In mid-May this year, Hammanskraal in South Africa’s Gauteng Province became the epicentre of the second biggest cholera outbreak in the country this century, resulting in approximately 900 cases and 34 deaths.
Cholera is not endemic to South Africa but according to Doctors Without Borders/Médecins Sans Frontières (MSF) water, sanitation and hygiene expert, Danish Malik, climate change and other pressures are driving increased human mobility, “with the result that the frequency and scale of cholera outbreaks is rising.”
“Outbreaks are occurring in places that rarely experienced them before, with impacts that are often more severe than they should be,” he said, and added that partnership with organisations with experience in the control of cholera, “can help to save lives in an outbreak, and build the capacity that is needed to respond effectively to future outbreaks.”
In August 2023, MSF teamed up with the National Department of Health (NDoH), the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) to deliver cholera readiness trainings for government teams from all nine provinces
“Nobody owns an outbreak,” said Tsakani Furumele, Director for Communicable Diseases in the NDoH.
“Institutions are not jacks of all trades – if other organizations have the expertise and the willingness to help, let them help, and this is what happened in response to South Africa’s recent cholera outbreak,” she said.
According to the WHO’s Sally-Ann Ohene, the Incidents Manager for the Cholera Outbreak Response in South Africa, “the cholera readiness trainings will help provinces to respond quickly and contain any cholera outbreaks that may occur in South Africa.”
“The interesting aspect of the training was the blending of theory and simulation exercises outdoors, which gave the participants hands-on experience of chlorinating water to the right specifications, and setting up cholera treatment units. They had fun while learning, and we expect they will return to their provinces and cascade their learnings to others,” said Ohene.
South Africa Cholera Readiness Training
The WHO, MSF and UNICEF first worked together during the Hammanskraal outbreak, providing technical and material support, and as case numbers dwindled MSF reviewed the response with its partners and was subsequently asked to assist with the updating of the national cholera guidelines and the roll-out of cholera readiness trainings.
“I think it has been a positive demonstration of organizations and government working together for a common good,” said Malik, who added that much remains to be done to lower South Africa’s cholera risk profile.
“Cholera typically comes from outside South Africa but for cholera to begin spreading here the environment has to be conducive, and such conditions are increasingly present in South Africa’s towns and cities, where under-serviced settlements are proliferating, and at the same time failing water infrastructure is causing the pollution of nearby water sources,” he said.