![]() The group has begun to establish other cholera treatment centres at 34 Military Hospital in the west of Freetown, expanding the total number of beds from 90 to 200. The organisation has treated approximately 4,600 patients in Sierra Leone and Guinea since February. In addition, Doctors Without Borders, in cooperation with the Ministry of Health and Sanitation, runs three cholera treatment units in Freetown, where more than 500 patients have been treated. The facility is a network consisting of private businesses and specialist aid organisations that provide rapid emergency medical, water and sanitation assistance to affected people in the country. Additionally, the Rapid Response Facility (RRF) established in March 2012 and activated by the British government is expected to assist Sierra Leone in coping with the epidemic. The British government announced that it allocated £2 million for an emergency plan to counter the cholera outbreak in Sierra Leone. The Sierra Leonean government and WHO predict that 32,000 people will be infected in September due to the rainy season. By the end of August 2012, approximately 13,300 people were infected by cholera humanitarian officials confirmed that 217 had already died by 23 August. ![]() At this time the cholera outbreak had a mortality rate of 1.8% in the country, nearly double the threshold for a state of emergency. On 17 August 2012, Sierra Leonean President Ernest Bai Koroma announced that the outbreak was a national public health crisis. In late August 2012, Amanda McClelland, the Emergency Health Coordinator of the International Federation of Red Cross and Red Crescent Societies, said that the outbreak “has the potential to cause a serious humanitarian crisis” and called for “more funds to deliver the most effective response”. The Ministry of Health and Sanitation reported that the disease is spreading more rapidly in cities than in isolated areas with poor sanitation. At the beginning of August, the disease began to ravage the Kenema district. There were 1,134 reported cases and 28 deaths in the Kambala district. The number of cases and deaths for Port Loko during the same period is 2,806 and 45, respectively. This area witnessed 4,965 cases and 63 deaths from 1 January to mid-August 2012. Of these districts, the one most affected is the Western Area, which includes the capital, Freetown. The outbreak has occurred primarily in eight districts: Port Loko, Kambia, Tonkolili, Bo, Moyamba, Bombali, Pujehun and the Western Area. The UN Office for the Coordination of Humanitarian Affairs reported that ten of Sierra Leone’s thirteen districts were affected. By 30 August, reported cases increased to 13,934 according to the World Health Organization (WHO). ![]() For the period of January to mid-August 2012, more than 11,600 cholera cases were officially recorded by the Ministry of Health and Sanitation in Sierra Leone. The disease has killed 327 people and infected more than 17,400 others in Sierra Leone and Guinea since February 2012, when the epidemic was reported. The UN figures indicate that there is only one doctor per 34,744 people. Poor health-care system in the country with the population of six million people also contributes to the outbreak. The water and sanitation systems were damaged after the civil war in Sierra Leone, and have not been rebuilt properly, leaving approximately 43% of Sierra Leoneans without access to clean water. According to The Africa Review, nearly 60% of toilets are pit toilets that easily drain directly into sources of drinking water and more than 30% of people defecate in the open. Only about 40% of people in Sierra Leone have access to a private or shared latrine, where approximately seven families typically share one toilet. Crowded living conditions, poor sanitation and inadequate access to safe water are responsible for the higher rates of the outbreak in the Western Area including Freetown, the capital of Sierra Leone. The outbreak was triggered by heavy rainfall and flooding in Sierra Leone and Guinea, combined with poor hygiene practices, unsafe water sources, and ineffective waste management. Cholera is a water-borne disease, primarily spread by the consumption of water or food contaminated by the feces of an infected person.
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