Yemen's cholera outbreak now the worst in history as millionth case looms

Experts predict fastest-spreading cholera epidemic since records began will affect at least 1 million people by turn of year, including at least 600,000 children

A mother sits with her sons while they are treated at a cholera centre in Sana’a, the capital of Yemen. The country’s cholera epidemic could reach 1 million cases by the end of the year. Photograph: Khaled Abdullah/Reuters

The cholera epidemic in Yemen has become the largest and fastest-spreading outbreak of the disease in modern history, with a million cases expected by the end of the year and at least 600,000 children likely to be affected.

The World Health Organization has reported more than 815,000 suspected cases of the disease in Yemen and 2,156 deaths. About 4,000 suspected cases are being reported daily, more than half of which are among children under 18. Children under five account for a quarter of all cases.

The spread of the outbreak, which has quickly surpassed Haiti as the biggest since modern records began in 1949, has been exacerbated by hunger and malnutrition. While there were 815,000 cases of cholera in Haiti between 2010 and 2017, Yemen has exceeded that number in just six months.

Save the Children has warned that, at the current rate of infection, the number of cases will reach seven figures before the turn of the year, 60% of which will be among children. In July, the International Committee of the Red Cross predicted there would be 600,000 suspected cholera cases in the country by the end of the year.

Tamer Kirolos, Save the Children’s country director for Yemen, said an outbreak of this scale and speed is “what you get when a country is brought to its knees by conflict, when a healthcare system is on the brink of collapse, when its children are starving, and when its people are blocked from getting the medical treatment they need”.

Kirolos said: “There’s no doubt this is a man-made crisis. Cholera only rears its head when there’s a complete and total breakdown in sanitation. All parties to the conflict must take responsibility for the health emergency we find ourselves in.”

More than two years of fighting between the Saudi-led coalition and Houthi rebels has crippled the country, causing widespread internal displacement, the collapse of the public health system, and leaving millions on the brink of famine.

The crisis was exacerbated when sanitation workers whose salaries had gone unpaid went on strike. This meant garbage was left on the streets, which was then washed into the water supply. It is estimated that19.3 million Yemenis – more than two-thirds of the population – do not have access to clean water and sanitation.

The government stopped funding the public health department in 2016, meaning many doctors and hospital staff have not received salaries for more than a year. Healthcare has since been provided mainly by international organisations, the efforts of whom have been hampered by the conflict.

The spread of the disease has nonetheless slowed. At the beginning of the most recent outbreak, in May this year, between 5,000 and 6,000 new cases were detected daily. That rate has since dropped to just under 4,000 a day. The mortality rate has also declined, from 1% at the beginning of the outbreakto0.26% now.

“Whatever decline we’re seeing now is due to the heroic efforts of workers at the scene,” said Sherin Varkey, the officiating representative of Unicef Yemen.

Varkey said the situation would not be solved until there was peace in the country.

“There are no signals that give us any reason for optimism. We know that both parties to the conflict are continuing with their blatant disregard of the rights of children,” he said. “We’re at a cliff and we’re staring down and it is bottomless. There seems to be no hope.”

Cholera should be easily treatable with oral rehydration salts and access to clean water. But Mariam Aldogani, Save the Children’s health adviser for the city of Hodeidah, said conditions in the country had made this very difficult.

Aldogani said: “All the NGOs are trying to increase the knowledge of how to prevent the disease, because it’s preventable, you have to boil the water. But if you don’t have money to buy gas, and you have to walk a long way to get the wood, how can you boil the water?”

Aldogani, who has been a doctor since 2006, said witnessing the suffering of her patients was deeply painful. “I saw one young man, he had cholera and severe dehydration. He was in a coma and he died in front of his mother. We tried our best, but he came too late and she was crying, and I cried. It makes me angry. When I see a mother lose her baby, especially a stillbirth, she waits for this baby for a long time and then she loses it because of cholera, it makes me so angry.

“The war is a big problem for us, it’s a wound. But with the cholera, you have the wound and you put salt in the wound. It hurts. I hope this war can be stopped. We need peace for the children of Yemen. Our situation before the war was not good, but it was not like this.”

