The current cholera epidemic in Yemen has been ongoing since October 2016. During the early phases of the epidemic, it was reported that cholera was killing a person every hour. With over a total of 2.5 million suspected cases and approximately 4,000 deaths (1,2), this crisis continues to represent one of the worst cholera epidemics in recent history.
Although annual case numbers have declined relative to the early phases of the epidemic, 230,540 suspected cases of acute watery diarrhea/cholera and 84 deaths were reported in 2020, and 5,676 suspected cases and two deaths were reported between January 1 and March 6 of 2021 (3).
Several factors have contributed to the initial rapid spread and persistence of the epidemic, including the country's ongoing armed conflict (4) and the limited access to safe drinking water and improved sanitation facilities. Only 55 % of rural populations and 79 % of urban populations have access to at least basic water sources. Furthermore, an estimated 30 % of people living in rural areas practice open defecation (5). With the destruction of healthcare facilities and insecurity, poor access to health services has also fueled continued cholera transmission, as over half of health facilities are not functional (2).
Since 2020, the COVID-19 pandemic has increased the pressure on the health system in Yemen, which is already on the brink of collapse, thereby further worsening the population's access to health services (2). As of March 10, 2021, Yemen's health authorities reported 2,590 confirmed cases of COVID-19, with 655 associated deaths (2). As only severe cases have been tested, the true rate of COVID-19 transmission at the community level remains unclear (6).
The response to the cholera epidemic has included case management; surveillance and laboratory diagnostic capacity; hotspot mapping; vaccination campaigns; risk communication; and water, sanitation and hygiene interventions (2). As many people in rural districts struggle to reach healthcare centers, fixed and mobile teams have been getting directly in touch with households, distributing hygiene kits with chlorine tablets and jerry cans, together with hygiene awareness messages (2,6). In addition to bolstering these cholera response efforts, it is critical to raise awareness of the impact that the ongoing conflict has on the health and well-being of the Yemeni population.
1. World Health Organization. Cholera case and death numbers by country [Internet]. The Weekly Epidemiological Record. Available here.
2. WHO EMRO. Emergency Health and Nutrition Project continues the fight against cholera in Yemen [Internet]. 2021. Available here.
3. UNICEF. Yemen Humanitarian Situation Report, February 2021 [Internet]. 2021. Available here.
4. Blackburn CC, Lenze Jr PE, Casey RP. Conflict and Cholera: Yemen’s Man-Made Public Health Crisis and the Global Implications of Weaponizing Health. Heal Secur. 2020;18(2):125–31.
5. WHO, UNICEF. WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) [Internet]. Household WASH data, per country. 2019 [cited 2019 Nov 27]. Available here.
6. UNICEF. Yemen Humanitarian Situation Report, January 2021 [Internet]. 2021. Available here.
Map of Yemen : Carport, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons