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Water-borne diseases are lethal threat to children in southern Somalia

NEW YORK (August 18, 2011) — An urgent multisectoral response is being mounted to contain the spread of cholera in southern Somalia, as there is an increasing number of confirmed cases in the capital Mogadishu and reports of growing numbers of acute watery diarrhea cases in the port city of Kismayo.

Some 75% of all cases of highly infectious acute watery diarrhea are among children under the age of five. Poor sanitation conditions, a shortage of safe water, overcrowding and high malnutrition rates are the perfect combination for infectious diseases, such as cholera and pneumonia, to spread and increase death rates.

Cholera is confirmed in the Banadir, Bay, Mudug and Lower Shabelle regions, and the number of acute watery diarrhea cases has increased dramatically in the last few months. Since January this year, some 4,200 cases of acute watery diarrhea/cholera were reported in Benadir Hospital in Mogadishu alone. At this stage most of the cholera cases in the various regions are contained and under control.

"Our major concern is to monitor and detect new disease outbreaks in the many informal settlements set up by internally displaced people in and around Mogadishu," said Dr. Marthe Everard, WHO Representative for Somalia. "For the last few years, a network of health workers reporting to the early warning system has been in place, however they report through a health facility or mobile clinic. Yet the large numbers of displaced people in Mogadishu are making it more difficult to record the various diseases."

"We urgently need more mobile clinics that will provide basic health care services to the many displaced and who will strengthen the reporting on new outbreaks. This is critical to our response and our ability to save lives," she added.

Cholera is endemic in Somalia, but the last major outbreak was in 2007 with 67,000 cases. In recent years, efforts to chlorinate the water supply of Mogadishu, along with efforts to improve hygiene and sanitation, prevented a serious outbreak. But there is now an acute shortage of safe water and adequate sanitation with the influx of 100,000 people into Mogadishu this year, bringing the total number of displaced people in the capital to 470,000, with many living in overcrowded settlements.

"There is no need for a child to die of diarrhea, yet this is a tragic reality for a Somali child who is acutely malnourished. It is a lethal combination,"said Rozanne Chorlton, UNICEF Representative for Somalia. "These types of diseases can be prevented and treated quickly. To save children's lives we are making sure that safe water, sanitation and hygiene along with early access to primary health care are an integral part of our emergency response."
 
Emergency diarrheal disease kits made up of medical supplies such as syringes,  infusions, and oral rehydration salts (ORS), already prepositioned by UNICEF and WHO, have been sent to 13 hospitals. An additional 200 diarrheal disease kits, each able to treat 100 severe and 400 moderate cases, are being procured and should be in southern Somalia in the next few weeks. These items would enable partners in the health and in the water and sanitation sectors to respond to up to 100,000 cholera cases, including 80,000 moderate and 20,000 severe cases. 
 
In addition, case management of severe dehydration with and without malnutrition is being strengthened, and the focus is now on mobilizing a network of community health promoters to move from door to door with health hygiene education messages. Health posts are being stocked with essential medicines and ORS.

Many of southern Somalia's rural and urban areas rely on shallow wells, which—unless they are protected or treated with chlorine—can be a perfect breeding ground for water-borne diseases.

Partners in the water, sanitation and hygiene sector are scaling up to target 1.5 million people across high risk areas of southern Somalia. Supplies of chlorine and essential items for hygiene and household treatment and storage of water are being distributed. Already 217 water sources are being chlorinated, and 58 water point outlets are benefiting 483,200 people in Mogadishu.

In addition, household hygiene supplies, including water purification tablets, soap and buckets, enough for 48,000 families, are being distributed at existing feeding centers for malnourished children. Campaigns to encourage hand washing with soap and to educate families about the treatment of drinking water and the safe disposal of waste will also be scaled up in high-risk communities.

As part of the updated 2011 UN Consolidated Appeal for Somalia, an estimated $80 million is needed for the health sector and $78 million is required for the water, sanitation and hygiene sector. So far only 30% and 37% respectively has been raised for each sector.

About UNICEF

UNICEF has saved more children's lives than any other humanitarian aid organization in the world. Working in more than 150 countries, UNICEF provides children with health and immunizations, clean water, nutrition, education, emergency and disaster relief, and more. The U.S. Fund for UNICEF supports UNICEF's work through fundraising, advocacy, and education in the United States.

UNICEF is at the forefront of efforts to reduce child mortality worldwide. There has been substantial progress: the annual number of under-five deaths dropped from 13 million in 1990 to 8.1 million in 2009. But still, 22,000 children die each day from preventable causes. Our mission is to do whatever it takes to make that number zero by giving children the essentials for a safe and healthy childhood.

For additional information, please contact:
Susannah Masur, U.S. Fund for UNICEF, 212.880.9146, (m) 646.428.5010, smasur@unicefusa.org
Kiní Schoop, U.S. Fund for UNICEF, 212.922.2634, kschoop@unicefusa.org

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