H5N1

Yemen COVID-19: Death rates in Aden could exceed its wartime fatalities

Via CNN: Yemen coronavirus: Death rates Aden could exceed its wartime fatalities. Excerpt:

Ghasan Saleh starts digging graves at the break of dawn to prepare for the dead bodies that will come in droves. Two men in white hazmat suits appear atop an approaching pickup truck. They hastily drop a corpse into a hole and cover it with dirt.  

The health workers come and go in near-silence. Fear of infection means there are no mourners for those suspected to have died from Covid-19. 

The cycle of digging and abrupt funerals continues under the blistering sun and suffocating humidity of Aden, the seat of power of the UN-recognized government in war-torn Yemen. 

The Al Radwan cemetery has quickly expanded over the past few months, with new graves creeping closer to the residential buildings that border it. "You can see my digging machine," says Saleh. "Just now I dug 20 graves." 

Local medical authorities say that death rates in Aden are soaring this year, despite a relative lull in a war that ravaged the place in previous years. 

In the first half of May, the city recorded 950 deaths -- nearly four times as many as the 251 deaths in the whole month of March, according to a Ministry of Health report. 

Those 950 deaths in two weeks in May represent nearly half the number of casualties the city suffered in all of 2015, when the country's civil war was raging. 

Back then Aden was devastated by heavy fighting, its streets blasted by rockets and its houses peppered with bullets. Now the city's biggest killers are silent. 

On top of Covid-19, there's also a mosquito-transmitted virus outbreak, known as Chikungunya virus, and more than 100,000 known cholera cases across the nation. Many malnutrition centers and hospitals have closed due to funding shortfalls and doctors' concerns about their personal safety from coronavirus. Flash floods this spring destroyed the city's power grid. 

"Yemen has faced wars and cannot handle three pandemics, economic collapse and a war and the coronavirus," Dr. Ishraq Al-Subei, the health official responsible for the response to the disease told CNN. 

The official Covid-19 death toll in southern Yemen stands at only 127. Health workers say they don't know what the actual number is, because of low testing capacity. But the huge surge in deaths in Aden is being seen as a warning of worse to come, as the health sector becomes overwhelmed and more people die of treatable diseases.

WHO: Drop in cholera cases worldwide

Some good news from WHO: Drop in cholera cases worldwide, as key endemic countries report gains in cholera control. Excerpt:

The number of cholera cases decreased globally by 60% in 2018, the World Health Organization (WHO) announced in a report that points to an encouraging trend in cholera prevention and control in the world’s major cholera hotspots, including Haiti, Somalia and the Democratic Republic of the Congo. 

“The decrease we are seeing in several major cholera-endemic countries demonstrates the increased engagement of countries in global efforts to slow and prevent cholera outbreaks and shows the vital role of mass cholera vaccination campaigns,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “We continue to emphasize, however, that the long-term solution for ending cholera lies in increasing access to clean drinking water and providing adequate sanitation and hygiene.” 

There were 499 447 cases of cholera and 2990 deaths in 2018, according to reports from 34 countries. While outbreaks are still ongoing in various countries, the case load represents a significant downward trend in cholera transmission that has continued into 2019, according to data collected by WHO.  

“The global decrease in case numbers we are observing appears to be linked to large-scale vaccination campaigns and countries beginning to adopt the Global Roadmap to 2030 strategy in their national cholera action plans,” said Dr Dominique Legros, who heads WHO’s cholera programme in Geneva. “We must continue to strengthen our efforts to engage all cholera-endemic countries in this global strategy to eliminate cholera."  

Nearly 18 million doses of Oral Cholera Vaccine (OCV) were shipped to 11 countries in 2018. Since the OCV stockpile was created in 2013, almost 60 million doses have been shipped worldwide. Gavi, the Vaccine Alliance, has provided funding for purchase of the vaccine and financial support for the global vaccination drives.  

