by Hanan Shaker, Community Health Volunteer
It is two years since Yemen witnessed the world’s largest outbreak of cholera, which saw over a million suspected cases and 3000 associated deaths. Now, after more than four years of conflict, Yemen is facing a renewed outbreak of cholera.
The lack of a functioning healthcare system and limited access to safe water and hygiene poses a serious threat to effectively controlling the spread of the disease. The early onset of this year’s rainy season, combined with dilapidated sewage systems and high fuel prices has led to a spike in cholera cases.
2019 has already seen around 300,000 suspected cases, with almost 600 deaths – and those figures are constantly on the rise. Extremely high rates of malnutrition among Yemen’s pregnant and breastfeeding women have left them and their small children weaker and more susceptible to contracting the disease. Around a quarter of cases are children under the age of five.
Humanitarian agencies are doing what they can to prevent the spread of cholera. I work as a community health volunteer with CARE. We conduct hygiene awareness sessions focused on cholera prevention, and we distribute information materials which help to educate people about the simple steps they can take to prevent the disease.
The toll on pregnant women
I’m from Hajjah, in the northwest of Yemen, an area facing the double threat of conflict and cholera. Up to half a million people have already been displaced from their homes, leaving them extremely vulnerable to disease as they lack even basic sanitation.
I recently visited a crowded corridor-turned-cholera isolation unit in a local hospital,
At the hospital doctors moved quickly from one bed to the next, hoping that no more cases came in that afternoon. It has been an overwhelming few weeks for hospital staff and the pressure doesn’t seem to cease. Amidst the outdated monitors and rows of rehydration drips were people of all ages – all waiting desperately for some form of relief.
Twenty-year-old Amal, a pregnant mother of two children, spent five days in the cholera isolation unit. She came to the hospital as soon as she started experiencing cholera symptoms. She told me, “When I started feeling sick I knew it was cholera and I was very worried about the baby inside me. I was afraid I would lose him.”
The cost of reaching a hospital
When I met nine-month-old Razye, I could see he was clearly suffering. He’d had severe diarrhoea that had left him desperately dehydrated and unable to move. Two weeks ago, Razye was admitted to the cholera isolation centre in Hajjah in a critical condition. His weak body had been attacked by an acute cholera infection. His parents had delayed bringing him to hospital, hoping that the infection would clear through home remedies.
Like thousands of others, poverty is what stopped Razye’s family from initially taking him to hospital when he began to show symptoms of cholera. His parents were forced to make the difficult choice between spending their meagre daily income on food for the family, or seeing a doctor.
His mother explains how lucky they are that in the end they were able to find the money to bring him to hospital. She told me, “I know that there are a lot of sick people in this city who are unable to even afford travel expenses to come to the hospital.”
Losing a mother
Kloud’s mother was eight months pregnant when she contracted cholera and died just four weeks ago. Kloud’s mother had contracted cholera two years ago and managed to survive, but this time tragically her body didn’t respond to treatment, and she and her baby both died.
Kloud remembers her mother suffering from severe diarrhoea and violent vomiting. “I tried to treat her at home,” she told me. “But she didn’t get better. She was weak and dehydrated and she couldn’t eat or drink anything. When we took her to the hospital it was too late.”
Cholera is spreading in Kloud’s village. Many of her friends and family have been infected by contaminated water. Kloud explained to me that, “they don’t have clean bathrooms in their houses, which forces them to go to the toilet outside in the open.”
What happened to Kloud’s mother could happen to thousands more unless more funding for cholera treatment and prevention is made available. Kloud says that when her mother was dying, “she asked me to take care of my siblings and keep them clean so that none of them would be infected by this terrible disease.”
To respond to the current cholera outbreak, CARE is providing water and taps for communities and chlorination tablets for household water treatment; as well as distributing basic hygiene kits to vulnerable households and conducting hygiene promotion and community engagement.
To read more about CARE's work in Yemen, click here.