Communities prepare to halt future outbreaks on Cholera

Published: 6 July 2011 16:25 CET

Ali Hakimi in Afghanistan

Afghanistan has experienced almost three decades of war and internal conflict, which has seriously affected the country’s infrastructure and health system. One of the main health issues is the lack of access to safe drinking water, particularly in rural areas, which makes communities prone to yearly outbreaks in cholera.

Cholera is an acute intestinal infection picked up through contaminated food or water. It can result in diarrhoea that can lead to severe dehydration and even death without prompt treatment. Diarrhoeal diseases are endemic to Afghanistan and there is a seasonal increase from July to September. Most of the vulnerability to waterborne diseases comes from contaminated water sources, as only 23 per cent of Afghans have access to safe drinking water.

Mohmandara district, 53km east of Jalalabad city and near the border of Pakistan, has suffered several cholera outbreaks over the last few years. The Afghan Red Crescent Society (ARCS) with close support of International Federation of Red Cross and Red Crescent Society (IFRC) recently conducted a pilot of emergency health preparedness and response field-based mission training (FBMT) with the goal of helping community be better prepared for future outbreaks.

“Cholera is very common in our village, so we asked the ARCS to come to our village and train the community volunteers to help stop the disease from spreading. And the ARCS promised to help us to combat the disease,” said Mohammad Zaher, council chief of Hazarnaw village in Mohmandara district. “All villagers came to this conclusion that ARCS should come and do the training here and we are so pleased they are here to help us.”

The emergency health preparedness and response field-based mission training was developed as a tool to strengthen the Society's operational preparedness. It enabled the ARCS staff and volunteers to experience an extended seven day simulation of a health emergency in a community, as opposed to the classroom.

In Mohmandara, the ARCS staff and volunteers carried out an assessment in a community affected by cholera, developed a plan of action, and implemented key interventions through an integrated approach using tools such as Emergency Medical Units (EMUs). community-based health and first aid, and disaster response units (DRUs). 

The Ministry of Public Health had a leading role in organizing the emergency taskforce coordination meetings and in dividing the tasks for the different organizations following an emergency. From the beginning, cooperation and coordination with the provincial office was vital and contributed to the success of the mission over the week.

“The process was really informative and it helped us recognize our strengths and weaknesses in order to build up the strengths and improve the weaknesses,” said Dr. Moqadasa Meraj, the Ministry of Public Health deputy of primary health care. “This process helped us to have better understanding of the whole emergency cycle and provided a good chance to learn more from the IFRC experiences,” she added.

The training was valuable not only for those involved, but for the management of the ARCS at branch and region levels.

Nangialai Yosufzai, Nangarhar branch president, said the training gave each person involved in a response a much better idea of what they should be doing, and when they should step back and allow others the space to work. “I personally learned from IFRC colleagues how a Red Cross and Red Crescent staff and volunteers should work under pressure,” he said.

“This field mission has shown the importance of investing in preparedness activities, and in building the capacity of a National Society like the ARCS. I have seen them learn in all areas required to respond in an emergency with them growing in confidence as well being much more efficient in how they operate”, said Nuran Higgins, IFRC head of operation for FBMT. “This is a great success for ARCS, as saving lives and being able to assist and protect the dignity of those most vulnerable following an emergency is what we should be working towards,” she added.

The IFRC supported the training from beginning to the end. The ARCS will develop a year plan to conduct more field-based trainings in vulnerable communities.