Diffa, Niger: Hepatitis E Outbreak Highlights Need for Better Water and Sanitation Conditions Among Displaced People

From December 2016 to April 23, 2017, 25 pregnant women died due to acute liver failure caused by hepatitis E in the main maternal and pediatrics health center in Diffa, Niger

NEW YORK/NIAMEY, NIGER, APRIL 26, 2017—The current outbreak of hepatitis E in Diffa, Niger declared by the Nigerien authorities last week highlights the poor water and sanitation conditions in which the vast majority of the displaced people and refugees in the region are living, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today. MSF is calling on authorities and humanitarian organizations in the area to act quickly to prevent further spread by ensuring adequate water supply and improved  sanitation conditions.

From December 2016 to last Sunday, 135 cases of jaundice—one of the most common symptoms of hepatitis E—have been detected in Diffa. Many of these cases were pregnant women who needed to be admitted to the main maternal and pediatric health center, where MSF is working with the Ministry of Health. Of these pregnant women, 25 died due to acute liver failure. There is no treatment for acute hepatitis E, which is especially deadly in pregnant women.

Hepatitis E is caused by the HEV virus and spreads mainly through contaminated water. The current outbreak in Niger is closely linked to an unclean water supply and hygiene and sanitation facilities for the 240,000 people who are currently displaced in Diffa. This is a particularly vulnerable population that for years has been suffering the consequences of the conflict between Boko Haram and armies in the region.

“The water and sanitation activities are clearly not covering the needs of these people, as we have been warning for months,” said Elmounzer Ag Jiddou, MSF’s head of mission in Niger. “For this reason, MSF is calling on the authorities and all humanitarian organizations present in Diffa to rapidly and significantly increase their intervention in this area and ensure adequate water supply and sanitation conditions.”

To contain the outbreak, MSF has been working with the Ministry of Health for several weeks. The organization is supporting the training of health staff and dedicating human and material resources at community, health centers and hospital levels to ensure early detection of cases, referral to health facilities and adequate case management of patients. At the same time, MSF teams are conducting awareness campaigns on basic hygiene measures like handwashing.

Additionally, MSF has significantly increased its water and sanitation activities in Kitchendi, Garin Wazan and Toumour villages, where around 135,000 people have settled—the vast majority of which are displaced. The organization also distributed water chlorination tablets, soap and new jerrycans for 16,800 families in these villages. So far, more than 27,900 gallons of water have been treated and jerrycans being used in the community have been cleaned to prevent the spread of the disease.

MSF has been working in the Diffa region since the end of 2014 to improve access to healthcare for the local and displaced population. MSF works with the Ministry of Health in the main maternal and pediatric health center in Diffa, in the district hospital of Nguigmi and at several health centers in the districts of Diffa, Nguigmi and Bosso.