November 15, 2017

Since 2015, civil war and famine have killed more than 10,000 people in Yemen, a country on the southwestern tip of the Arabian Peninsula. To make matters worse, an outbreak of cholera, an infectious disorder of the intestines, has killed thousands more in the past year. Fighting between Sunni Muslim government forces and Shī`ite Muslim rebels has destroyed much of Yemen’s already poor infrastructure and displaced millions of citizens. Sewage systems in urban areas have collapsed, as have Yemen’s health services. Throughout the country, people have crowded into temporary camps. Unsanitary conditions and shortages of food, clean water, and medicine led to the cholera outbreak. Cholera is transmitted by water or food that has been contaminated with the feces (solid body wastes) of people who have the disease.

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Yemen. Credit: WORLD BOOK map

The World Health Organization (WHO), a specialized agency of the United Nations, estimates that more than 800,000 Yemenis have fallen ill with cholera since late 2016, and more than 2,100 people have died from the disease. More than 25 percent of the cholera deaths have been among young children already weakened by malnutrition. The cholera epidemic in Yemen is the largest and fastest-spreading outbreak of the disease in modern history. Cholera cases in Yemen are expected to exceed 1 million by the end of 2017, and deaths too are expected to rise.

Cholera occurs when the comma-shaped bacterium Vibrio cholerae enters the intestines and releases cholera toxin. The toxin causes the intestines to secrete large amounts of water and salt. Because the intestines cannot absorb the water and salt at the rate they are secreted, the victim suffers severe diarrhea. This loss of fluid causes severe dehydration and changes in the body chemistry. If untreated, the illness can lead to shock and eventually death. With proper medical treatment, cholera lasts only a few days.

Heavy fighting in Yemen, as well as a naval blockade and an extensive aerial bombing campaign, have prevented health workers and medicine from reaching many cholera victims, resulting in high numbers of otherwise preventable deaths. Such international relief agencies as Médecins Sans Frontières (Doctors Without Borders), the international Red Cross and Red Crescent, Save the Children, WHO, and UNICEF (United Nations Children’s Fund) are doing all they can to help, organizing Yemeni health workers and volunteers from other countries and setting up temporary hospitals and oral rehydration and intravenous therapy centers. Until the fighting stops, however, cholera will continue to add to Yemen’s miseries.