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RWANDA-CHOLERA Jan-10-2006 (630 words) xxxi
Empty hospital beds in Rwanda show cholera epidemic is fading
By Evan Weinberger
Catholic News Service
KIGALI, Rwanda (CNS) -- Many of the beds set up to deal with a cholera epidemic at the Masaka Health Center are empty.
But Joyce Ngoma, a nurse at the church-supported health center on the outskirts of the Rwandan capital, said the empty beds are a recent development.
"The other day it was full," she said Jan. 10 while taking a break from treating some of the more seriously ill patients at the health center.
A deadly cholera outbreak hit Masaka Dec. 29 and was declared an epidemic by the Rwandan Health Ministry Jan. 2. The outbreak, which has since spread to surrounding areas and reportedly as far away as Ruhengeri in Rwanda's northwest, killed nearly 20 people. None died at the Masaka Health Center.
At the height of the outbreak, Ngoma said, the Masaka Health Center filled all 250 beds set up to deal with the outbreak. On Jan. 10, there were only 25 cholera patients, and only four were dehydrated enough to require intravenous fluids.
Ngoma said that is a sign that the epidemic is lessening.
But the smell of disinfectant still hung in the air as health center workers sprayed around a massive white tent set up in the courtyard to deal with the less serious cases. Those patients, all clad in green hospital scrubs, simply required a day or two of oral rehydration salts and constant fluids. The more serious cases require the antibiotic doxycycline along with intravenous fluids.
Since cholera is a messy disease that comes from poor hygiene and unclean water, workers at the center maintain a constant rhythm of cleaning every surface -- from the windowsills to the dirt paths between the buildings -- with a soapy solution. Black tanks with clean water, often purified with chlorine or iodine, are found throughout the center's compound.
The authorities still see some danger of a much larger epidemic coming from Masaka. The road leading to the health center is guarded by armed police, who raise and lower a cloth barrier that looks like a race finish line. The quarantine, according to Rwandan Red Cross members, has been in effect for several days.
Dr. Prince-Bosco Kanani, director of health and AIDS services for Caritas Rwanda, the church's charitable agency, said he believed the cholera outbreak was directly related to poor sanitation and hygiene in Masaka. The district is a typical Kigali neighborhood, with dirt roads and ramshackle houses hastily built during the 11 years since the 1994 genocide.
There is little or no running water, and people have to fetch water every day from nearby wells and distribution centers set up by Electrogaz, the local power utility. Kigali has seen startling growth as people come in from the countryside for jobs, and local utilities have not been able to keep up.
Rwandan Red Cross officials at the Masaka Health Center said that Electrogaz, the International Committee of the Red Cross and the Rwandan government have been trucking in clean water. Four distribution stations have been set up throughout the district where residents can also get clean food and soap.
Dr. Paul Nkubanvorsiwa, director of health services for Caritas in Kigali, said water deliveries will have to continue for at least five days after the last case is reported in Masaka.
It is still unclear where the cholera epidemic started. Every day at 10 a.m., Nkubanvorsiwa gathers with other doctors from the Rwandan Ministry of Health, UNICEF, the Red Cross and other agencies to assess the situation, recount the number of cases from the previous day and discuss finding the outbreak's source.
But until the source is found and the outbreak is over, the tent will not come down and the barrier at the Masaka Health Center will have to remain.
END
Copyright (c) 2006 Catholic News Service/USCCB. All rights reserved.
This material may not be published, broadcast, rewritten or otherwise distributed.
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