Cholera prevention and control in refugee settings: Successes and continued challenges

• Published in: PLoS neglected tropical diseases 2019-06, Vol.13 (6), p.e0007347-e0007347
• Main Authors: Shannon, Kerry, Hast, Marisa, Azman, Andrew S, Legros, Dominique, McKay, Heather, Lessler, Justin
• Format: Article
• Language: English
• Subjects: Adaptation; African refugees; Biology and Life Sciences; Cholera; Cholera - epidemiology; Cholera - prevention & control; Cholera - transmission; Comorbidity; Death; Disease Outbreaks; Disease Transmission, Infectious - prevention & control; Ecology and Environmental Sciences; Emergency medical care; Epidemics; Epidemiology; Fatalities; Health aspects; Health care services accessibility; Health policy; Health services; Human settlements; Humans; Infection Control - methods; Infections; International organizations; Interpretation and construction; Living conditions; Local government; Malnutrition; Management; Medicine and Health Sciences; Mortality; Organizations; Outbreaks; People and Places; Policy Platform; Populations; Prevention; Public health; Refugee Camps; Refugees; Rwandan refugees; Sanitation; Trends; Tropical diseases; Vaccines; Vulnerability; Waterborne diseases
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0007347

In response to this unprecedented tragedy, the humanitarian community developed and adopted the Sphere standards for the minimum acceptable living conditions and availability of health services in refugee camps and other humanitarian responses [11]. Since this time, the Sphere standards have been updated, and additional coordinating systems have been developed, including the cluster approach to humanitarian response, the Transformative Agenda, and the adaptation of United Nations High Commissioner for Refugees’ (UNHCR) refugee coordination in the context of the Transformative Agenda [12–14]. A similar population is camps of internally displaced persons (IDPs), who are displaced within the borders of their country of origin. Because of different regulations regarding these populations, UNHCR does not have a general or exclusive mandate over IDPs, and local governments do not always allow humanitarian organizations unrestricted access to these populations [54]. [...]cholera preparedness and response are not always standardized in IDP camps to the same extent as in refugee camps, potentially leaving them more vulnerable to cholera introductions and outbreaks. [...]crude mortality rates in IDP camps have remained higher than refugee camps on average, and large and severe cholera outbreaks continue to occur [26].