Fight Against World's Worst Cholera Outbreak Continues

Jul 4, 2017
Originally published on July 4, 2017 2:58 pm

Cholera is spreading rapidly across Yemen, where civil war has decimated the public health services needed to contain the outbreak.

Nearly 1,600 people have died from the disease in the last two months; an estimated 5,000 are infected every day.

Dr. Sherin Varkey of UNICEF speaks with NPR's Kelly McEvers about the humanitarian response to the crisis.

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The World Health Organization says it is the worst cholera outbreak in the world. In Yemen, close to 1,600 people have died from the disease in the last two months. An estimated 5,000 are infected every day. This, of course, is all happening during a civil war that has decimated public health services. Dr. Sherin Varkey joins us from the Yemeni capital of Sana'a. He is coordinating UNICEF's response to the cholera outbreak. Welcome to the show.

SHERIN VARKEY: Thank you, Kelly, for having me.

MCEVERS: So first, just tell us how did it get so bad? How did this happen?

VARKEY: This is a direct result of two years of a devastating conflict. And there have been rising levels of malnutrition, a crumbling economy and an almost totally collapsed health, water and sanitation system. We know that clean water is essential to prevent the spread of cholera, and that has remained the challenge. Many of the public water pumping stations have come to a standstill due to the lack of fuel or simply due to the lack of workers not being paid their regular salaries. In addition, poor environmental hygiene has also resulted in further fueling the spread of this outbreak.

MCEVERS: And I understand the people most affected by this outbreak are children. Can you give us a sense of that?

VARKEY: So we know we see 5,000 cases every day. And we know that half of these cases are children. To understand the scale, we know that one new child is reporting sick with diarrhea every minute. The conflict has had a direct impact on children in terms of many children injured, maimed and killed. But the additional effect on children is due to the failure and collapse of the public service systems. All in all, the situation for children is catastrophic in Yemen today.

MCEVERS: Could you just describe how people get the disease and how they need to be treated?

VARKEY: So cholera is a highly infectious disease and can spread very quickly. We have cases of cholera who exhibit symptoms of diarrhea, vomiting. And most of the deaths have been due to dehydration. For the severe cases, it is essential that patients receive IV fluids and antibiotics. And for the mild and moderate cases, simple rehydration and appropriate care is enough to ensure smooth recovery. The challenge in Yemen today is with more than 55 percent of health facilities being nonfunctional and a large number of health workers not being paid their salaries, it is difficult to scale up this response for these different kinds of cases.

MCEVERS: What so far has the humanitarian response been? And is it working?

VARKEY: For the cholera response, we do feel that the response is working. This is - this we know from the fact that in the districts where a comprehensive set of interventions is being implemented, we are beginning to see a decline in cases. The level of mortality we are seeing in this outbreak is much less than expected. These all indicate that the interventions are working and the care is reaching to places where it is required. It is important, of course, to keep up with the scale of the outbreak and ensure the quality of services which does remain a challenge.

MCEVERS: Dr. Sherin Varkey of UNICEF in the Yemeni capital of Sana'a, thank you very much.

VARKEY: Thank you so much. Transcript provided by NPR, Copyright NPR.