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Yemen: The World’s Worst Cholera Crisis

Yemen: The World’s Worst Cholera Crisis

What is cholera

Cholera is an infectious disease that could lead to severe dehydration, watery diarrhoea and even death if left untreated. It is caused by eating contaminated food or drinking water which contain bacterium called Vibrio cholerae. The illness is mostly common in places where war, poor sanitation and famine are rampant. Causes of cholera range from contaminated municipal water supplies, food and drinks sold which contains the infectious disease, vegetables grown with water containing the disease and undercooked seafood caught from contaminated waters. When a person consumes the polluted food or water, the Vibrio cholerae bacteria releases a poison inside the intestines that causes severe diarrhoea. The disease, dependant on severity can kill within hours. The symptoms of cholera can begin from a few hours to as long as five days after infection. Usually, the symptoms have minor effects in the early stages and the immune system can fight off the bacterium, but in some cases, the illness outpowers the body’s natural defence. Usually every 1 out 20 infected would suffer from severe watery diarrhoea and vomiting, which can cause and speed up dehydration. Moreover, even if the carrier suffers minimal effects of the symptoms, they can still spread the illness as it is easily infectious. The Sub effects of cholera can be just as dangerous as the vibrio cholerae bacterium itself and one of the major sub effects is dehydration. This can cause rapid heart rates, loss of skin which results in further infections that opens doors for other illnesses, dry mucous membranes inside the throat, mouth, eyelids and nose, low blood pressure and muscle cramps. Dehydration can also lead to shock and death in just a few hours if not treated.

War and disease

Yemen has experienced two major cholera epidemics since the conflict began according to the Worlds Health Organisation (WHO). Years of war in Yemen has led to the country suffering the world’s worst cholera outbreak in recorded history. Since the beginning of the war, more than 1.2 million Yemenis have been victimised by the disease which resulted in over 2500 deaths and rising. In the early stages of the outbreak, the international health organisations focused more on case management then on prevention and no vaccinations were delivered until 16 months into the outbreak. In addition, it is children who make up of a shocking 58% of reported cases up until now. A spike in the outbreak returns in 2019 whereby a frightening 1000 children are infected with cholera each day. Humanitarian aid organisation says that the seasonal heavy rains will cause the disease to spread faster if urgent action is not carried out. Millions of Yemenis are in need and the healthcare system on the verge of collapse making Yemen the world’s worst humanitarian crisis.

So how did the cholera come about and in such a large scale in Yemen? Years of conflict created the world’s worst famine and malnutrition the world has ever saw putting an already stunted country into the worst crisis in the history of the planet. Major food shortages, water and medical supplies increased the probability of disease. This factor also increased the possibility of outbreak especially in children as it is children who make up the majority of those suffering from severe hunger. Malnutrition disrupts the immune system and the lack of energy means that the body cannot defend itself even from minute illnesses. This causes infections to spread fast throughout the body. In addition, a blockade on the country has played a big role in Yemen’s man-made crisis alongside armed conflict. A staggering 19 million Yemenis lack access to safe drinking water, sanitation and basic healthcare which has forced millions to survive by drinking and eating whatever they find. Thousands of families are left vulnerable in the face of disease and agencies have stated that 21 out of the 23 governates have been affected by the cholera.  Currently, there is over 440,000 reports of cholera cases which is an increase of 24% in comparison to last year’s figures and an additional 2000 new cases are being reported each day which has led to an emergency outcry. The rise in patients is indicating frightening signs that Yemen is heading back to the same figures of cholera that ravished through the country in 2017.

Cholera Treatment and Prevention

Although there are cholera vaccinations, preventions in areas where the disease is rampant is a better solution than curing the infected. Other means of protection can be done through pre-boiling water, chemically disinfecting water, or using bottled water. Food must be cooked using unintoxicated water and It only takes one to three minutes to boil and to chemically disinfect contaminated water. Sadly, millions of Yemenis lack the required energy source needed to boil or chemically disinfect water.  As a result of the conflict, many families are forced to eat their food raw as the conflict is tightening its noose on resources and survival in general. Anyone affected by Cholera must seek medical help immediately as cholera is severe in its dangers, yet it is a highly treatable illness. Mainly, its the sub effects of the disease that cause death. Hydration is one of the main treatments for cholera depending on how severe the diarrhoea is.  Overall, Cholera is a highly preventable disease that can be cured by replacing fluids in the body (using a mixture of sugar, salts and clean water). However, due to the severity of the outbreak in Yemen, many require dedicated medication such as intravenous fluids and antibiotics. This is will help kill the infectious bacterium and can reduce the duration of the diarrhoea by half, thus reducing the excretion of the bacteria which also helps or prevents the spread of the disease.

