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To combat cholera in Yemen, one scientist goes back to basics

As epidemic rages on, health care system is close to collapse

By
1:00pm, August 7, 2017
Yemeni women waiting for charity water

FUELING THE FIRE  Women line up for clean water in war-torn Yemen, home to an ongoing cholera outbreak.

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Rowa Mohammed Assayaghi teaches people how to wash their hands. In Yemen, that’s life-saving work.

The Middle Eastern country is facing the world’s largest cholera outbreak, with nearly 409,000 suspected cases and 1,885 deaths from late April to late July, the World Health Organization reports. That tally is higher than 2015’s worldwide reported cholera deaths. A bacterial infection spread by feces-contaminated water, cholera causes diarrhea, vomiting and dehydration. The outbreak, which began in October 2016 and ramped up in April, is a result of a two-year civil war.

“The war ... greatly affected all service sectors such as the health sector, water supply, sanitation, electricity, transportation and roads, hygiene services and so on,” says Assayaghi, a medical microbiologist at Yemen’s Sana’a University.

More than half of Yemen’s 27.4 million residents lack access to clean water, according to UNICEF. Most wells are contaminated by garbage, septic backups and rainwater runoff — perfect conditions for Vibrio cholerae to thrive.

It’s possible that people are also contracting E. coli from “charity water” being brought in to help. “We found high count of E. coli” in samples of the water, she says. That one-two punch could be making the cholera outbreak more severe, says Nagi Alhaj, a microbiologist and Assayaghi’s former colleague. Alhaj fled to Malaysia when his toddler son was injured in an air strike soon after the war began. “My country has been destroyed by war and microbe,” he says.

Only a handful of Yemen’s hospitals and clinics remain functional enough to deal with the fallout. The epidemic is so severe that the United Nations scrapped plans to deliver more than a million cholera vaccines so health workers could focus on treating the sick. All that’s left to defend against V. cholerae is a patchwork of dedicated aid workers, health care professionals and scientists, Assayaghi among them. She had been studying viruses to treat cancer. But the war and collapsing economy put that work on hold.

Assayaghi, age 40, travels to cholera-affected regions, teaching people how to avoid contracting or spreading the disease. “Focusing on health awareness is one of the most important measures to follow,” she says.

She shows people how to sterilize what water they have via filters, chlorine tablets and boiling. She distributes soap and instructs people on what to do if family members start showing symptoms: Wear gloves, wash hands after contact, give the person oral rehydration solution the moment diarrhea appears and go to the nearest health center.

When not volunteering, Assayaghi tries to continue some research despite intermittent electricity and scarce supplies. She remains in Yemen because of her job and to take care of her father and two sisters. “I am responsible for my family,” she says. Taking them all abroad would be too costly. If she could, Assayaghi says, she would leave Yemen immediately.

Citations

Yemen cholera outbreak: Daily epidemiology update. World Health Organization. July 27, 2017.

Further Reading

S. Shah. The fight against infectious diseases is still an uphill battle. Science News. Vol. 190, December 24, 2016, p. 32.

N. Seppa. People may have evolved to fight cholera. Science News. Vol. 184, July 27, 2013, p. 14.

R. Ehrenberg. Twitter kept up with Haiti cholera outbreak. Science News. Vol. 181, February 25, 2012, p. 16.

A. Witze. Tracking diseases from anthrax to cholera. Science News Online, October 6, 2011.

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