Healthy Dose: Sierra Leone Declares National Emergency over Cholera

August 17, 2012

Sierra Leone-9600

176 deaths and over 10,000 reported cases of cholera has led the government of Sierra Leone to declare a national emergency. From Al Jazeera:

“A decision has been taken to declare cholera as a national emergency,” a source at the health ministry said on Thursday on condition of anonymity.

“The decision followed a cholera situation report which revealed that a total of 176 people have so far died out of 10,800 reported cases recorded between January 1 to August 14 and signs of the disease spreading to various parts of the country.”

The decision was announced after a meeting between government and officials from the World Health Organisation and United Nation’s children agency UNICEF.

Government has also set up a special task force to deal with the epidemic.

According to the World Health Organisation (WHO), of eight of the country’s 13 districts are affected by the outbreak, with the increase in the number of cases in the Western Area of particular concern.

Other badly affected districts are Port Loko in the north of the country, where 43 people have died and Moyama in the south where 35 people have died.

Abass Kamara, a health ministry spokesman, rejected criticism from the public that government was doing little to stem the tide of the outbreak.

“A series of robust resource mobilisation including the setting up of dozens of cholera treatment units in affected areas have been undertaken.”

State doctor Harrison Williams said patients came from areas with limited access to proper water drainage and sanitation as the country is at the height of its rainy season.

“We are many times overstretched working from mornings to late evenings. The unprecedented rainfall which is dislodging clogged-up gutters and bringing garbage into the streets has added to the filth.”

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Global Health and Development Beat

TB – Significantly more funding is needed to address the problem of tuberculosis in Cambodia, says the director of the National Centre for Tuberculosis and Leprosy Control.

HIV/AIDS – Homeless Kenyans struggle to access lifesaving HIV and TB drugs and services.

Dengue – Officials in Vietnam’s HCM City are concerned that cases of dengue will increase over the next few months if prevention measures are not undertaken.

Cholera – NGOs and the governments in West Africa are working to improve overall sanitation, notably by providing clean toilets, to reduce the chances of cholera outbreaks.

West Nile Virus – A state of emergency has been declared in Dallas, TX following at least 14 deaths due to West Nile Virus, reports the BBC. The city plans to begin insecticide spraying says the AP.

Bird FluIRIN reports that Vienamese farmers in the north and central regions of the country are preparing for a spike in bird flu cases.

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The Players

OCHA – Heavy flooding in Niger has affected an estimated 80,000 people, says OCHA.

Save the Children – Is raising awareness about the poor state of education across the Sahel as the result of the ongoing crisis,

Haiti – The Haitian government hired a lobbyist to ensure that the US government delivers on its $3 billion aid promise in the wake of the earthquake.

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Buzzing in the Blogs

The structural drivers of HIV/AIDS are the 500 pound gorilla in the room, says Molly Fitzgerald, AIDSTAR-One Technical Advisor, JSI Research & Training Institute, Inc. She writes in the USAID Impact blog:

There is increasing agreement worldwide that structural issues are too often overlooked where HIV prevalence remains high. Women who are not empowered to take charge of their sexual lives cannot practice HIV prevention, be it in the form of condoms or pre-exposure prophylaxis. Most-at-risk populations, such as men who have sex with men, will not seek out prevention and care services if they fear stigma or prosecution. Countries that cannot afford an extensive public health network cannot offer voluntary medical male circumcision or antiretroviral therapy to its rural citizens.
Unfortunately, specific operational guidelines, definitions, and evidence to clearly guide implementation of scalable structural approaches remain inadequate. To fill this gap, the U.S. Government and the global HIV community are working toward achieving consensus on how to prioritize which structural interventions. Addressing structural drivers can have a tremendous impact on the epidemic, but bringing promising approaches to scale requires sustained investment, a significant challenge in the face of competing priorities and tightening budgets.

Recent PEPFAR guidance recognizes the importance of addressing structural drivers as part of a comprehensive combination prevention package of services. At the International AIDS Conference, USAID – along with other U.S. Government agency staff, implementers, researchers, and policymakers – discussed the structural issues that impede progress, with the goal of building consensus to move forward.

The challenge is figuring out which structural approaches will achieve the maximum impact within different contexts. Implementers at the community level know that addressing structural drivers—which are deeply entrenched in social, economic, and political systems—requires sustained investments with strategies tailored to local contexts. Identifying what works is also difficult. Although there is increasing evidence that supports the links between these factors and HIV, measuring change can often be hard in relatively short-term project lifecycles. Experts also disagree on which types of evaluation methods are adequate to demonstrate change, and balancing the need to address these factors while also scaling up other proven interventions continues to be a challenge. Because structural drivers are linked to the very fabric of social, economic, and political systems, they often require a broader sector response, unlike more narrow biomedical and behavioral approaches.

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By Mark Leon Goldberg and Tom Murphy; Photo Credit

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