An outbreak of the highly infectious and potentially fatal disease cholera has escalated in the West African coastal state of Sierra Leone, due to heavy seasonal rains and desperately poor sanitation conditions.

Catholic Relief Services is working closing with the Ministry of Health and Sanitation, the World Health Organization (WHO), UNICEF and other NGOs and Church partners to help combat the latest spike in this endemic infection.

As of August 30, there were 14,521 reported cases with 240 deaths since the beginning of the year, though these numbers have recently risen dramatically, with around a thousand new cases emerging per day.

“It’s an ugly and complex situation,” says CRS Sierra Leone Country Representative Michael Ghebrab. “This year is much worse than the last major outbreak in 2007”.

With 11 out of 13 districts now affected, President Ernest Koroma has declared a national humanitarian emergency.

Cholera is spread by poor hygiene conditions and water and food contaminated by feces. Sierra Leone’s capital city, Freetown, is heavily overpopulated. A brutal civil war in the country in the 1990s, which ended in 2002, meant many refugees came to the city, more than doubling its population. This has led to congestion, pollution, poor housing conditions and inadequate sanitation.

Because most people do not have access to a hygienic toilet, waste is dumped in the open. A CRS assessment in Freetown found that only 11 per cent of households use any kind of water treatment, like boiling or adding bleach or chlorine. CRS’ Ghebrab explains, “These intense rains we’re having can seem like ‘mercy from above’ for those living in the congested slums in Freetown. But ironically, they are one of the main causes of the rapid spread of the disease, as they’re spreading the waste around.”

To help tackle the outbreak, CRS is putting in place a two-pronged attack. First, to help improve water, sanitation and hygiene conditions, CRS plans to work with Caritas Freetown to distribute hygiene kits and water treatment tablets to over 5,000 households. Second, to spread the word about safer hygiene behavior, CRS will work with the Health for All Coalition to train volunteers and City Council staff on cholera prevention and treatment so they can pass on that knowledge. They will also set up inspection systems in every market in Freetown to ensure food handling and preparation is carried out hygienically.