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Mutiny in the cholera centre

BMJ 1995; 311 doi: (Published 08 July 1995) Cite this as: BMJ 1995;311:134
  1. Cristina M De Wind

    The first cases of severe watery diarrhoea arrived in Burao Hospital in Somaliland at the beginning of May 1994. On the eighth day the team of Medecins sans Frontieres (MSF) helped the local health authorities to move 27 inpatients to an empty school nearby. This was the start of a cholera epidemic where the political problems we encountered posed more problems than the disease itself.

    The school, with its separate wards for intravenous and oral rehydration was like a five star cholera hotel, although the patients preferred to lie outside in the spacious gardens where trees provided shade and served as drip stands. Male hospital nurses, all with experience of previous epidemics, ran the cholera treatment centre helped by enthusiastic Red Crescent volunteers. MSF's expatriate doctor, nurse, and logistician, and our local Somali staff also helped. The police posted 20 guards at the gate. Machine guns in hand, they saw to it that everybody going in and out stepped through the chlorine footbath. A total of 842 patients were treated, with a mortality of about 1%. These statistics came under severe criticism from our headquarters in Amsterdam, however, because the …

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