Fears are mounting that a cholera epidemic could spread rapidly among the hundreds of thousands of people living in often unsanitary conditions in Mogadishu after fleeing drought, famine and insecurity.
"The number of cases is two or even three times what was there last year so we can say that we have an epidemic of cholera going on," said Michel Yao, public health adviser at the World Health Organization (WHO).
In Mogadishu's largest health facility, Banadir Hospital, 4,272 cases of acute watery diarrhoea, a symptom of cholera, have been recorded so far this year, causing 181 deaths. (Random laboratory tests showed that 60 percent of the cases also tested positive for malaria, according to WHO.)
Children under five, weakened by malnutrition, make up three-fourths of the cases. Of the total cases, 1,633 were reported in June and July.
WHO spokesman Tarek Jasarevic said: "This sudden increase had various reasons. First, the numerous informal settlements of internally displaced persons with makeshift shelters, poor sanitation and limited access to safe water. Second, the limited capacity of existing health partners to access those informal settlements and provide essential health services. And third, the high number of malnourished children due to the ongoing famine increased the susceptibility to waterborne diseases such as acute watery diarrhoea."
Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a copious, painless, watery diarrhoea that can quickly lead to severe dehydration and death if treatment is not prompt.
|Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae|
An estimated 100,000 people, fleeing drought, famine and conflict, have made their way to Mogadishu over the past two months, according to Adrian Edwards, a spokesman for the UN Refugee Agency, UNHCR. They joined another 370,000 people who had fled to the capital earlier.
The security situation also remains a major concern for the humanitarian community in Mogadishu, even though the opposition Al-Shabab group announced on 6 August that it was pulling out of the city.
"The move is not expected to end insecurity in the Somali capital nor immediately open up access elsewhere,” said Elisabeth Byrs, a spokeswoman for the UN Office for the Coordination of Humanitarian Affairs.
With two million acutely malnourished children across the Horn of Africa, the UN Children's Fund (UNICEF) has termed the crisis “a children’s famine".
"Over half a million children are at imminent risk of death if they do not get help within weeks," Marixie Mercado, UNICEF's spokeswoman, said. "Beyond being a malnutrition crisis, it is also a crisis for child survival more generally because children who are malnourished are that much more susceptible to cholera, measles and malaria.
"This is going to be with us for a while, but we can save lives if we act now."