The Global Task Force on Cholera Control launched the Global Roadmap strategy for effective long-term cholera control and elimination in October 2017. The Global Roadmap aims to reduce cholera deaths by 90% and to eliminate transmission in up to 20 countries by 2030. The strategy provides a framework for national action plans that emphasize three main axes of cholera control:  

• early detection and rapid response to contain outbreaks 

• a multisectoral approach integrating strengthened surveillance, vaccination, community mobilization and water, sanitation and hygiene to prevent cholera in hotspots in endemic countries 

• an effective mechanism of coordination for technical support, resource mobilization and partnership at the local and global levels 

“The Global Roadmap provides clear guidance for how to prevent and, ultimately, to eliminate cholera. Every death from cholera is preventable with the tools we have today,” said Dr Tedros. 

The new report shows several countries, including Zambia, South Sudan,United Republic of Tanzania, Somalia, Bangladesh, and Nigeria have made significant progress in developing national action plans within the framework of the Global Roadmap strategy.

DR Congo: MSF urges humanitarian organisations to return to southern North Kivu

Via MSF.org, a sobering account of the other problems North Kivu is dealing with: DR Congo: MSF urges humanitarian organisations to return to southern North Kivu. Excerpt:

KINSHASA – For years, the territories of Masisi, Walikale and Rutshuru, in the southern part of North Kivu, Democratic Republic of Congo, have been plagued with armed violence and banditry. In the past months, these armed clashes have intensified, further aggravating the dire humanitarian situation, leading to significant numbers of displaced people and worrying signs of malnutrition, sexual violence and gunshot wounds among them. 

“Since the start of the year, the number of victims of sexual violence treated by MSF in Masisi has doubled compared to last year, and we have seen an increase in malnutrition cases”, says Ewald Stals, MSF field coordinator in Masisi health zone. “The escalation of armed clashes has also led to more people being treated for bullet wounds, and to a surge of displaced families arriving in already overcrowded camps where access to water and sanitation is scarce. Unsurprisingly, cholera cases have been reported and we’ve had to rapidly set up a cholera treatment centre.” 

“Where are the humanitarians?” 

From January to September 2019, MSF teams working in the territories of Masisi, Rutshuru and Walikale treated more than 11,220 malnourished children, 2,310 victims of sexual violence and 1,980 people with weapons injuries. Despite this critical situation, these territories – often referred to as the ‘Little North’ of North Kivu in the aid sector – suffer from a glaring lack of assistance from humanitarian organisations.   

“In recent years, several NGOs have left the ‘Little North’ because of insecurity, difficulties in movement around the region, and a lack of funding,” says Karel Janssens, MSF Head of Mission in DRC. “Given this reduction in the number of organisations, we have been responding to an increasing number of medical, but also non-medical, needs, especially in camps. Now we’re running at maximum capacity, and other emergency organisations must urgently come back and help respond to the massive humanitarian needs on the ground.” 

According to recent estimates, more than 687,000 people are living in camps for internally displaced people or are being hosted by local families in the territories of Masisi, Rutshuru and Walikale. For months, MSF has been advocating for the on-the-ground return of other humanitarian organisations. These efforts resulted in the arrival of a handful of organisations with temporary funding from the DRC Humanitarian Fund in mid-November.  

“This support is temporary and far from enough to meet the needs,” says Janssens. “Given the scale of the crisis, a much larger humanitarian response is needed in southern North Kivu, with organisations being present on the ground and benefitting from longer-term funding. The Humanitarian Response Plan 2020 for DRC must clearly take this into account in its upcoming revision.”

Once the breadbasket of Africa, Zimbabwe now on brink of man-made starvation, UN rights expert warns

Via the UN Office of the High Commissioner of Human Rights, a warning about a story far graver than Ebola: Once the breadbasket of Africa, Zimbabwe now on brink of man-made starvation, UN rights expert warns. Excerpt and then another link:

GENEVA / HARARE (28 November 2019) - Despite the constitutional protection of the right to food and a sophisticated set of human-rights based national laws and policies, man-made starvation is slowly making its way in Zimbabwe, said the UN expert of the right to food after visiting the country from 18 to 28 November 2019.  

"More than 60% of the population of a country once seen as the breadbasket of Africa is now considered food-insecure, with most households unable to obtain enough food to meet basic needs due to hyperinflation," said Hilal Elver, Special Rapporteur on the right to food, presenting a preliminary statement at the end of an 11-day visit. 

