D.R. Congo: Children face worst cholera outbreak in six years

A spike in conflict and displacement in eastern Democratic Republic of Congo (D.R. Congo) is pushing children into the worst cholera crisis since 2017, the United Nations Children's Fund (UNICEF) has warned on Thursday. 

According to the agency, across the country, there have been at least 31,342 suspected or confirmed cases of cholera and 230 deaths in the first seven months of 2023, many of them children. 

The worst-affected province, North Kivu, has recorded more than 21,400 confirmed or suspected cases, including more than 8,000 children under the age of five, according to the Ministry of Public Health. This compares with 5120 total cases reported for the whole of 2022, of which 1200 are children under five. 

"The size of the cholera outbreak and the devastation it threatens should set alarm bells ringing," said UNICEF's Senior Emergency Coordinator in the country.

Shameza Abdulla specified that, if urgent action is not taken in the coming months, there is a significant risk of the disease spreading to areas of the country that have not been affected for many years.

"There is also a danger of further spread in displacement sites, where systems are already overwhelmed and people, especially children, are very vulnerable to disease and potentially death. Displaced families have already suffered a lot," Abdulla added. 

In a similar situation in 2017, cholera spread across the country, including the capital Kinshasa, causing nearly 55,000 cases and more than 1100 deaths.

6.3 million internally displaced persons

D.R. Congo, enduring one of the worst displacement crises globally and one of the worst in Africa, has seen more than 1.5 million people displaced in the provinces of North Kivu, South Kivu and Ituri since January 2023. In total, there are more than 6.3 million displaced people across the country.

IDP camps are often overcrowded and overburdened, making them conducive to cholera transmission. For example, families living in IDP camps around the provincial capital, Goma, face massive water and sanitation shortages, UNICEF notes.

In addition, nearly 300,000 people, including 183,000 children, lack access to adequate water. Less than a third of the population has access to a latrine, meaning that 159 people have to share a single latrine.

In-depth investigations conducted by the Ministry of Public Health in May and June in households with cholera cases in the four major cholera hotspots in North Kivu revealed that between 62% and 99% of cholera-affected households, depending on the hotspot and the week of investigation, were families who 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 antenatal care and vaccinations. 

Humanitarian aid needed

UNICEF is appealing for $62.5 million to scale up its cholera prevention and response and water, sanitation and hygiene activities over the next five months to reach 1.8 million people, including 1 million children, with safe water, hygiene kits, latrines, medical supplies and child-friendly cholera care. The appeal is currently only 9 per cent funded.