In Conakry, the old adage that cholera rears its ugly head once every seven years is long out of date. The sanitary situation in the city is such that the bacteria which causes the disease, Vibrio cholerae, finds fertile ground for its rapid and murderous spread every year during the rainy season.

In many parts of the city, the streets are strewn with household waste, and over-flowing latrines are too close to water points. It is an unhealthy environment which makes it hard for the population to maintain good levels of hygiene.

Additionally, in this city of two million people, which is laid out along a thin peninsula, the sick are widely dispersed, making it more difficult for them to reach treatment centres.

Since January this year, nearly 2500 cases of Cholera have been recorded, of whom 90 have succumbed to the disease. Due to the increasing number of cases and the limited treatment capacity in local health facilities in the city,Ã? at the end of June, MSF began providing medical support to Donka Hospital. In August, this was followed by two additional centres in densely populated areas of town called Matoto and Ratoma.

“The number of people infected by the disease in Conakry has considerably increased since July,” explains Sergio Martin Esteso, one of the programme heads for MSF in Guinea. “Of the 1260 patients treated in the three centres where MSF works, more than 1000 have been in the past three weeks.”

MSF is part of the Emergency Cholera Unit set up by the Ministry of Health to effectively co-ordinate the approaches of all the organisations involved in the outbreak.

While the emergency response is today in place, this year has once again witnessed ill- prepared health facilities and an insufficient medical system. “Without rapid access to treatment, it is well known that cholera victims die quickly and in high numbers,” underlines Esteso. “But once again, health facilities weren’t well enough prepared to cope with this emergency.”

Trained medical staff in the Cholera treatment centres at Dabompa (Matoto area) and the Donka hospital and have been in particularly short supply. “If, as we fear, the number of sick continues to increase over the next few weeks, the local teams in place at the moment will soon be exhausted. As a result we are going to have to offer support to bridge this gap,” adds Caroline Franco, an MSF coordinator for the operation.

The preventative aspects, such as the distribution of a chlorinated solution called “sur’eau”, and public health campaigns telling people to drink clean water and pay greater attention to their standards of hygiene, are being dealt with by local organizations. However, potable water is still not free, which limits the impact of the messages, as well as encouraging the spread of the disease.

“Regarding the sanitary state in Guinea, we are expecting to face more epidemics of this type in the future. So it is vital that the authorities are better prepared to take care of the sick. It is an essential component in saving a lot of lives,” concludes Esteso.

Extremely contagious, Cholera causes a severe intestinal infection, marked by uncontrollable diarrhea and vomiting. After only a few hours, infected people dehydrate and die. Simple medical care (oral rehydration or a perfusion, depending on the state of the patient, which if necessary can be followed by an antibiotic which kills the bacteria) is all that is required for patients to quickly recover.