"In rural areas, a staggering 5.5 million people are currently facing food insecurity, as poor rains and erratic weather patterns are impacting harvests and livelihoods. In urban areas, an estimated 2.2 million people are food-insecure and lack access to minimum public services, including health and safe water.  

"These are shocking figures and the crisis continues to worsen due to poverty and high unemployment, widespread corruption, severe price instabilities, lack of purchasing power, poor agricultural productivity, natural disasters, recurrent droughts and unilateral economic sanctions." 

Elver said women and children were bearing the brunt of the crisis. 

"The majority of the children I met were stunted and underweight," she said. "Child deaths from severe malnutrition have been rising in the past few months. 90 % of Zimbabwean children aged six months to two years are not consuming the minimum acceptable diet.  

"I saw the ravaging effects of malnutrition on infants deprived of breast feeding because of their own mothers' lack of access to adequate food. 

"In a desperate effort to find alternative means of livelihood, some women and children are resorting to coping mechanisms that violate their most fundamental human rights and freedoms. As a result, school drop-outs, early marriage, domestic violence, prostitution and sexual exploitation are on the rise throughout Zimbabwe."  

Elver said people she met in the drought-affected areas of Masvingo and Mwenezi, located in the driest regions of the country, told her they ate only one portion of cooked maize a day. Women, the elderly and children are barely able to meet their minimum food needs and are largely dependent on food assistance, while most of the men are abroad seeking work, she added. 

"Without access to a diversified and nutritious diet, rural Zimbabweans, particularly younger children, barely survive," she said, adding that the agricultural and food system needs immediate reform.  

"I strongly urge the Government to take the necessary measures to reduce the country's dependence on imported food, particularly maize, and to support alternative wheats to diversify the diet. The Government should create the conditions for the production of traditional seeds to ensure the country's self-sufficiency and preparedness for the climate shocks that hit the country." 

The Special Rapporteur said the crisis in Zimbabwe's cities was no less severe than in rural areas.

"I witnessed some of the devastating consequences of the acute economic crisis in the streets of Harare, with people waiting for hours on long lines in front of gas stations, banks, and water dispensaries," she said. 

"The Zimbabweans I spoke to in Harare and its suburbs explained that even if food was widely available in markets, the erosion of their incomes combined with an inflation skyrocketing to over 490%, made them suffer from food insecurity, also impacting the middle-class. 

Elver also said that she received "disturbing" information that public hospitals have been reaching out to humanitarian organizations after their own medicine and food stocks were exhausted.  

Elver also received indication that the distribution of lands or food had been manipulated for political ends throughout the last two decades, favoring those who support the ruling political party. 

"I call on the Government of Zimbabwe to live up to its zero hunger commitment without any discrimination," Elver said.

Meanwhile, The Zimbabwean reports striking doctors say poor conditions in hospitals are causing a "silent genocide":

The senior doctors described the situation at the country’s hospitals as a silent genocide, saying doctors are forced to work without basics such as bandages, gloves, and syringes.

“We have watched the past few months as the situation in our hospitals continues to deteriorate.

“In March this year, the situation in hospitals deteriorated to the point where there were no bandages, gloves, and syringes available forcing senior doctors to highlight the dire situation publicly. It is important to find out why this has taken so long to be resolved as a silent genocide continues to be perpetrated upon the people of Zimbabwe,” the statement said.

DRC: 16 new cholera cases, including 2 deaths, recorded in week 45 in Mbuji-Mayi (Kasai Oriental)

Via provinces26rdc.net: DRC: 16 new cholera cases, including 2 deaths, recorded at the 45th week of the year in Mbuji-Mayi (Kasai Oriental). The Google translation:

The statistical data of the 45th week of the year are not satisfactory. Several rural and urban health areas experienced a slight increase in cholera, while almost all areas affected by the disease had not reported any more cases in recent weeks.  

Dr. Jean-Pierre Sumba, Epidemiologist Epidemiologist of the Provincial Health Division in Kasaï Oriental is concerned about this situation affecting his sector.  

"We had around 16 cases of cholera for week 45, including 2 deaths with 6 cases from the health zone side of Tshishimbi with Tshilundu [...]. At the level of the city of Mbuji-Mayi, it is also the same because we had for the week just ended 7 cases in the health zones of Muya, Lukelenge and Dibindi, "confirmed Dr. Jean-Pierre Sumba.  

