By Bismarck Swangin and Moohialdin Fuad
SANA’A, Yemen, 5 July 2017 – In late April, cholera and acute watery diarrhoea broke out in Yemen, and have since spread rapidly across the country. Children are particularly vulnerable, making half of the suspected cases and a quarter of the deaths. There are now real fears that the number of acute watery diarrhoea cases could reach up to 300,000 by August, as the rains are about to start. The risk for malnourished children is even greater. When malnutrition rises, the immunity of children falls, making them more susceptible to diseases such as cholera.
UNICEF is establishing oral rehydration centres and diarrhoea treatment centres across the country, distributing rehydration salts, repairing water networks, and delivering hygiene promotion campaigns.
UNICEF-supported community volunteers are playing a key role in raising awareness about how to prevent and respond to cholera. You can find them walking the streets in many villages, towns and cities, distributing posters and pamphlets and plastering them on the walls, particularly near water points where people gather to collect water. The four key messages they spread are: keep your water safe, wash your hands with soap, keep food safe, and how to handle a sick family or community member. These messages can help prevent cholera.
It is not an easy feat going around town the whole day in the hot weather, even more so during the fasting period of the Muslim holy month of Ramadan.
Fathya Ahmed Faraj, 45, is one of over 16,000 community volunteers who have taken on the challenge to combat the cholera outbreak in their country. “We started to work a week before Ramadan. We normally start with the water points where people begin to gather in the morning. Before the dawn prayers start we will have covered five to six water points where we paste posters and even check the water tanks to make sure they are clean. Many people listen to us attentively and wash their containers before filling them up,” she says.
After the water points she and a friend head for the market that is teeming with people. Fathya says it is easier to get large audiences here. They then head to people’s homes, going door to door and giving people information leaflets.
Fathya often has a bunch of children following her. “These children listen to me at every stop,” she says.
“Allah will bless my efforts and answer our prayers to end this disease.”
Since the outbreak of cholera, community volunteers like Fathya have spread out, especially in hotspot districts, and have reached approximately one million people. In addition to providing counselling and education on cholera prevention, they also report and refer cases to the cholera treatment centres and demonstrate to families how to prepare homemade oral rehydration solutions.
Insecurity and violence
UNICEF is working to equip Fathya and the army of volunteers with the skills and the right messages to communicate.
The escalation of conflict in Yemen more than two years ago, combined with the rising malnutrition and near total collapse of health, water and sanitation services have created the perfect circumstances for cholera to spread unabated.
There is a shortage of doctors and nursing staff – many have fled due to insecurity and violence. The few who stayed have not been paid for nine months.
At the household and community levels, UNICEF is helping to treat the sick and to repair and chlorinate water sources to prevent the disease from spreading even further. But without an end to the conflict, such outbreaks will continue to affect the lives of many, especially children.