Global Health

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This is a reaction essay to Cholera in Sierra Leone: the case study of an outbreak retrieved from http://www.who.int/features/2012/cholera_sierra_leone/en/index.html. * -------------------------------------------------

According to A.D.A.M. Medical Encyclopedia,“Cholera is an infection of the small intestine that causes a large amount of watery diarrhea. Cholera is caused by the bacterium Vibrio cholerae. The bacteria releases a toxin that causes increased release of water from cells in the intestines, which produces severe diarrhea (National Institute of Health ,U.S. National Library of Medicine - The World's Largest Medical Library,A.D.A.M. Medical Encyclopedia, May 30th 2012).” If left untreated, it can kill within hours and almost eighty percent of cases can be successfully treated with oral rehydration salts. People get infected by eating or drinking contaminated food and water and it usually manifests in places with poor sanitation, crowding, war, and famine like Africa, Asia, India, Mexico and South and Central America. The availability of safe drinking water and proper sanitation is critical in reducing the impact of cholera and other waterborne diseases. Oral cholera vaccine also reduces the risk of death by fifty percent . Sierra Leone, a West African country that has been ravaged by wars for years , experienced the worst Cholera outbreak in fifteen years. As of september 19th of this year, 19000 cases and 274 deaths have been reported. It was unusual for the Cholera outbreaks to occur in February , the middle of the dry season because most cholera outbreaks take place in the rainy season. At the onset of the cholera outbreak, the Ministry of Health and Sanitation, WHO , UNICEF and Médecins Sans Frontières-Belgium worked together to detect, confirm ,treat and prevent the cholera outbreak . But when it started raining in June, cholera spread rapidly and by August, 2000 cases were reported per week. The Ministry of Health and Sanitation have also set up a network for all health centres to report daily cases of outbreaks and have been working with WHO and partners in spreading messages about safe drinking water, hand washing and food preparation.WHO has also brought in additional experts in epidemiology, surveillance, logistics, social mobilization, water and sanitation from other WHO country offices and set up a ‘ Cholera command and control centre’. Inspite of all these efforts, there is a severe shortage of oral rehydration salts and they are expecting 32 000 cases in this outbreak. * -------------------------------------------------

“—The health of a country is often based on infant and mother morbidity and mortality rates (GCH-205-DL2, Module 4, Lauren Savaglio).” In 2007, Sierra Leone had the highest level of child mortality in the world. Maternal mortality is also one of the highest in the world. One in eight women risk dying during pregnancy and childbirth. The infant mortality rate of Sierra Leone is 123 deaths per 1000 live births in 2009 . Babies born in Sierra Leone in 2005 had a life expectancy of only 38 years. So it can be said that public health is generally poor in Sierra Leone. “Epidemiology is the study of the distribution and causes of health and illness in populations (Jacobsen,p.7).” In the case of the cholera outbreak in Sierra Leone, the infections started in the western area of the country where the capital, Freetown, is located. Cholera outbreaks usually occur in the rainy season but the outbreak in Sierra Leone started in February which is in the middle of the dry month. According to World Health Organization, “ Cholera is an extremely virulent disease. It affects both children and adults and can kill within hours.About 75% of people infected with V. cholerae do not develop any symptoms, although the bacteria are present in their faeces for 7–14 days after infection and are shed back into the...
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