N'Djamena/Brussels - With more than 1,500 people infected with cholera throughout the country, Medecins Sans Frontieres (MSF) has started construction of a new cholera treatment centre in the capital city of N'Djamena, Chad, in collaboration with the Ministry of Health. N'Djamana is in the far west of the country and this outbreak is not related to Sudanese refugees situation in the east of the country on the Chad-Sudan border.

There are over 800 cholera cases in N'Djamena alone and this outbreak is limited to the west of the country, in and around the capital. The centre should take some pressure of existing facilities, such as the city's Hôpital Liberté, where hundreds of people have found treatment but where the situation has become untenable. In the week of 9 - 15 August, health workers confirmed 449 new cases throughout the region. Two-thirds of them were found in N'Djamena, a city with an estimated population of one million.

Cholera is endemic in Chad, but the extent to which the disease spreads in the summer months varies greatly and this year's data indicate a serious epidemic. The first confirmed case, in mid-June, was an 11-year-old boy from Guitte, a fishing village on the banks of Lake Chad, north of the capital.

The following weeks saw a rapid increase in the number of infected people, with mortality rates of up to 10 per cent. The government's treatment center in Guitte has so far taken charge of over 250 people, while another 200 found treatment in various clinics north of N'Djamena. As of early July, the epidemic has started spreading towards the south, with an alarming number of infections confirmed in the city: starting with 10 new cases per day five weeks ago, the capital now sees 50 new cases daily. In total 75 people are known to have died of cholera in Chad since the outbreak began.

The Ministry of Health, in addition to making treatment available, has also initiated a public health education campaign, informing people by radio, television and through community workers in the province of the hygienic measures they should be taking in order to escape infection. In spite of these efforts, the situation is not under control.

MSF already provided support and supplies to the health authorities. The treatment centre that the team is building on a parking lot for trucks will have a capacity for 100 people and should open shortly after the weekend. Standard cholera kits, developed by MSF during years of fighting similar epidemics, have already been flown from Brussels to Chad last week.

A team of a medical coordinator, a nurse and a specialist in water supply and sanitation, is on the spot to oversee the centre's construction and care of the patients. Treatment is relatively simple if patients are found early enough. It is much more difficult to control the spread of the diseases. Immediately isolation and treatment of infected people, strict waste management, and adherence to hygienic measures by the population are crucial elements in fighting an epidemic.