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Another cholera outbreak is threatening Yemen, and doctors say it could get worse

“Action is needed urgently to reinstate the health system to a functional status or we risk losing more people to preventable diseases.”
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Yemen is staring down its third major cholera outbreak in four years, according to the United Nations, which puts the number of suspected cases in March at double that of previous months.

The recent spike has invited early comparisons to 2017’s outbreak, when more than 1 million suspected cases of cholera were reported. And the situation could still get worse, doctors and aid officials warned, pointing to a health care system pushed to the brink by years of war and crippling blockades.

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With much of the country’s basic infrastructure, including its sewage system, in disarray, there’s particular concern that the water-borne disease will spread rapidly once the rainy season arrives.

"The increase in cases is concerning, as the rainy season — which could aggravate the overall situation — has not even started yet," said Hassan Boucenine, MSF head of mission in Yemen, in a statement.

The statistics for 2019 were already bleak: There were 39,000 cases reported in January and 32,000 in February.

But numbers spiked in March, with 76,152 new suspected cases and 195 related deaths. Some 40,000 of those were reported between just March 13 and March 26, marking a 150 percent increase over the same period in February, according to Save the Children.

More than one-third of those 40,000 were children under the age of 15, according to Save the Children. The organization warns that children are especially at risk in the current environment.

“The conflict has also caused high rates of malnutrition, which makes children more vulnerable to disease. Malnourished children have compromised immune systems and are even more susceptible to contracting cholera and dying from it,” said Emily Clifton, associate director of humanitarian response at Save the Children.

The outbreak is concentrated in six governorates, including in the Red Sea port of Hodeidah, and Ibb governorate, according to Save the Children.

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“We are doing everything possible to avoid the 2017 scenario,” UNICEF and WHO officials said in a statement last week, but warned that an “intensification of fighting,” and “access restrictions” presented challenges to the emergency response.

“WHO and UNICEF are working with local partners to rapidly contain and prevent further spread of the disease focused on 147 priority districts,” The World Health Organization said in a statement to VICE News.

The country is still in the throes of the world’s worst man-made humanitarian crisis. Ten million Yemenis are on the edge of starvation, while an estimated 80 percent of the country still requires some form of humanitarian aid or protection assistance. Meanwhile, Yemen’s health facilities are severely strained, with many people unable to access basic medical care. Barely half of the country’s 3,500 medical facilities are fully functioning, according to the U.N.

“Many hospitals have been damaged by airstrikes or ground fighting,” said Save the Children’s Clifton. “Action is needed urgently to reinstate the health system to a functional status or we risk losing more people to preventable diseases.”

Cover: A man is treated for suspected cholera infection at a hospital in Sanaa, Yemen, Thursday, March 28, 2019. A United Nations humanitarian agency said on Monday that Yemen has witnessed a sharp spike in the number of suspected cholera cases this year, as well as increased displacement in a northern province. (AP Photo/Hani Mohammed)