South Africa: MSF, WHO, UNICEF, and National Department of Health Collaborate on Cholera Readiness Training

In mid-May this year, Hammanskraal in South Africa's Gauteng Province became the epicentre of the second biggest cholera outbreak this century, resulting in approximately 900 cases and 34 deaths.

Cholera is not endemic to South Africa, but according to Doctors Without Borders (MSF) water, sanitation and hygiene expert Danish Malik, climate change and other pressures are driving increased human mobility, "with the result that the frequency and scale of cholera outbreaks is rising."

 South Africa Cholera Readiness Training. Photographer: Sean Christie | Location: South Africa
South Africa Cholera Readiness Training. Photographer: Sean Christie | Location: South Africa

"Outbreaks are occurring in places that rarely experienced them before, with impacts that are often more severe than they should be," he said, and added that partnership with organisations with experience in the control of cholera "can help to save lives in an outbreak, and build the capacity that is needed to respond effectively to future outbreaks."

In August 2023, MSF teamed up with the National Department of Health (NDoH), the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) to deliver cholera readiness trainings for government teams from all nine provinces.

"Nobody owns an outbreak," said Tsakani Furumele, Director for Communicable Diseases in the NDoH. "Institutions are not jacks of all trades – if other organisations have the expertise and the willingness to help, let them help, and this is what happened in response to South Africa's recent cholera outbreak," she said.

Cholera Readiness in South Africa
In May 2023, the community of Hammanskraal in South Africa became the epicentre of the country’s second-biggest cholera outbreak this century, resulting in 907 cases, with 34 deaths. In August 2023, MSF teamed up with the National Department of Health (NDoH), the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) to deliver cholera readiness trainings for government teams from all nine provinces. More here: https://msfsa.me/3EhDc8u
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According to the WHO's Sally-Ann Ohene, the Incidents Manager for the Cholera Outbreak Response in South Africa, "the cholera readiness trainings will help provinces to respond quickly and contain any cholera outbreaks that may occur in South Africa."

"The interesting aspect of the training was the blending of theory and simulation exercises outdoors, which gave the participants hands-on experience of chlorinating water to the right specifications and setting up cholera treatment units. They had fun while learning, and we expect they will return to their provinces and cascade their learnings to others," said Ohene.

The WHO, MSF and UNICEF first worked together during the Hammanskraal outbreak, providing technical and material support, and as case numbers dwindled, MSF reviewed the response with its partners and was subsequently asked to assist with the updating of the national cholera guidelines and the roll-out of cholera readiness trainings.

"I think it has been a positive demonstration of organisations and government working together for a common good," said Malik, who added that much remains to be done to lower South Africa's cholera risk profile.

"Cholera typically comes from outside South Africa but for cholera to begin spreading here the environment has to be conducive, and such conditions are increasingly present in South Africa's towns and cities, where under-serviced settlements are proliferating, and at the same time failing water infrastructure is causing the pollution of nearby water sources," he said.

No new cholera cases have been confirmed in South Africa since 20 June. The last cholera readiness pieces of training for teams from the Eastern Cape, Western Cape, and Northern Cape concluded on 24 August.

An interactive guide to an MSF cholera treatment centre

Article_Confronting Cholera Outbreaks_A Tale of Collaboration and Preparedness.doc 48 KB
Seipati Moloi
Seipati Moloi Communications Specialist, Doctors Without Borders (MSF)

About Doctors Without Borders (MSF)

Doctors Without Borders (MSF) is a global network of principled medical and other professionals who specialise in medical humanitarian work, driven by our common humanity and guided by medical ethics. We strive to bring emergency medical care to people caught in conflicts, crises, and disasters in more than 70 countries worldwide.

In South Africa, the organisation is recognised as one of the pioneers of providing Antiretroviral Treatment (ART) in the public sector and started the first HIV programmes in South Africa in 1999. Until today, the focus of MSF’s interventions in the country has primarily been on developing new testing and treatment strategies for HIV/AIDS and TB in Eshowe (Kwa-Zulu Natal) and Khayelitsha (Western Cape).

In Tshwane, we run a migration project, and we offer medical and psychosocial care to migrants, refugees, and asylum seekers who struggle to access public health services under South Africa’s increasingly restrictive.

Previously, we offered free, high-quality, confidential medical care to survivors of SGBV in Rustenburg.

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