Chronicle of the Middle East and North Africa

Algeria’s Government Under Attack for Chaotic Handling of Cholera Outbreak

Algeria- Cholera Algeria
A doctor gestures outside a hospital in the Algerian town of Boufarik, as the country faces a cholera outbreak, on August 28, 2018. Photo AFP

Three weeks after the Algerian Ministry of Health, Population and Hospital Reform (MSPRH) officially confirmed a cholera outbreak in several provinces, recent statements by local authorities indicate that the spread of the highly infectious disease is finally under control.

The number of suspected hospitalized cholera cases has decreased ‘significantly in the past four days’, according to a government statement quoted by the state-owned news agency APS on 2 September 2018. Five days later, the MSPRH announced the last cholera patients had been discharged from a hospital in the province of Blida, south-west of the capital Algiers.

In its latest update on the scale of the crisis on 30 August, the MSPRH had confirmed 74 cases of cholera in six provinces – 39 in Blida, 15 in Algiers, 15 in Tipaza, 3 in Bouira and 1 each in Médéa and Aïn Defla. Two people in Blida later died in an outbreak that critics say was largely avoidable. The patient who was later confirmed as being the first person infected was hospitalized in Bouira on 7 August, but the government only admitted it was dealing with a cholera outbreak on 23 August.

In the weeks since, the government has been under heavy fire for its failed health policies in recent years and the reluctant and chaotic handling of the crisis. “The occurrence of a cholera outbreak [has been] predictable since January,” Abdelouahab Bengounia, head of epidemiology at the Mustapha Basha hospital in Algiers, told El Watan newspaper in an attention-grabbing interview.

Algeria’s public health sector suffers from persistent underfunding, which has led to insufficient and outdated equipment and infrastructure as well as a lack of essential items such as medication. Doctors and nurses also complain about poor working conditions especially in health facilities in remote areas.

”[Cholera] is easily diagnosable and any delay is unforgivable. If this becomes an epidemic today, it is because of the delay in reporting and taking preventive measures,” Bengounia commented, adding that he considers the government responsible for the “blatant easing” of medical prevention pro-grammes since the early 2000s.

The opposition party FFS has already called for a parliamentary committee to investigate the circumstances of the outbreak.

Meanwhile, people across the country have been outraged by the government’s chaotic response to the disease, which was last recorded in the country in 1996. Journalist Zahra Rahmouni described a ‘wave of panic’ sweeping Algeria as uncertainty and rumours about the origin of the disease dominated public discourse and street talk for weeks.

Only on 6 September did the MSPRH finally confirm that it had identified the source of the outbreak as a contaminated wadi in Blida. The interim governor of the province, Rabah Ait Hocine, had immediately put in place a series of emergency measures to clean up and cover the wadi, according to a government statement.

The late discovery of the source of the outbreak sparked further public outrage. This was compounded when the Ministry of Agriculture issued assurances that fruits and vegetables were safe to eat, a narrative that was contradicted by the Pasteur Institute in Algiers in what El Watan called a ‘war of information. In a statement, the institute said that fruits and vegetables – if consumed raw – might be the source of the cholera. On 1 September, however, it ruled out any link between consumption of local agricultural products and the spread of the disease.

A similar spat occurred over rumours that irrigation water or springs might be responsible for the spread of the disease. After the MSPRH indicated that the Sidi Lekbir spring in Tipaza was contaminated with cholera bacteria, Toufik Amrani, the local director of the health department, denied the government’s claim in a 30 August interview with the private TV channel Ennahar. Abdelkader Bouazghi, the Minister of Agriculture and Development, also contradicted the government line, reassuring the public that irrigation water was not the source of the outbreak.

Meanwhile, authorities reportedly arrested more than 1,700 farmers in 15 provinces on charges of ‘watering crops with polluted water, burying unhealthy substances that can contaminate water and digging wells to extract underground water without permission’.

The news outlet TSA Algérie pointed out that the traceability of agricultural products in Algeria is considered poor. The agricultural sector is largely informal, which makes it almost impossible to track contaminated products on the market. Unsurprisingly, the ongoing uncertainty about the origin of the outbreak has affected agricultural exports, with Russia, Qatar and Canada reportedly sending back shipments of potatoes and dates to the country.

Although Minister of Health Mokhtar Hasbellaoui declared that the crisis is under control, several neighbouring countries have taken preventative measures. Morocco, for instance, has reinforced controls at its airports and border crossings. Further afield, the French government has updated its travel information on Algeria and introduced disinfection procedures for planes coming from Algerian airports.

Meanwhile, the Algerian medics and resident doctors syndicate CAMRA CAMRA held a rally in front of the MSPRH building in Algiers on 2 September. This followed the temporary suspension in June of an eight-month campaign of strikes and sit-ins. Although CAMRA did not address the cholera outbreak directly, it called on the Minister of Health to return to the negotiating table to tackle hospital underfunding and other problems facing the public health sector.

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