A. SITUATION ANALYSIS
Description of the disaster
Starting on the night of 4 – 5th July 2018, with three patients originating from the JIBIYA health Centre in neighbouring Nigeria to N’Yelwa Health Centre in the Madarounfa Health District of Niger, with acute watery diarrhoea and vomiting, the Niger cholera outbreak rapidly surged, with large numbers of new cases and deaths registered. New districts including Madarounfa, Maradi Commune, Guidan-Roumdji, Dakoro, Aguié and Tessaoua (Maradi region), Gaya (Dosso region), Damagaran-Takaya,Takeita and Mirriah (Zinder region), Birni-N’Konni, Malbaza, Keita and Madaoua were also reported to be affected. According to the Directorate of Surveillance and Epidemics Response of the Niger Ministry of Health (MoH) report presented during the last WASH cluster meeting held on 28 February 2019, the Maradi Cholera epidemic outbreak erupted on week 27 and ended on week 44. The outbreak affected 3,824 people with at least 78 deaths, for a lethality rate of 2%. Madarounfa Health District in Maradi Region was the most affected with 2,638 cases, (68.88%) of the cumulative cases reported. Eighty-three percent of cases were age 5 and above and females constituted 56.2% of the cases reported (WHO, 1 Oct 2018). The areas of Dan Issa, Gabi, Harounawa, Madeini, Maraka and N’Yelwa were the most affected in terms of Health Centre (each Health Centre covers an area with a specific number of inhabitants). The risk factors for the spread of the disease in the communities were huge. The latest WASH assessment carried out by UNICEF and WHO states that only 37% of the population in Maradi Region has access to basic sources of potable water -- 75% of the population are said to practice open defecation, with only 10% having access to basic sanitation (WHO, 7 Sep 2018). The precarious sanitation conditions in most of the affected health districts and the movement of population across borders with Nigeria, where cholera was reported several months before this operation, were among the major contributors to the outbreak. The heavy rainfall and floods in the affected area affected more than 38,000 people and exacerbated the risk of contamination. (ACAPS, 24 Aug 2018).
The outbreak was initially located in Madarounfa department on week 27 but finally spread to the heavily populated city of Maradi, the capital of the region and over to other regions. All places, likely to exacerbate the risk of contamination of water sources. According the MoH report, the epidemic finally affected four (4) regions including Maradi, Zinder, Dosso and Tahoua. The outbreak ended on week 44 with an overall 3,824 people affected with 78 deaths recorded.