• This article was amended on 13 October 2017. A previous version said Mariam Aldogani had been a doctor since 2010, she has been a doctor since 2006 and joined Save the Children in 2010
• 
  (the guardian)

Worst floods in years hit Vietnam, death toll rises to 54 as another storm approaches

Posted by TW on October 13, 2017

The death toll caused by the latest round of severe flooding across central and northern Vietnam has risen to 54 and the number of missing to 39, country's disaster agency said Friday, October 13. This is the fourth wave of severe flooding to hit Vietnam in several months and the end of the misery is still not over as another storm is on the way and expected to hit Vietnam's central regions late October 16 or early on the 17th (UTC).

The floods that hit Vietnam this week starting on Monday, October 9 after Tropical Depression 23 made landfall are the worst in years, officials said. The death toll has risen to 54 and there are now 39 people missing.

Nineteen people from four neighboring households in Hoa Binh Province were buried alive after a landslide struck around 01:00 local time Thursday, October 12, but only nine bodies have been found, the disaster agency said.

There are at least 317 homes destroyed in floods and landslides and more than 34 000 submerged or damaged. More than 200 000 people have been ordered to evacuate.

In addition, more than 22 000 ha (54 300 acres) of agricultural land (mostly rice) have also been damaged and around 180 000 animals killed or washed away.

Over a three-day period (Monday - Wednesday), some parts of central and northern Vietnam recorded up to 500 mm (19.7 inches) of rain.

As reported by Reuters, the neighboring Thailand was also badly hit with 7 of their 77 provinces affected. More than 480 000 ha (1.2 million acres) of agricultural land have been affected, Thailand's Department of Disaster Prevention and Mitigation said.

While search and rescue efforts in Vietnam are in progress and country is still battling floods, forecasters warn another tropical cyclone is approaching and will hit the country within just a couple of days.

Tropical Storm "Khanun" passed over the northern Philippines on October 12 and is now heading toward Hainan, China where landfall is expected on Sunday, October 15.

The storm is expected to hit Vietnam late October 16 or early October 17 (UTC) with heavy rain and powerful winds, unleashing yet another wave of floods.

Natural disasters in Vietnam this year have left nearly 200 people dead or missing.

Featured image: Worst floods in years hit Vietnam - October 2017. Credit: AFP

(THE WATCHERS)

Death toll jumps to over 230 after twin bomb blasts in Somali capital (VIDEO, PHOTOS)

The death toll from two car bomb explosions in Somalia’s capital, Mogadishu, has risen to 231, AP reports. The attack has become one of the deadliest in the recent history of the country beset by Islamist insurgency.

Follow The Associated Press ✔@AP BREAKING: Death toll in Somalia's worst-ever attack rises to 231, senator says; 275 injured. 9:20 AM - Oct 15, 2017 4444 Replies 1,6991,699 Retweets 772772 likes

Medics are attempting to help hundreds of victims, many of whom have been burned beyond recognition, AP added.

The first blast happened near the Safari Hotel, close to Somalia’s Foreign Ministry. The blast area lies in the center of the city where government offices, hotels, restaurants, and shops are located, police said.

The second explosion took place in the city’s Madina district hours later, according to police.

A general view shows the scene of an explosion in KM4 street in the Hodan district of Mogadishu, Somalia October
14, 2017. © Feisal Omar / Reuters

The attacks happened just two days after the head of US Africa Command was in Mogadishu to meet with Somalia’s president, Mohamed Abdullahi Mohamed.

No group has claimed responsibility for the attack so far. However, similar assaults in the country have been blamed on fighters from Islamic extremist rebel group Al-Shabaab.

The group controlled Mogadishu from 2006 until August 2011, when African Union (AU) and Somali forces pushed them out of the capital. The extremists have launched regular attacks on the city since 2011.

Civilians carry the dead body of an unidentified man from the scene of an explosion in KM4 street in the Hodan district
of Mogadishu, Somalia October 14, 2017. © Feisal Omar / Reuters

Al-Shabaab has repeatedly targeted army bases and communities across the southern and central parts of the country.