One of the worst cholera outbreaks in Zambia began in Lusaka District, in October 2023. By December, following a dramatic surge in cholera cases with thousands of people affected across the country, the Zambian government requested support to respond to the public health crisis. Answering the call, UK-Med specialists in case management, deploying as the UK Emergency Medical Team (EMT), arrived in Zambia in mid-January.
By the time the expert team, comprising two infectious disease specialists – one being a paediatric infectious disease clinician- reached Zambia, over 13,600 cholera cases had been reported alongside 518 deaths, with the disease spreading by the day at an alarming rate.
There have been more than 30 cholera outbreaks in Zambia since 1977. While tragically not a new occurrence, the latest outbreak was Zambia’s most severe in recent history. By comparison, the preceding outbreak, lasting from October 2017 to June 2018, claimed 114 lives.
Cholera – an extremely virulent, waterborne disease – can kill within hours if left untreated. While treatment for cholera is relatively simple – requiring urgent rehydration – it still affects around 3 million people globally every year, particularly those living in underserved or precarious areas.
It most commonly affects people with inadequate access to safe water and basic sanitation, the provision of which is vital to prevent and control the spread of cholera. In areas of Zambia where access to clean water is limited and healthcare might not be easily accessible, the disease spreads quickly and it is more difficult to contain.
In this context, effective case management is a priority, requiring urgent intervention in the early stages of the disease. During outbreaks, the ability to quickly identify cholera and to control the spread of infection is vital, particularly for those with preexisting medical conditions.
The dramatic increase in cholera cases at the end of last year put a strain on the local health system in Zambia, leaving many health facilities struggling to cope at the township level. Despite the presence of a central level Cholera Treatment Centre (CTC), more rural or smaller medical centres became overwhelmed, prompting an urgent response from the UK Emergency Medical Team, to reinforce and support local health workers in tackling the outbreak.
As such, the focus of the UK Emergency Medical Team was to support the Zambian Ministry of Health and its staff in case management and training across three cholera treatment centres (CTCs) on the outskirts of Lusaka: Levy, Matero, and Chipata CTCs.
Strengthening local capacity in Zambia
Through bed-side mentoring and accompanying wards rounds covering both paediatric and adult patients, including pregnant women, patients with comorbidities, and those who are malnourished, our highly skilled team provided essential trainings for local staff.
At Levy CTC, a referral health facility that received a high number of children with cholera, as well as patients with comorbidities such as diabetes, hypertension, renal dysfunction, and malnutrition, the team provided mentorship and on-the-job training for medical doctors, officers, and nurses.
“It was great working with the UK EMT, who were very helpful and went out of their way to organise training sessions for all of the staff working at our CTC. Being so overwhelmed with cases during the cholera outbreak, the training gave us a chance to slow down and better understand ways of working.” said one of the local health staff who received training from our specialist team.
The work of our medics helped to bolster the confidence of local staff in their case management skills and their ability to quickly identify and triage cholera patients; skills that can save lives when treating a deadly disease like cholera.
Throughout the team’s eight-week deployment to Zambia, they trained a total of 330 health staff in cholera case management, ensuring the country’s health system will be better prepared to handle similar outbreaks in the future.
Towards the end of the cholera response, the team also supported the inaugural training of Zambia’s own Emergency Medical Team. Recognising the enormous impact a well-trained EMT can have during deadly disease outbreaks, our team were proud to support Zambia’s first step towards establishing their own roster of highly skilled medics.
During the training, which was facilitated by the World Health Organization alongside the Zambia National Public Health Institute, our specialists shared their experience and knowledge of triage for cholera cases, case management of complicated cholera cases, mass casualty plans, as well as explaining how best to prepare for future outbreaks.
Our cholera outbreak response in Zambia was funded by UK Aid
