Major spike in cholera likely as agencies struggle to reach infected people

Fears that the world’s worst cholera outbreak could be set for a massive resurgence are growing as aid agencies in Yemen are struggling to reach almost 40,000 people suspected to have the disease, Oxfam warned today. Fighting and restraints on access – including checkpoints and permit requirements imposed by the warring parties – are making it extremely difficult to reach some affected areas. 

The number of suspected cases is already on the increase, with the imminent rainy season likely to accelerate the spread of the disease due to flooding and contamination of water sources. In the last two weeks of March, around 2,500 suspected cases were being reported every day, up from around 1,000 a day in February. That’s more than 10 times higher than the number of reported cases and associated deaths during the same period in 2018.   

More than 3,000 people have died since the outbreak began in 2016. At its height in June 2017, 7,000 suspected cases were being identified every day and the outbreak was described as the worst in human history by the World Health Organization. Oxfam has calculated that if suspected new cases continue to be identified at current rates for the rest of the year, this spike in the outbreak will exceed that of 2017. 

Muhsin Siddiquey, Oxfam’s Yemen Country Director, said: “The people of Yemen have already endured the worst cholera outbreak in history, amid more than four years of war and the collapse of the country’s economy. 

“Allowing this disease to spread across the country again causing yet more unnecessary deaths would be a stain on the conscience of humanity. The international community urgently needs to ensure safe, secure and unimpeded access for humanitarian aid for all people in need across the country.” 

Some 195,000 people are suspected to have contracted the disease so far this year, of which more than 38,000 are in districts that are hard for aid agencies to reach. Earlier this month Oxfam was forced to relocate its office in Shafer, in the northern governorate of Hajjah, as fighting reached the outskirts of the city. It is providing clean water and cash to buy food for more than half a million people in nearby districts. 

Fighting is continuing on various battle fronts across the country, including in Hudaydah, Taizz, and Hajjah, three governorates where the majority of deaths associated with cholera have been reported. 

Continuing conflict, airstrikes and access restrictions have left 14 million people facing famine in Yemen. Nearly half of all children aged between six months and five years are chronically malnourished. 

The ongoing conflict has led to a deterioration in water and sanitation systems across Yemen. Clean water and proper sanitation are essential in preventing cholera. The UN estimates there are 17.8 million people in Yemen in need of help to get clean water.   

Only half of health facilities are functional in Yemen and many people cannot afford the cost of treatment. 

Siddiquey said: “With jobs destroyed and salaries unpaid, the role of aid agencies operating in Yemen providing people with clean water, food and medical help is more vital than ever. Imposed delays on the delivery of aid threaten the lives of over a million Yemenis already exhausted by four years of war." 

Oxfam and its local partners are working to prevent the spread of cholera in parts of Amran, Taizz and Al Dale’e governorates, including trucking in fresh water, fixing water and sanitation systems and giving out soap, washing powder, basins and jerry cans. Oxfam is also helping health authorities and local response teams spread information about how cholera is transmitted, its symptoms and prevention.