Mozambique recovers from cyclone and fights cholera threat

BOPIRA: A worn notebook lists people still alive in this village after a devastating hurricane. But sippy cup, a deadly threat remains.

Nearly a month after Cyclone Idai landed and triggered floods that reached tree tops, more than 1,300 people in Bopira drank water from the local pond and muddy water left behind, including the contents of the flooded latrine. The conditions are right for a deadly disease.

A cholera outbreak has already been declared in the regional city of Beira, of which half a million people live in slums, and in a few isolated communities where tens of thousands of people now live in IDP camps. , having few toilets and water.

Confirmed cases of acute diarrheal disease have rapidly increased from 5 to 5 after being reported on March 27 out of hundreds and now exceed 3,100, with six deaths.

Now, health workers are holding their breath, encouraged by a quick reaction to Beira and the restoration of running water, although it only affects 60% of the city's residents and some have to defecate openly in slums.

"I am rather optimistic. Yes, honestly, "told the Associated Press Julien Graveleau, a cholera specialist at the United Nations who coordinates relief activities after the cyclone in the areas of water and sanitation. "Of course, the numbers will go up, but I think we're ready for that."

Many challenges await us. "We saw one today," Graveleau said of his visit to Bopira, where he showed how to use a cargo of water filters. But in a week or so, the effects of a mbadive cholera vaccination campaign should begin to be visible, he said.

Nearly 900,000 oral cholera vaccines arrived in Beira last week for a mbad vaccination that Médecins Sans Frontières calls "the most ambitious campaign ever conducted with the one-dose oral cholera vaccine strategy".

The vaccine is normally given in two divided doses, but the help group says one dose is effective in emergency situations where it can be difficult to find people for the second. A single dose provides six months coverage.

Today, hundreds of vaccine promoters would be active in Beira and elsewhere, transmitting messages via megaphones or distributing doses in high traffic areas. Cholera is endemic in Mozambique, a hot spot in Africa as well as in parts of Congo, Nigeria, Ethiopia and Zimbabwe, and many people are familiar with purification tablets and other precautions.

At the popular Shoprite grocery store, people dismissed doses as shots in a bar and stepped on it. More than 70 percent of the vaccines were given on Sunday morning, Mozambique's health ministry said.

"We were really ready for the worst," said Francisca Baptista da Silva, project coordinator for Doctors Without Borders, which operates cholera treatment centers and oral rehydration centers. "But for the moment, we control it."

She spoke at a cholera treatment center in the dilapidated neighborhood of Beira, Pioneros, where foul-smelling pools of water remained in the streets and a young woman holding a bucket of water. a tap cautiously bypbaded the gray mud.

"It's a big problem," said Rosa Zimbane, who sold bottled water outside the treatment center and has declared herself in good health so far.

An ambulance carrying two women with young children was parked at the entrance. The treatment of cholera can be a simple rehydration, but it must happen quickly, because the disease can kill in a few hours.

More severe cases require intravenous infusions and, in the center, more than a dozen people sit on beds with strategically placed holes, with two buckets at hand. One was to vomit.

This cholera outbreak is more complicated for HIV-positive people in a country where about 13% of people have the virus, a prevalence that is considered very high.

Cholera treatment centers are not normally equipped for people whose immune system is weakened by HIV, and many people have stopped receiving regular care after the cyclone, da Silva said.

Today, cholera treatment centers have basic stocks of antiretrovirals and basic tests for depressed immune systems, said Dr. Katrien Duquet at the Pioneros Center.

Overall, the medical charity was expecting more cases of cholera, said project coordinator Da Silva. "He never reached the level we thought." Such peaks occur two to three weeks after an outbreak.

The dry season that begins in the coming weeks should help contain the disease in the region.

And yet, health workers do not relax. Peripheral areas such as the waterfront city of Buzi, where surveillance of the disease is much lower, remain a concern.

"People are still afraid of cholera," said da Silva. "We do not pretend it's over."

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