The epidemic is under control because all areas are provided with inputs necessary for the proper management of diseases. 

"The care there, we have enough inputs that we bring to all levels where there are problems. Not long ago, we sent inputs to the Tshishimbi health zone, but at the Muya health zone, there are plenty of inputs, there is no problem," added the epidemiologist doctor of the Provincial Health Division in Kasai Oriental, Dr. Sumba. 

After nearly two years of response, Kasai Oriental is still struggling to end cholera, a situation that exposes the precarious hygienic conditions in this part of the DRC.

WHO scales up cholera vigilance in Khartoum, Sudan

WHO EMRO has published WHO scales up cholera vigilance in Khartoum, Sudan. Excerpt:

5 November 2019, Khartoum, Sudan -- To prevent a potential spread of the current cholera outbreak to Khartoum State – including to the country’s capital Khartoum City – and at the request of the Federal Minister of Health Dr Akram Eltom, WHO is working closely with health partners, nongovernmental organizations, and at-risk communities to ensure that suspected cases are quickly identified and responded to, and that people can effectively protect themselves from infection.   

“The risk of cholera spreading is very real. If not properly managed, this could have potentially serious consequences. More than 8 million people live in Khartoum State, where the public health system is impacted by the economic crisis, recent flooding, and ongoing outbreaks of infectious diseases,” said Dr Naeema Al Gasseer, WHO Representative in Sudan.  

As of 3 November, Sudan’s Ministry of Health reported 332 suspected cases of cholera, concentrated in Blue Nile and Sennar States. Two cases were confirmed in Khartoum State on 19 October.  

Together with the Ministry of Health, WHO has conducted initial risk mapping in Khartoum State to identify which areas are more likely to be at increased risk of an outbreak. This will allow for more informed planning to ensure high-risk areas, including Sharq Elnil and Ombada localities, are better prepared to respond as needed. 

Scaling up health capacities to detect and respond to cholera 

To ensure that health facilities and cholera treatment centres in Khartoum State are equipped to diagnose and treat suspected patients, WHO has delivered cholera medicines and supplies sufficient for 400 severely dehydrated patients, and 500 rapid diagnostic tests used for immediate detection and screening of cholera patients in health facilities.  

WHO is also supporting the establishing of 2 cholera treatment centres in Ombada and Bahri localities by providing additional cholera medicines, medical supplies, and rapid diagnostic tests.   

To strengthen disease surveillance in Khartoum State, WHO, with the support of MSF, is providing refresher training for 271 health staff and paramedics from all 7 localities on cholera detection and management. An additional 35 health staff are being trained to form rapid response teams who will be the first to respond to suspected cases at locality level.

North Kivu: At least 830,000 people expected to be vaccinated against cholera

Via Radio Okapi: North Kivu: at least 830,000 people expected to be vaccinated against cholera. Excerpt from the Google translation:

Approximately eight hundred and thirty thousand people will be vaccinated in seven health zones in North Kivu against cholera. The campaign was launched Wednesday (October 30th) by the Congolese Minister of Public Health, Eteni Longondo, and will last five days. It concerns all people aged at least one year.  

A total of thirty-four health areas, considered high-risk, are targeted in the seven health zones selected for this second cholera vaccination campaign in the provinces.  

While cholera is endemic in the four eastern provinces of the DRC (North and South Kivu, Tanganyika and Upper Lomami), the province of North Kivu alone has recorded almost one-quarter of all the cases enumerated since the beginning of the year in the country.  

This situation justifies the need and urgency of this reactive vaccination, says Goma WHO official in Goma Kwam. "The province of North Kivu has registered almost a quarter of the total number of cases registered in the country, or 4836 with 46 deaths," he says. 

Cholera in DRC: Epidemic reported in Maniema, 40 cases tested positive

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Via Actualite.cd: Cholera in DRC: epidemic reported in Maniema, 40 cases tested positive. The Google translation:

The governor of Maniema province, Auguy Musafiri, said Saturday the cholera outbreak in his jurisdiction after forty cases were tested positive in the county seat Kindu.

