cholera

Kinshasa – The Democratic Republic of Congo is strengthening the multisectorality of the cholera response by addressing malnutrition. The integration of appropriate nutrition is crucial for an effective response to the country’s health crises, where 47.9% of children under five suffer from chronic malnutrition and 81.1% of children aged 6 to 23 months do not receive adequate nutrition.

In 2023, the DRC faced an outbreak of cholera, an acute diarrheal disease caused by ingesting contaminated food or water. More than 52,000 cases and 470 deaths were recorded in 15 of the country’s 26 provinces that year, and more than 22,000 additional cases, including 281 deaths, were recorded between January 1 and July 28, 2024. Without treatment, cholera can be fatal within hours.

“Malnourished people have a harder time recovering from cholera and their care is more complex because the disease exacerbates their malnutrition, creating a vicious circle that complicates their recovery,” explains Dr Bah Keita, Acting WHO Representative in the DRC.

In 2023, the National Nutrition Program, the National Institute of Public Health and the World Health Organization (WHO) published the “Guide de soutien alimentaire et nutrition en contexte d’urgences sanitaire en DRC”, calling for a holistic approach in crisis management. In addition to hygiene measures and access to drinking water, the Ministry of Health, with the support of partners, has established Cholera Treatment Centers and Units (CTCs) close to affected populations. These centers also provide nutritional support to patients in all affected provinces of the country to reduce the risk of the disease spreading from the treatment center to the community following exchanges between cholera patients and their relatives.

Cholera causes a significant loss of essential nutrients such as sodium, potassium, zinc, chlorine, proteins and carbohydrates. “We focus on foods that replace these lost nutrients to strengthen the patient’s immune system and speed up recovery,” says Dr. Basile Ngoy, chief medical officer of the Kisanga health zone in Haut-Katanga province, where five cholera treatment centers have been set up. “There are also medications that cannot be taken without a proper diet,” he adds.

Thanks to the integration of nutritional support into treatment plans, the recovery rate in the country has improved considerably.

“During the four days my son was in hospital, we were provided with meals. Breakfast, lunch and dinner,” says Annie, a shopkeeper whose child was seriously ill. “By the third day, he was back to full strength, especially since we don’t have that many meals at home.”

“We make a point of nutritional support for cholera patients by adapting meals to their specific needs,” says Rebecca Bupele, a nurse at the CTC in Kisanga. “We serve nutritious meals that are suitable for adults and children and advise parents on how to best manage their condition. Rice starch is a key component of our therapeutic feeding plan. It is particularly effective in reducing diarrhea and preventing dehydration, while being readily available and simple to prepare, even with limited resources.”

Cholera particularly affects populations without access to basic sanitation services, or who lack good hygiene practices, such as hand washing and consumption of safe water and healthy foods. WHO also supports chlorine water treatment actions in the most affected health zones.

“The conditions here are extremely precarious. Without the nutritional support provided by WHO, we would face enormous difficulties in caring for patients,” says Rebecca Bupele. “This approach allows us to deploy all the means necessary to save lives. Every action counts, and I do it without hesitation.”