected millions”.

There are between 5000 and 7000 cases of cholera diagnosed every day. Under 15s make up 44% of new cases and 32% of deaths, with one child diagnosed every 35 seconds. One million Yemeni under-5’s are suffering from malnutrition, making them three times as likely to die due to their weakened immune systems. Similarly, over 60s make up a third of deaths.

Why is this happening in Yemen?

15 million Yemenis are living without access to basic healthcare, clean water or sanitation, due to the civil war. Cholera is a caused by the bacterium Vibrio cholerae, symptomised by severe diarrhoea, vomiting and dehydration. It is spread through water and food that have been contaminated with the faeces of an infected person, meaning it is more prevalent in countries with poor or underdeveloped sanitation and waste disposal systems such as Yemen.

Additionally, 17 million are ‘at imminent risk of famine’ and 70% of the country lives in need of humanitarian aid. 90% of food in Yemen is imported but deliveries have been disrupted by conflict, causing prices to rise and making what does arrive inaccessible to the poor and internally displaced.

Malnutrition and cholera would be easily treatable with basic healthcare and sanitation, making cholera a ‘man-made disaster’. Oral rehydration solutions replace lost fluids and electrolytes, preventing dehydration, shock and death.

A lack of education regarding the  prevention, cure and diagnosis of the disease has particularly impacted upon isolated communities without access to phones or the media. Many do not understand the illness or cannot afford to travel to health centres.

Armed conflict

The civil war between the Saudi-led coalition and the Houthi rebels has led to the destruction of infrastructure in Yemen and has made it more difficult to access medical care. Many health workers have left the country to escape the conflict but 30000 who remain have not been paid in 10 months. This is due to the government’s refusal to pay public employees who are working in rebel-controlled areas.

The policy has also led to blocked drains and rubbish-lined streets lined in Sana’a as water engineers and sanitation workers have been striking for months. To make matters worse, Saudi Arabia and its allies have also been obstructing fuel deliveries to UN planes bringing food and medical aid to Yemen.

The Red Cross estimates that one in 45 Yemenis (approximately 600,000) will contract cholera before the end of the year. A global stockpile of 1 million vaccines has been set aside for Yemen but they are not being regularly distributed in areas already affected by the infection.

It was not until four weeks after the outbreak began that the first plane carrying medical aid was allowed to land in capital city Sana’a. Transporting food, clean water and medical supplies to Yemen and educating citizens about cholera are necessary measures to halt the spread of the disease.