MSF is currently trying to control a cholera outbreak in the town of Gal Hareeri in Somalia's Galgaduud region. Reaching the patients has been a major logistical challenge due to tensions between clans along the main road. Gal Hareeri is one of several places in Somalia where cholera has been reported in recent weeks.

Since March 21, MSF has been treating cholera patients in Gal Hareeri. The town is home to approximately 9,000 people. "Two people have tested positive for cholera and we are awaiting more test results from the laboratory," reports Dave Michalski, Head of Mission for MSF in Somalia, upon his return to Nairobi, Kenya, after setting up the cholera treatment centre.

"Today we are treating approximately 150 patients for suspected cholera, and we see between 15 and 50 new admissions per day. In total, over a period of just two weeks, we have already treated 300 patients," Michalski said. Supplies have been flown in to Guri El town, which has an airstrip and where MSF already runs a hospital.

From there, Gal Hareeri is a meandering 17-hour drive. Because of clan tensions along the route, the more direct five-hour journey cannot be used. MSF has now reached an agreement to fly some of the supplies into a nearby town of El Bur. "Community support is a key factor that will allow the medical work to succeed," said Michalski. "The team is urgently informing the community that we are in Gal Hareeri to provide treatment," adds the Brussels-based Operational Coordinator, Sonia Peyrassol.

"Right now, we do not know how many people are sick and dying in their homes. The majority of our patients are from Gal Hareeri town itself, but the team is also admitting some patients from surrounding villages." People with chlera suffer vomiting and diarrhoea, resulting in severe dehydration.

The treatment is based on re-hydrating patients, either with a sugar and salt solution taken orally, or - for the most severe cases - with intravenous drips of a similar fluid called Ringer's lactate. Without treatment, about 50 per cent of people who contract cholera die from the disease.

Mortality levels among MSF's patients are low: between March 25 to 28, five patients in the treatment centre died. The MSF team in Gal Hareeri consists of a field coordinator, logistician, three nurses, clinical officer and a water and sanitation specialist. In the coming days more staff will arrive.