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Feature BMJ Annual Appeal

The BMJ Appeal 2022-23: Cholera on the rise and how IFRC is working to fight it

BMJ 2023; 380 doi: (Published 06 January 2023) Cite this as: BMJ 2023;380:o3007
  1. Jane Feinmann, freelance journalist
  1. London
  1. jane{at}

Cholera affects the world’s poorest people in communities lacking adequate sanitation or safe drinking water. Jane Feinmann follows the work of the International Federation of Red Cross and Red Crescent Societies in fighting this easily treated, yet rising, worldwide threat

In a single week last October eight members of the 3200 strong fish farming community at Mulirasambo, in northern Malawi, were infected with cholera, four of whom died.

“It was the dry season, a time when cholera outbreaks are least expected,” says Prisca Chisala, director of programmes and development at Malawi Red Cross Society.

Unlike other pathogens that cause diarrhoea, cholera, transmitted through the faecal-oral route, can be fatal within hours for children and frail elderly people, and even for healthy adults, without intervention.

“Once ingested through contaminated water or food, the cholera bacterium causes a particular type of acute watery diarrhoea that leads to rapid loss of fluids,” says Chris Brewer, Africa cholera coordinator for the International Federation of Red Cross and Red Crescent Societies (IFRC). “Many people die in the night after deciding to get help the next day if the infection hasn’t cleared up.”

In December the World Health Organization reported outbreaks in 29 countries in 2022, including in Haiti, Lebanon, Pakistan, Bangladesh and 15 African countries.1 Over the whole of 2017-21 fewer than 20 …

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