Medical supplies management in the cholera epidemic in Somalia 1985

In March/April 1985 a cholera epidemic of explosive speed affected a population of 45,000 newly arrived refugees in the town of Hargeysa in the North-West region of Somalia. Seven hundred and sixty one people were killed by the disease within ten days. Great efforts were made on regional, national and international levels in order to reduce mortality and to control the spread of the disease, and large amounts of relief supplies were immediately flown into the country from various aid organizations and governments. This paper describes the supplies management during the operation, with an emphasis on the mobilization of supplies from abroad and from the capital into the emergency area. Recommendations are offered for the organization of medical supplies during cholera outbreaks. The author worked during the epidemic as co-ordinating secretary for relief supplies in Mogadishu.     

Cholera in Sudan: An account of an epidemic in a refugee camp in eastern Sudan, May-June 1985

In 1985 cholera has been a serious problem in the horn of Africa, particularly affecting the many famine victims and refugees in that region. In this paper the history of cholera in Africa is briefly summarized, as is the background to the current refugee situation in eastern Sudan. A cholera epidemic involving 1,175 cases in two adjacent refugee camps in eastern Sudan is described. In this epidemic there were thirteen inpatient deaths and thirty-eight known home deaths from cholera. The management of the epidemic is described in detail. Overall an average of 8 1. of intravenous fluid was used per case, a higher figure than was anticipated, probably because of the unexpected degree of vomiting and the shortage of trained nursing staff.
The relationship between cholera and malnutrition is explored and hypochlorhydria is suggested as the main reason for the increased susceptibility to cholera among malnourished populations. It was observed that severely malnourished adults and children appeared to nave less severe diarrhoea with their cholera, presumably because of reduced mucosal surface area and poor enterocyte function. Finally possible means of aborting cholera epidemics are discussed.