In early July, MSF reacted to an outbreak of cholera among refugees sheltering in the Cibitoke region of Western Burundi. The refugees, reportedly up to 30,000 in number, have been in Burundi since late May 2004, having fled renewed fighting in troubled Eastern Congo.

According to the MSF head of mission for Burundi, Véronique Parqué, "while the general health of the refugees is quite reasonable for the moment, the close proximity of people combined with the lack of basics essentials for hygiene, such as plentiful clean water, mean that refugee camps such as those in Cibitoke are the perfect breeding ground for cholera."

MSF was first alerted to the danger of cholera in the camps when a small number of positive samples were discovered in late June. Working with the Burundese health authorities, an MSF team - including a pharmacist, a doctor and a water and sanitation expert - set up isolation wards in the local hospital.

The wards are capable of dealing with 25 cholera patients, with the possibility of doubling this in case of emergency. Additionally, MSF has organised four 'triage structures' (clinics designed to identify cholera patients), and is undertaking active searches for cholera cases in surrounding villages as well as a public awareness campaign around the issue. "While the last two weeks has seen the isolation ward filled to capacity, the cholera outbreak is now under control and the threat of an epidemic has died down," said Parqué.

"Cholera is relatively easy to treat once the right conditions are in place. So even though we are still receiving new cases every day at the hospital, there have been no more deaths." With the on-going work improving water, sanitation and general awareness, MSF hopes to minimise new cases by the end of the month.