"In view of these results we declare the cholera epidemic in the province of Maniema, and to do so, we seek the support of the Central Government, humanitarian partners and others, to help us in the proper care Governor Musafiri said.  

He called on the population to give priority to hygiene measures. 

Acute intestinal infection due to ingestion of water, food or food contaminated with the bacillus Vibrio cholera, Cholera is transmitted through droppings, dirty hands or contaminated equipment, is endemic in the Democratic Republic of the Congo. Congo.    

It has made more than 900 deaths in 2018.The previous year (2017), cholera had killed 1190 people in the DRC for 55,000 cases.

With thousands of cases registered each year in many provinces, cholera is a major public health problem in the DRC, according to the UN. 

The worst cholera epidemic known to the DRC dates back to 1994. It declared itself in the wake of a massive influx of Rwandan refugees in the eastern city of Goma (Goma) bordering Rwanda. More than 58,000 people died, according to the authorities. 

South Kivu: 130 cases of cholera recorded within a week (provincial division of health)

Via Actu30.info: South Kivu: 130 cases of cholera recorded within a week (provincial division of health). The Google translation:

130 cases of cholera were recorded over a period of one week in the province of South Kivu, announces the provincial division of health on a local media.  

According to Claude Bahizire, communication officer of the DPS, the most affected territories are those of Kabare, Uvira and Fizi with respectively 22 cases, 52 cases and 28 cases.  

The health zone Katana-Idjwi recorded 12 cases, he added.  

The city of Bukavu is also affected by the epidemic with 7 cases recorded in Bagira commune, 5 cases in Kadutu commune and 4 cases in Ibanda commune.  

While urging residents of South Kivu province to observe the hygiene measures established to deal with this epidemic, Claude Bahizire announces the imminent launch of awareness campaigns to stop the spread of the epidemic.

Critical WHO supplies arrive in Sudan to manage cholera outbreak

WHO EMRO has published Critical WHO supplies arrive in Sudan to manage cholera outbreak.

25 September, 2019 – A shipment of 36 tons of cholera treatment medicines and supplies have arrived in Khartoum and are being prepared for distribution as part of the World Health Organization’s response activities supporting the Federal Ministry of Health in Sudan to contain and halt a cholera outbreak.  

The shipment includes 5000 rapid diagnostic tests (RDTs) for immediate detection and screening of cholera patients at health facilities and high-risk areas. RDTs are an essential part of early detection and response activities as their use ensures timely management and reporting of cholera cases.  

The shipment also contains medicines that can treat 2500 severely dehydrated patients, and which will be distributed to cholera treatment centres in Blue Nile and Sinnar states, where cases have been confirmed, as well as in the neighbouring at-risk states of White Nile, Kassala, Gedaref and Khartoum.  

“Even with the rapid depletion of our resources, we are accelerating our coordinated response, including delivering more medicines and supplies,” said Dr Naeema Al Gasseer, WHO Representative in Sudan. “We are working around the clock with the Federal Ministry of Health, state authorities and partners to control the outbreak and prevent more deaths.”  

As of 24 September, a total of 184 cholera cases have been reported, including 128 cases from Blue Nile State and 56 cases in Sinnar state. Eight cholera-related deaths have been recorded by the Federal Ministry of Health, including 6 in Blue Nile State and 2 in Sinnar State.  

Open defecation, lack of clean water outside the capital city and a dilapidated health sector are serious threats in a country of about 40 million people. Cholera, a bacterial disease usually contracted from contaminated water supplies, can be fatal if not treated early. 

As part of an overall integrated cholera response plan, WHO is working with the Ministry, state-level health ministries, United Nations agencies and nongovernmental organizations on surveillance of cases to monitor and control spread of the disease; maintain clean water, sanitation and nutrition; and raise awareness among at-risk communities. 

To date, WHO has deployed international experts to support the ongoing response activities and has trained and deployed 9 rapid response teams, each consisting of at least 3 members, for assessment and surveillance of high-risk areas. 18 health volunteers have also been trained and deployed to conduct water quality assessments in the 2 affected States. 

WHO is also actively disseminating awareness messages on health and sanitation through focus group discussions with community leaders, especially women, and training workshops are ongoing for volunteers on conducting house-to-house and community visits to deliver relevant health messages.