A fierce cholera epidemic is spreading through the coastal slums of West Africa, killing hundreds and sickening many more in one of the worst regional outbreaks in years, health experts said.
Cholera, transmitted through contact with contaminated feces, was made worse this year by an exceptionally heavy rainy season that flooded the sprawling shantytowns in Freetown and Conakry, the capitals of Sierra Leone and neighboring Guinea.
In both countries, about two-thirds of the population lack toilets, a potentially lethal threat in the rainy season because of the contamination of the water supply. Doctors Without Borders said there had been nearly twice as many cholera cases so far this year as there were in the same period in 2007 in Sierra Leone and Guinea, when it said the area experienced its last major outbreak.
Already, more than 13,000 people suffering from the disease’s often fatal symptoms — diarrhea, vomiting and severe dehydration — have been admitted to hospitals in the two nations’ capitals, and 250 to 300 have died, Doctors Without Borders said.
In Sierra Leone, the government declared the cholera outbreak a national emergency last week, while aid workers in Guinea said the outbreak was unlikely to have reached its peak yet. Both countries have been wracked by years of civil and political unrest, with Sierra Leone still recovering from a decade of bloody civil war that drove thousands from rural areas into the city’s slums, and with Guinea emerging from a half-century of often brutal dictatorship.
Rains have already contributed to cholera deaths in the landlocked nations of Mali and Niger as well, health officials said.
Aid workers said the number of cases of the highly contagious disease continued to increase, particularly in Freetown, where most live in slums and children swim in polluted waters. Often, patients arrive at treatment centers in poor condition.
“They come barely conscious because they are severely dehydrated,” said Natasha Reyes Ticzon, a cholera field coordinator for Doctors Without Borders in Freetown. “We’ve had some deaths because they come too late.”
There have been more than 11,600 cholera cases in Sierra Leone since January, at least 216 of them fatal, according to the country’s health minister, Zainab Bangura. More than 1,000 new cases a week are being recorded in Freetown, health officials said.
In Guinea, there have been 80 deaths out of 2,700 cases so far.
“There has been heavy rain throughout the past month, and this is not helping,” said Danicel Mouqué of Doctors Without Borders in Conakry. The houses of cholera patients are being sprayed with chlorine to stem the spread of the disease, Mr. Mouqué said.
In the 14 countries of West and Central Africa there have been 40,799 cholera cases this year, and 846 deaths, with over half the reported cases originating in the Democratic Republic of Congo.
Unicef said those figures were comparable to the regional totals for 2011, when there were more than 105,000 cases and nearly 3,000 deaths in what was considered to be one of the greater region’s worst cholera epidemics.
Whereas last year’s epidemic was focused on the Lake Chad area of Cameroon, Nigeria, Chad and Niger, this year it is concentrated on the coast.
As in Freetown, sanitary conditions in Conakry are poor. “Garbage collection is highly irregular. There are piles of garbage everywhere,” said Dr. Sakoba Keita, the Guinean government official in charge of fighting against diseases. For now, officials are working to contain the epidemic, even while acknowledging that a long-term resolution remains elusive in this impoverished region.
“If your area is flooded with rainwater, and if people are defecating in the open, it will get into the water supply,” said Jane Bevan, a regional sanitation specialist for Unicef. “We know governments have the money for other things. I’m afraid sanitation is never given the priority it deserves.”
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