As violence and displacement worsens in the east of the Democratic Republic of Congo, the country’s children are facing the worst cholera outbreak since 2017.
The United Nations Children Emergency Fund, Unicef, recorded at least 31,342 suspected or confirmed cholera cases and 230 deaths, many of them children, in the first seven months of 2023.
The figure is well over the 18,403 suspected cases recorded the year before.
The spread is even worse in war-battered North-Kivu province, where more than 21,400 confirmed or suspected cholera cases have been recorded this year alone. More than 8,000 children under five have been affected.
Grant Leaity, Unicef representative for the DRC, says insecurity in the country's east has caused massive displacement which in turn has caused this health crisis.
There are now 6.1 million internally displaced people. A total of 1.5 million of them, including 800,000 children, have been displaced since the start of this year.
No access to clean water
"Many of these people are now living in camps around Goma, the provincial capital, that are generally overcrowded and overstretched, making the situation ripe for cholera transmission," Leaity says.
Almost 300,000 people, including 183,000 children, lack access to enough clean water, while "159 people have to share a single latrine".
Health personnel and humanitarian workers have had a hard time reaching some communities due to the fighting, Leaity adds.
"This means we are sometimes unable to respond to suspected cases, deliver humanitarian supplies or carry out longer-term development work such as improving water supply infrastructure."
Leaity also said the cholera crisis was likely to worsen with the coming rainy season.
"There is a significant risk that case numbers will continue to rise and the disease will spread much further into communities and then on to parts of the country that have not been affected for many years," Leaity says.
Climate change has worsened the situation. Significant rainfall and flooding, which is becoming more frequent, affects access to clean water.
"That means children and their families often rely on unsafe water, which exposes them to greater risk of contracting this water-borne disease," Leaity says.
"If the outbreak spreads to the capital Kinshasa, the results could be devastating – with children paying with their lives."
Infrastructure, awareness
Despite the statistics, some progress has been made. Leaity announced that Unicef will be inaugurating a piped water system in the next two weeks to provide clean water directly to thousands of displaced families.
Unicef teams – working with the Red Cross – are able to respond very quickly when a suspected case of cholera is reported using its Case Area Targeted Intervention approach.
"Families receive cholera kits, have their households decontaminated and learn about good hygiene practices within 48 hours of the case being notified to the authorities," Leaity says.
Unicef provides hygiene kits which contain soap, water purification tablets, buckets and jerry cans.
In addition, the organisation raises awareness through programmes that promote protective hygiene measures such as handwashing with soap and the safe disposal of faeces.
More than a million people in the DRC benefited from Unicef's rapid response to cholera system in 2022.
"Unicef is also helping to ensure that hospitals have the medical supplies and drugs required to provide child-friendly cholera care," Leaity says.
He complained, however, that funding has remained a major stumbling block to Unicef’s efforts.
The organisation needs $62.5 million to scale up its prevention and response activities for the cholera and water crises over the next five months, but only 9 percent of this is covered.