A forced Situation

Lack of clean drinking water is a fact in the daily lives of millions of Yemenis. In desperation to survive, they are forced to drink whatever they find, regardless of hygiene. With few healthcare resources, the treatment is becoming impossible for many Yemenis since they are way below the poverty line. Before the war, half of all children under 5 were stunted due to severe malnutrition, this meant that over half of all children had a had lower resilience against cholera. Destruction to hygiene, water, clean sanitation and infrastructure has left the country fragile against water borne diseases. The infrastructure for sanitation was already limited in Yemen and thus the outbreak of war has led to major outbreaks of preventable disease. Destruction of hospitals and medical centres has largely hampered with prevention possibilities for those suffering. This has increased the spread of the disease faster than expected. The blockade has closed off the main supplies that the country used to import 100% of their medicines from. The blockade, especially on the port of Hodeida was one of the biggest causes of the outbreak and thus weakened the country from disease on a mass scale. The cost of fuel, water, medicines and other basic necessities increased which decreased the resilience the country had towards cholera. The factors mentioned above created the perfect fertile ground for the disease. War and poverty has forced millions of Yemenis towards this epidemic with no chance of escape, apart from forcing millions of Yemenis to rely on humanitarian aid in order to survive. 

Caring for the sick – Islamic perspective

One of the most beloved and highest deeds to Allah (SWT), the most merciful, the exalted, is to honour the sick by caring and showing kindness to those weak from sickness. This is from the greatest acts of chivalry in Islam and should be prioritised by all Muslims as it is an act of obedience and a way purifying ourselves from sin which helps us get closer to Allah (swt). Our purpose in life is to submit ourselves to our creator in all that is asked of us.  Islam is a strong religion of charity and any act of kindness is charity. Charity is mercy and Allah (swt) is the most merciful, thus charity is the best way to bridge a better relationship with Allah (swt).

The Prophet (blessings and peace of Allah be upon him) said: “Those who show mercy will be shown mercy by the Most Merciful. Show mercy to those who are on earth and the One Who is in heaven will show mercy to you.” Narrated by Abu Dawood [4941] and at-Tirmidhi [1924]

The mercy of Allah(swt) is the best attribute one can receive in Islam. It is only through Allah(swt) mercy that we enter Jannat (paradise). Our health, wealth and strength is a blessing given to us by the mercy of the most high. Hence, why we begin every chapter in the Quran (except surat al-towbah) with, In the name of the most compassionate, the most merciful. In order to receive Allah’s (swt) mercy, one must show mercy. This could be done best best by helping those who are sick and needy.

It was narrated from Ibn ‘Umar (RA), that the Messenger of Allah (PBUH) said: “The Muslim is the brother of his fellow Muslim; he does not wrong him or let him down. The one who meets the needs of his brother, Allah will meet his needs. Whoever relieves a Muslim of distress, Allah will relieve him of distress on the Day of Resurrection.”

Narrated by al-Bukhaari [2442] and Muslim [2580].

By helping others in need of our help, we are in essence alleviating our own distress on the day of judgement. The true mercy will be shown on the day of judgement but only to those who deserve the Allah’s (swt) mercy.

In another narration, the Prophet said, “From one part of mercy the creation is merciful between themselves, and ninety-nine parts are for the Day of Resurrection.” Sahih Muslim [2753]

We know that there are 100 parts of mercy, Allah (swt) has placed one part for us in the dunya (this world). Each part can fill what is between the heaven and the earth. From only one part of mercy that Allah (swt) has given us in this dunya, we see many natural acts of mercy. Acts such as the compassion that a mother has for her child. The mercy that animals have for each other and every act of mercy you can think of is all one part of the mercy given to us, the rest is with Allah (swt). However, to be deserving of that mercy, we are given an opportunity in this dunya to show mercy and what better way than to help the helpless, in this particular case, the sick and needy in Yemen who are reaching for a way out of poverty that they suffer on a daily basis. Overall, we can see that it is a great blessing to the those whom Allah (swt) has allows to extend a helping hand towards. It is a great achievement in the Islamic perspective to the one who spends his health and his wealth in acts of kindness. We hope that Allah (swt) grants him mercy and forgiveness in this life and the next.

Our Work?

SABA Relief is working hard to tackle the issues faced by the war struck civilians victimised by years of merciless warfare. We work hard, especially in times like this, where cholera and other illnesses grip the country. We provide treatments to the victims of cholera and other solutions such as provision of clean water and constructive workshops that aim to reduce the spread of cholera. We find that the best cure is prevention and thus we are calling out in an emergency appeal to help put an end to the cholera epidemic that is gripping the country.

Our workshops aim to educate and raise awareness about the dangers of Cholera in order to reduce the outbreak from spreading. The more workshops conducted in addition to the provision of clean sanitation and safe drinking water, the faster we can end the cholera epidemic in Yemen. By eliminating the outbreak, we, as part of the humanitarian sector can focus more on other issues in Yemen that need addressing, such as hunger and displacement.

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