Executive Summary

Since February 2006, Luanda is going through its worst ever cholera epidemic, with an average of 500 new cases per day. The outbreak has also rapidly spread to the provinces and to date, 11 of the 18 provinces are reporting cases.

The population of Luanda has doubled in the last 10 years, and most of this growth is concentrated in slums where the living conditions are appalling. Despite impressive revenues from oil and diamonds, there has been virtually no investment in basic services since the 1970s and only a privileged minority of the people living in Luanda have access to running water.

The rest of the population get most of their water from a huge network of water trucks that collect water from two main points (Kifangondo at Bengo river in Cacuaco and Kikuxi at Kuanza river in Viana) and then distribute it all over town at a considerable profit. Water, the most basic of commodities, is a lucrative and at times complex business in Luanda, with prices that vary depending on demand.

Without sufficient quantities of water, and given the lack of proper drainage and rubbish collection, disease is rampant in the vast slums. This disastrous water and sanitation situation makes it virtually impossible to contain the rapid spread of the outbreak.

Médecins Sans Frontières is already working in ten cholera treatment structures, and may open more in the coming weeks. Out of the 17,500 patients reported in Luanda (the figure for all of Angola is 34,000), more than14,000 have been treated in MSF centres.

Despite significant efforts to ensure that patients have access to treatment, very little has been done to prevent hundreds more from becoming infected.