DR Congo: Children pushed into worst cholera crisis since 2017

A spike in conflict and displacement in the eastern Democratic Republic of the Congo is pushing children into the worst cholera crisis since 2017, warns UNICEF.

Across the country, there have been at least 31,342 suspected or confirmed cholera cases and 230 deaths in the first seven months of 2023, many of them children. The worst affected province, North Kivu, has seen more than 21,400 confirmed or suspected cases, including more than 8,000 children under 5 years, according to the Ministry of Public Health. 

This compares to 5,120 total cases in all of 2022, with 1,200 for children under 5 years."The size of the cholera outbreak and the devastation it threatens should ring alarm bells,” said Shameza Abdulla, UNICEF DRC Senior Emergency Coordinator, based in Goma. “If urgent action is not taken within the next months, there is a significant risk that the disease will spread to parts of the country that have not been affected for many years. 

There is also the danger it will continue to spread in displacement sites where systems are already overwhelmed and the population – especially children – is highly vulnerable to illness and – potentially – death. Displaced families have already been through so much.”

In a similar situation in 2017, cholera expanded to the entire country, including the capital city, Kinshasa, leading to almost 55,000 cases and more than 1,100 deaths. 

The DRC – which shoulders the worst displacement crisis in Africa and among the worst globally, with more than 6.3 million displaced people across the country – has seen more than 1.5 million people, including over 800,000 children, displaced in North Kivu, South Kivu, and Ituri provinces since January 2023. 

The displacement camps are generally overcrowded and overstretched, making them ripe for cholera transmission. For example, families living in displacement camps around the provincial capital Goma are facing a massive shortage of water and sanitation: Almost 300,000 people, including 183,000 children, lack access to sufficient water; fewer than a third of people have access to a latrine, meaning 159 people have to share a single latrine.

In-depth investigations by the Ministry of Public Health in May and June in households with cholera cases in North Kivu’s four biggest hotspots found that between 62 per cent to 99 per cent of cholera-affected households – depending on the hotspot and week of investigation – were families that had been displaced this year. 

The survey also showed that families living in cholera hotspots face multiple other health risks, including malnutrition and lack of access to prenatal care and vaccinations.UNICEF is calling for US$ 62.5 million to scale up its prevention and response activities to the cholera and WASH crisis over the next five months, which seeks to reach 1.8 million people, including 1 million children, with safe water, hygiene kits, latrines, medical supplies, and child-friendly cholera care. Currently, the appeal is just 9 per cent funded.