The World Health Organisation (WHO) has warned that more than 7.6 million Yemenis are living in areas that are affected or at-risk of cholera, with more than three million displaced persons especially vulnerable to infection.
As of November 24th, 103 cases of cholera have been confirmed in 31 districts, with eight deaths, according to a report from relief agencies including WHO, the UN Office for the Co-ordination of Humanitarian Affairs, UNICEF and the Yemeni government.
According to the report, a total of 6,121 suspected cases have been reported in 86 districts, and WHO and partner agencies have established and supported 26 cholera treatment centres in 24 districts.
In response to the cholera outbreak , WHO issued a donor appeal on October 17th for $22.35 million. As of October 26th, contributions totaling $1.7 million have been received for health activities in support of this appeal.
The population’s health conditions have deteriorated as a result of food shortages, increasing cases of malnutrition and a lack of health services, WHO said.
The agency warned that drinking water shortages have contributed towards a rise in illness, particularly among those who have been forced to flee their homes in central Yemen due to the ongoing war.
"The ministry has registered 61 cholera suspected deaths" as of November 22nd, said Dr. Abdul-Hakim al-Kahlani, director of the epidemiological monitoring system at the Ministry of Public Health and Population.
The ministry has been working to contain the cholera epidemic with the support and joint collaboration of WHO and UNICEF, he said.
The main elements of the joint plan to confront the disease are the early detection of cholera cases and a stronger epidemiological surveillance, he said, as well as reinforcing the capacity of diagnostic laboratories in Aden, Taiz, al-Mukallah and soon al-Hodeidah.
"The joint plan involves immediate treatment of cholera cases after taking samples and treating people who have come in contact with confirmed cases," he said.
Raising public awareness
Public awareness campaigns are being conducted via public service announcements on the radio, news bulletins, newspapers, social media, mobile text messages and via schools and mosques, al-Kahlani said.
Efforts to prevent the spread of the disease also "include testing drinking water for levels of chlorine and distributing chlorine tablets to homes as well as looking at water selling stations for general consumption", he said.
The ministry is training doctors and health workers and is opening treatment centres for cases of diarrhoea in all directorates where cholera cases have been confirmed, he added.
"UNICEF and WHO are working to assist the government in its efforts to contain the disease, including a response and intervention plan in 15 provinces that can be rolled out in other provinces," said Mohammed al-Asaadi, official spokesman for UNICEF in Yemen.
"The UN has delivered 25 tonnes of medical aid for cholera cases that is enough to treat 7,500 cases, and there are sufficient supplies for targeted provinces to which the disease has spread," he told Al-Mashareq.
UNICEF has worked to contain the disease by focusing on preventative measures and water treatment, adding chlorine to wells and water tanks, he said.
"UNICEF has recruited 10,000 volunteers to help raise awareness directly to a target population of 400,000," al-Asaadi added. "We also have taken part in the official media and social media campaign."
Headway despite difficulties
Agencies working to contain the outbreak have made headway, al-Asaadi said, despite deteriorating health conditions, no working budget in health centres and health workers going without payment.
Other difficulties that hinder containment of the disease and generally affect public health and response efforts include the difficulty people face in reaching health centres as a result of poverty and high transportation costs, as well as a lack of awareness, he said.
It is difficult for health centres to function, particularly those in rural areas, "when they have shortages in laboratory technicians that could confirm cases and, as a result, handle such cases appropriately", he said.
Efforts to limit the spread of cholera have been largely successful, said Dr. Issam al-Qaifi, deputy director of al-Sabeen Hospital in Sanaa.
"There are eight cases at al-Sabeen Hospital, some of which have not been clinically confirmed," he told Al-Mashareq.
"Al-Sabeen Hospital has become a centre for receiving cases that have been diagnosed and confirmed, in addition to receiving diarrhea cases that the hospital places in isolation if it is confirmed that the patient has cholera," he said.
The war has facilitated the spread of diseases such as cholera due to the weakened health sector, state institutions and economy, as well as low family income, all of which have had a detrimental effect on public health, he said.