Global & Disaster Medicine

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Somalia in crisis: Measles, Cholera, Drought, Famine

WHO

WHO and Federal Ministry of Health of Somalia call for urgent support to address measles outbreak in Somalia

16 August 2017 – As millions of people in Somalia remain trapped in a devastating cycle of hunger and disease, WHO and health partners are working with national health authorities to save lives and reach the most vulnerable with essential health services.

More than 2 years of insufficient rainfall and poor harvests have led to drought, food insecurity and a real risk of famine. Malnutrition, mass displacement as a result of the drought, and lack of access to clean water and sanitation have created ideal conditions for infectious disease outbreaks.

“Somalia is facing one of the worst humanitarian crises in the world. Millions of people, already on the brink of famine, are now at risk of rapidly spreading infectious diseases like cholera and measles. Normally, these diseases are easy to treat and prevent, but they can turn deadly when people are living in overcrowded spaces and are too weak to fight off infection,” said Dr Ghulam Popal, WHO Representative in Somalia.

Drought has led to a lack of clean water and the largest cholera outbreak in the last 5 years, with more than 57 000 cases and 809 cumulative deaths reported as of 31 July 2017. Health partners, together with national health authorities, scaled up its efforts to respond to this event by setting up cholera treatment centers in affected districts and providing support in water and sanitation to prevent the spread of the disease. In March, WHO and partners conducted Somalia’s first national oral cholera vaccination campaign, and successfully reached over 450 000 vulnerable people. Due to ongoing efforts, the number of cholera cases in Somalia has declined, from 13 656 cases of acute watery diarrhoea/cholera in May 2017 to 11 228 cases in June 2017.

Somalia is also facing its worst measles outbreak in 4 years, with over 14 823 suspected cases reported in 2017 (as of 31 July), compared to 5000–10 000 cases per year since 2014. The situation is especially critical for millions of under-vaccinated, weak and hungry children who are more susceptible to contracting infectious diseases. More than 80% of those affected by the current outbreak are children under 10 year of age.

In early 2017, WHO and partners, in collaboration with national health authorities, vaccinated almost 600 000 children aged 6 months to 5 years for measles in hard-to-reach and hotspot areas across the country. Despite these efforts, the transmission of measles continues, compounded by the ongoing pre-famine situation, continued mass displacement, and undernourished children living in unhygienic conditions.

In order to contain the outbreak, a nationwide campaign is planned for November 2017 to stop transmission of the disease, targeting 4.2 million children. The campaign will also intensify efforts to strengthen routine immunization and reach unvaccinated children to boost their immunity. As shown by the response to the cholera outbreak, with the right interventions, health authorities are confident that similar success may be seen in controlling the measles outbreak.

US$ 14.4 million (a cost of US$ 3.36 per child) is required by WHO and health partners to conduct the measles vaccination campaign in November 2017, of which WHO required US$ 6.8 million. To date, no funding has been received.


Famine: South Sudan

Famine-SouthSudan_Lancet-2017: Document (www.thelancet.com   Vol 389   May 20, 2017)

“South Sudan, together with Yemen, Somalia, and Nigeria pose what the UN calls the biggest humanitarian crisis since 1945 as millions flee conflict and drought…”

 


WHO calls for immediate action to save lives in Somalia

WHO

News release

WHO is concerned by the chronic shortage of funding for life-saving work in Somalia in response to the ongoing drought that has plunged the country further towards famine, disease, and health insecurity. Drought in Somalia led to the destruction of crops and livestock, leaving more than 3.3 million people hungry every day. If the current situation continues, famine could soon be a reality, creating a devastating cycle of hunger and disease as the health of people deteriorates and they become more susceptible to infection. Drought has also led to lack of clean water and the largest outbreak of cholera Somalia has seen in the last 5 years, with more than 36 000 cases and almost 690 deaths so far in 2017 alone. With the beginning of the expected rainy season and floods this month, these numbers are expected to increase to 50 000 cases by the end of June. Cases of measles are also on the rise, with nearly 6 500 cases reported this year, 71% of them children under the age of 5 years.

“History has shown the terrible consequences of inaction, or action that comes too late. More than a quarter of a million lives – half of them children – were lost as a result of the devastating famine of 2011. This year, a much larger percentage of the population is now at risk. We will not stand by and watch millions of already vulnerable men, women, and children become victims of an avoidable catastrophe,” said Dr. Peter Salama, WHO Executive Director for Emergencies.

WHO commends the Government of the United Kingdom for its leadership in hosting an international conference today to tackle the country’s most urgent challenges, and calls on the international community to take decisive action to help avoid a humanitarian catastrophe. So far in 2017, health sector requirements of US$ 103 million are only 23% funded and WHO has received less than 10% of US$ 25 million required for an organizational response. WHO urgently appeals for additional support from the international community to ensure the health response can continue and expand, to save lives and alleviate the suffering of millions of Somalis.

Background

Whilst the operating environment in Somalia remains challenging, and humanitarian access restricted as a result of ongoing conflict and violence in many parts of the country, WHO and health partners continue to scale up their response, with coordination hubs established in Mogadishu, Garowe, Hargeisa and Baidoa. In March and April 2017, WHO delivered nearly 50 tons of medicines and medical supplies to provide life-saving support for almost 4.3 million people. Cholera treatment centres are now operational in 40 districts, and the numbers of surveillance sites for epidemic-prone diseases have been increased across the country, with Rapid Response Teams deployed to support investigation and response activities. In March, WHO and partners conducted the first national oral cholera vaccination campaign in Somalia, reaching over 450 000 vulnerable people. A second campaign is ongoing in South West State and Middle Shebelle, targeting 463 000 vulnerable people.


The secretary general of the United Nations appealed for $825 million in aid to address drought and cholera in Somalia on the brink of famine.  The money was needed to help 5.5 million people, about half of Somalia’s population, survive the next six months.

NY Times

  • 330,000 acutely malnourished children
  • That number that could rise to a million; 3.3 million people in need of medical care to deal with diseases in a country that lacks health infrastructure;
  • 7,731 cases of cholera — 183 fatal — in the past two months.

 


At least 110 people, most of them women and children, have died from starvation and drought-related illness in Somalia in the past 48 hours.

CNN

 


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