Tag Archives: Guinea-Bissau

Guinea / Guinea-Bissau: driving home the cholera message

In Bafata, Guinea-Bissau, children go door-to-door counting mosquito nets, monitoring hand-washing and checking the distance between kitchens and latrines. The activities are among efforts by health NGOs and authorities to fill the gap between cholera-prevention messages and behaviour, after a 2008 epidemic killed some 220 people and infected at least 13,000.

The national flag is hoisted in front of the cleanest house, and the family is feted in schools and on local radio, Ingrid Kuhfeldt, head of NGO Plan International in Bissau, told IRIN. Plan International, which has been working in Bafata for 15 years, launched the scheme to prevent future cholera outbreaks.

“There is much more competition now on who has the best hygiene materials and the cleanest house – we hadn’t seen this kind of rivalry before,” Kuhfeldt said.

Children also try to dispel hygiene “myths” with families – for example that lemon juice can disinfect water – and show people how much chlorine to drop into a well to clean the water, Kuhfeldt said.

Rather than resenting the children, adults listen, partly because of children’s rising status in society over recent years, according to Kuhfeldt. “[People] have a growing respect for their children having seen them make speeches in front of audiences in schools, heard them on the radio and seen them set up committees,” she said. “They’re starting to realize they can learn from [the children].”

In Guinea, with the support of aid agencies and the local health services, a local radio station in Kindia helps spread hygiene messages through radio spots and village contests. A team from the radio station organizes public games in remote communities, quizzing people on hygiene and cholera prevention and asking people to make up songs on a hygiene-related theme, according to Aboubacar Sylla, head of programming at the station. Prizes include radios, water buckets or farming tools.

“Hundreds of people come out for these activities; people really like it,” Sylla said. “And it is quite interactive; we encourage everyone to talk about the subject at hand.”

Bafata and Kindia recorded no cholera in 2008, despite infections in neighbouring regions.

Source: IRIN, 15 Oct 2009

West Africa: Stopping cholera emergencies

Cholera outbreaks in West Africa generally trigger extra hand-washings in households and panic-buying of bleach for treating water. But beating the deadly – but easily preventable – illness requires that such hygiene practices become routine, health experts say.

Researchers with the London School of Hygiene and Tropical Medicine (LSHTM) say knowing the drivers behind behaviour and tying hygiene messages to those impulses is crucial for preventing cholera, which has become a recurring health emergency in West Africa.

“If we want sustainable change we need to make sure people practice things so they become habits,” Jeroen Ensink of LSHTM’s environmental health group told IRIN.

One way for aid agencies to do so, he said, is to dissociate hygiene messages from cholera – which is seasonal – and link them instead to general diarrhoeal disease.

Ensink also said it might be time to “re-brand” hygiene and health messages, as knowledge of cholera’s causes does not always translate into new habits. “Hand-washing messages need not be just about health; they can be about: if you want to be modern, to smell nice, to be attractive to the opposite sex, use soap.” The use of proper latrines can be linked to privacy instead of just proper hygiene, he added.

LSHTM has studied the impact of government and aid agency prevention and preparedness measures in Guinea and Guinea-Bissau as part of a project funded by the European Commission humanitarian aid department (ECHO).


The ECHO project aims to build a more coherent approach to cholera control with sound preparedness and early response. And ECHO says ‘quick impact’ actions in vulnerable communities should be accompanied by longer-term prevention measures.

To date, emergency and development strategies fail to address the disease properly, lacking common objectives and complementary actions, ECHO says.

ECHO is focusing on Guinea and Guinea-Bissau, where cholera has become endemic; during 2007 and 2008 over 23,000 people were infected and 560 died in the two countries.

But all of West Africa is highly vulnerable to cholera and a regional approach is needed; ECHO and its partners will study lessons from Guinea and Guinea-Bissau to see what might be applied more widely.

As part of the ECHO-funded project UN Children’s Fund and NGOs are training local health workers in responding to cholera, boosting communications strategies and developing emergency kits, which include sanitation and water purification materials, to keep outbreaks in check.

[T]o be effective anti-cholera actions must not be merely reactive, health experts say. LSTHM researchers observed in Guinea-Bissau that while most people could recite verbatim hand-washing and other hygiene messages, they apply them consistently only when cholera strikes. Changing such behaviour takes years, not months, said LSHTM’s Ensink.

Source: IRIN, 15 Oct 2009

Guinea-Bissau: Cholera epidemic out of control

DAKAR, 17 September 2008 (IRIN) – With 6,461 cholera cases and 122 deaths, experts say the cholera epidemic in Guinea-Bissau is out of control. The number of reported cases has doubled in the past three weeks. All of the country’s 11 health regions have been affected.


According to Franck Bouvet, UNICEF’s regional water, hygiene and sanitation specialist, international agencies over-estimated the government’s ability to coordinate the battle against the epidemic, costing valuable time.

Emergency response teams from the UN and government, MSF-Spain, French NGO Médecins du Monde and the Guinea Bissau Red Cross, are trying to make up for lost time.


UNICEF is disinfecting city wells and other water sources with bleach or chlorine in the capital with local organisation Aqua Guinea-Bissau (AGB) and volunteer sanitation brigades. [T]he is working with the Guinea Bissau Red Cross and UNICEF to go from door-to-door to give hygiene tips to avoid cholera.


The US-based Centre for Disease Control […] is currently carrying out a [nation-wide comprehensive] study […] to find out how the infection is spread, [and] its source.

“There are behavioural, climactic, and socio-economic determinants to the cause and spread of cholera and it can be hard to identify exactly why it appears when and how. However, we know that key factors increase the risk of an outbreak: inappropriate hygiene behaviour, lack of drinking water, and inadequate sanitation,” Bouvet said.

Source: IRIN, 17 Sep 2008

Guinea Bissau: Cholera Epidemic Lessons Ignored

A cholera epidemic sweeping across Guinea Bissau has now infected 1,077 people – three-quarters of them in the capital Bissau – and killed 25, leading experts to ask why lessons from previous epidemics have not been taken on board.

Cholera killed 400 people and infected 25,000 across the country in 2005. “We wrote reports and made many recommendations to the government after the 2005 cholera outbreak but none of them were ever implemented, and so we are left to start all over again,” said Augostino Betunda, joint director of services at the Bissau centre of epidemiology, which is charged with diagnosing the disease. (…)

Source: IRIN

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Gunea-Bissau: Cholera epidemic reaches capital, Bissau

“Cholera which first broke out in Guinea Bissau in May in the southern region of Tombali has now broken out in the capital Bissau killing four people and infecting 214, according to Daniel Kertesz, representative of the World Health Organization (WHO).

So far across the country 325 cases have been reported and twelve people have died.”


The Ministry of Health is working with WHO, UNICEF, NGOs and others on a two-pronged strategy involving hygiene promotion and household water treatment.

“The Ministry of Health in setting up special sanitation brigades which go house to house showing people how to treat water by boiling it or purifying it with small amounts of bleach”


“Preventing cholera in the long term would involve drastically improving Guinea Bissau’s water and sanitation infrastructure. The country has some of the worst coverage of modern water and sanitation facilities in the world according to the UN. In rural areas under half of people have access to clean water and under a quarter can access a modern toilet.”

“Many people misinterpret cholera as a health problem when it is a problem of water and sanitation,” said Kertesz. “If people have clean water and access to sanitation facilities, they won’t get cholera.”

Read more: IRIN, 10 July 2008