DAKAR (AlertNet) – A cholera outbreak has killed hundreds of people in the Democratic Republic of Congo (DRC) and aid agencies are concerned the disease which is spreading fast may cause further deaths if efforts to combat the epidemic are not stepped up.
The epidemic has hit several communities along the Congo River and has spread to the neighbouring Republic of Congo, the U.N.'s World Health Organisation (WHO) said.
Cholera is an acute intestinal infection spread through contaminated food and water. It is easy to treat, but many can die if a community is unprepared for a major outbreak.
Here is an overview of the situation and current response to the crisis.
How many people have died?
The government and aid agencies responding to the crisis disagree on the numbers.
The government says cholera has killed 117 people and infected another 2,700 since the epidemic started in March in the eastern town of Kisangani. The WHO puts the death toll at 265 and the number of infections 3,800.
Congo's Minister of Health Makweng Kaput has insisted that only he is authorised to provide statistics on the disease.
"U.N. agencies must therefore avoid publishing statistics," Kaput told AlertNet.
How widespread is the epidemic?
The epidemic started in Orientale province in eastern Congo, and spread along the Congo River to Bandundu, Equateur and Kinshasa provinces. The ministry of health says it is now under control in Orientale.
Thousands of people travel up and down the Congo River transporting goods in boats, barges and canoes. Aid groups believe many carry the infection to different villages.
Fewer than 150 cases have been reported in the capital Kinshasa. But aid groups say the factors which fuelled the spread of the disease in other regions - including poor hygiene and little access to safe drinking water - are present in the city of over 8 million inhabitants, putting hundreds of thousands of people at risk.
"If the epidemic takes root in Kinshasa the consequences could be disastrous," said Luis Encinas, operations coordinator for the medical charity Medecins Sans Frontieres (MSF).
Is this the worst epidemic in the DRC in recent times or are such epidemics regular?
Cholera is endemic in eastern Congo, particularly in areas close to the Great Lakes region where outbreaks are reported every year. There were 18,552 cholera cases and 232 deaths mainly in eastern Congo last year. However, the western provinces of Kinshasa, Bandundu and Equateur have been relatively "cholera free" in the last ten years, which makes the current epidemic unusual.
Aid agencies are worried that the relative rarity of the disease in the western part of the country might mean few people know how to help the sick.
"The local people know enough about cholera to be very concerned, but not enough to know how to protect themselves, recognise the symptoms and take the appropriate course of action," MSF said in a statement.
Can the health system cope with the epidemic?
Congo is a vast country with urgent medical needs that stem from a long and brutal conflict. The health system lacks infrastructure and medical supplies, and some of the staff lack motivation. Doctors and nurses in some of rural areas hit by the cholera outbreak also need training on how to effectively handle the disease.
"There is definitely need of international help in terms of funds to support supplies and human resources," a spokeswoman for the U.N. Children's Fund (UNICEF) said.
What has been the response so far?
The government has set up commissions at national and provincial levels to coordinate response activities. It has been working with U.N. agencies and non-governmental organisations (NGOs) to set up cholera treatment centres in affected areas and boost surveillance and medical services.
The United Nations has released $4 million from its central emergency fund (CERF) to help WHO and UNICEF respond to the crisis.
UNICEF is sending out cholera prevention messages using leaflets and radio and TV public service announcements. The agency has supplied chlorine, water purification tablets and oral rehydration salts which are being distributed by the government and NGOs fighting the epidemic.
MSF responded to the initial outbreak in Kisangani where doctors have treated more than 1,000 cases. The organisation has also set up cholera treatment centres in Bandundu, Equateur and Kinshasa provinces.
Oxfam GB has been carrying out water and sanitation activities in Bandundu and Equateur provinces.
Sources: UNICEF, DRC Ministry of Health, MSF, WHO and the U.N. Office for the coordination of humanitarian affairs (OCHA)
(Additional reporting by Bienvenu-Marie Bakumanya in Congo)