Cholera has broken out in the northern Nigerian state of Kano. The first cases were seen in mid-May but the outbreak exploded in the last few weeks, with over 300 cases reported by MSF and the State Ministry of Health in the last week of June. By the end of June there were over 1,200 cases and 23 deaths.

"The cholera treatment centre is running well at the moment. We've reduced the case fatality rate to below 2%, but the number of people arriving at the cholera treatment centre has doubled in the past weeks with about 40 new admissions each day" said Dr Roy Male, project co-ordinator of MSF in Kano.

Cholera is endemic in Kano State, where over 7,000 cases were treated by MSF last year. In addition to providing supplies medical assistance to the cholera treatment centre, MSF is carrying out community health education throughout the region to limit disease spread.

MSF first arrived in Kano State in 1996 during a meningitis epidemic, vaccinating 3.5 million people in the region then treating 10,000 patients in a cholera outbreak that followed. MSF subsequently developed a surveillance system for measles, meningitis, cholera and yellow fever as part of an emergency preparedness programme for a rapid response in the event of disease outbreak.

Despite Nigeria's fertile land and vast oil resources, years of mismanagement and corruption have kept the country among the poorest in the world. In a recent WHO report on the health care services, Nigeria came fifth from last, placing it alongside the world's most war-ravaged countries such as Sierra Leone the Democratic Republic of Congo and Angola.