Heavy rainfall is accelerating the spread of cholera in Sierra Leone and Guinea. Existing health risks such as poor hygiene practices, unsafe water sources and improper waste management are believed to have triggered outbreaks of the disease, which has killed 327 people and infected more than 17,400 in both countries since February.
The UN Office for the Co-ordination of Humanitarian Affairs (OCHA) said Sierra Leone was facing its worst cholera outbreak in 15 years. Ten of the country's 13 districts have been affected, and the government has declared the outbreak a national emergency. Cholera has also broken out in nine of Guinea's 33 districts, OCHA said. Conakry, the capital, has been the hardest hit area, with 3,247 cases so far.
"The onset of the rainy season in west Africa has caused an increase in cholera cases on both sides of the border between Sierra Leone and Guinea," said Laura Marconnet, an external relations officer with Unicef in Sierra Leone."The rains are particularly heavy in Sierra Leone this year."
Prevalence is high in the congested slum areas in the capitals of Guinea and Sierra Leone. There are few clean toilets and most people defecate in the open, often dangerously close to open wells, the chief source of water for most residents.
Freetown's densely populated Mabella slum, with tin shacks and poor drainage, has been badly affected. There are several community water taps, but residents complain of a lack of adequate toilets, most of which are usually clogged with water and waste during the rainy season.
"We have seen a dramatic increase in the last five to six weeks in cases, especially in Freetown," said Amanda McClelland, the Africa emergency health adviser at the International Federation of Red Cross and Red Crescent Societies (IFRC).
"The response is quite difficult in terms of co-ordinating resources. The conditions in Freetown are the perfect storm for cholera. We know we haven't contained it by any means, and it has the potential of increasing further and becoming a regional issue."
On 17 August, Sierra Leone's president, Ernest Bai Koroma, declared the outbreak a national public health crisis. The authorities, backed by aid groups, have ramped up efforts to treat people, inform them, and improve sanitation to stem further escalation.
"We are moving quickly to increase our capacity to handle all the new patients that will arrive," said Karen Van den Brande, head of the Médecins Sans Frontières (MSF) mission in Sierra Leone. "Our present cholera treatment facilities are stretched to the limit with patients. Everybody is at risk."
A new, quick-disbursing humanitarian funding facility is being used for the first time to help tackle the emergency.