IRIN, September 14, 2009

AFGHANISTAN: Health Ministry reports cholera deaths

Annually up to 50,000 children die from diarrhoeal diseases

Twenty-eight deaths from cholera and/or acute watery diarrhoea (AWD) have been reported in Afghanistan in the past two months, the Ministry of Public Health (MoPH) has said.

Boy drinking from common tap water in Western Kabul
Only 23 percent of Afghanistan’s estimated 27 million people have access to clean drinking water, according to UNICEF (Photo: Manoocher Deghati/IRIN )

At least 673 cases of AWD and/or cholera had been reported in 11 of the country’s 34 provinces, it said.

According to the World Health Organization, cholera, which is rarely reported in Afghanistan, is an acute diarrhoeal infection caused by ingestion of the bacterium vibrio cholerae. The disease is characterized in its most severe form by a sudden onset of AWD that can lead to death by severe dehydration and kidney failure.

There are strong diagnostic similarities between AWD and cholera - hence the difficulty health workers have in distinguishing between the two.

Health Minister Mohammad Amin Fatimie, in a Kabul press conference on 12 September, said MoPH was relying on NGOs and partner agencies for help, but sounded an optimistic note: “There is no outbreak of cholera but only a few single cases. The Health Ministry is capable of diagnosing and controlling cholera.”

However, health officials in the northern province of Samangan have called for emergency assistance to thwart a possible cholera outbreak in Dara-e-Sof District.

“Over the past three days cholera has killed five people in Dara-e-Sof. Unless preventive measures are implemented urgently it could spread to other areas,” said Abdul Hameed, director of Samangan’s health department.

MoPH said medical supplies, including antibiotics and sachets of oral rehydration salts, had been dispatched to cholera-affected provinces and more support would be provided if necessary.

The disease has also been reported in the eastern province of Nangarhar where flash floods affected about 4,000 people on 31 August, the UN Office for the Coordination of Humanitarian Affairs (OCHA) reported on 2 September. OCHA had warned about an outbreak of malaria from stagnant flood waters. Water sources usually get contaminated during floods.

Lack of access to safe drinking water and sanitation as well as poor awareness about personal hygiene appear to be major causes of cholera and AWD.

The UN Children’s Fund (UNICEF) estimates that only 23 percent of Afghanistan’s estimated 27 million people have access to clean drinking water and 12 percent to safe sanitation, and that annually up to 50,000 children die from diarrhoeal diseases.

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