“We built the cholera clinic in one day.”

تم النشر: 8 يونيو 2015 14:30 CET

By Caroline Haga, Finnish Red Cross

Low brick buildings surrounded by a fence. Dark rooms with ripped mattresses on stone floors. Intravenous drips and sleeping patients. We are at the Red Cross cholera treatment centre at the Nyarugusu refugee camp.

“We set up this clinic in one day,” says Dr Lawrence Mhima proudly. “These buildings used to host a vocational school. There was no electricity, no water supply, no latrines or hand washing stations, no fence. The first cholera case at the camp was reported on 14 May. Only two days later, our clinic received the first patients.”

The Nyarugusu refugee camp is the final destination for the more than 46,000 Burundian refugees who have poured into Tanzania in an attempt to escape pre-election violence in their country. Due to poor hygiene and contaminated water along their journey, the highly-contagious cholera began spreading among them. Efforts by the Tanzania Red Cross Society and other international aid organizations have halted the spread for now, but nobody knows if it will last.

Only 15 actual cholera cases

The swiftly built clinic is sure to have played a key role in containing the spread of cholera at the camp, probably also other stomach diseases. All patients with severe diarrhoea are taken here. They are treated with fluids and antibiotics. No visits are allowed. The clinic even has its own cooks to prevent family members from bringing food to their loved ones.

Dr Mhima, who is in charge of the clinic, shows us around the premises. It is calm, barely anybody speaks. The nurses are busy taking care of the patients in the room with the most severe cases. The drips need to be changed constantly because as much as 4 to 5 litres of a saline and glucose solution is needed to curb the dehydration that sets in with cholera. 

“We only have 33 patients at the moment, mainly women and some children. Altogether we’ve treated 488 people in the past 10 days. Luckily, only 15 of them turned out to have cholera. But we do expect more, especially if the refugees continue to arrive,” Dr Mhima predicts.

A sad morning

“Unfortunately this morning we lost a seven year old boy,” says Dr Mhima, sadly. “He was brought here two days ago, severely sick and emaciated. We tried to treat him in all possible ways but there was nothing we could do.”

This was the first death at the clinic and it has clearly touched both the staff and the other patients. They stand outside the wards solemnly, each in their own thoughts. Despite having symptoms associated with cholera, doctors discovered that the boy did not suffer from it. But he did, along with his mother, turn out to be HIV-positive, which was the most likely the cause of his passing.

Despite the grief, work at the clinic must go on. Two new cases are brought in: a little baby and a woman who cannot talk or walk. Dr Mhima tells us that most cases turn out well in the end.

“After two hours, the woman who was just brought in will be much better, I expect. We’ve already discharged 455 patients, most of them after only three days.”

Worried about the future

The cholera clinic currently has 2 doctors and 20 nurses. Fifteen of the nurses are refugees themselves from Congo or Burundi who have volunteered to help out for a small compensation. Dr Mhima, who has worked at the camp’s health centre for two years before setting up the clinic, is afraid that more staff and equipment will still be needed.

“We’re worried that there may be many new arrivals still coming to the camp. We’re also concerned for the communities here since the new refugees may infect them before their symptoms begin. We don’t have nearly enough medicine and staff for a larger cholera outbreak.”

The International Federation of Red Cross and Red Crescent Societies (IFRC) has launched an emergency appeal of  1 million Swiss francs to support the Tanzania Red Cross Society as it responds to this unfolding crisis. The appeal aims to assist 20,000 Burundian refugees through the provision of emergency health care, shelter, water and sanitation, and non-food items including basics such as blankets and buckets. The appeal is currently 10 per cent funded.