Amid ruined lives, Mozambique’s cyclone survivors face cholera

Locals look on as a chopper takes off after they received food aid from a South African National Defence Force (SANDF) helicopter in the aftermath of Cyclone Idai in Nhamatanda village, near Beira, Mozambique, March 26, 2019. Picture taken March 26, 2019. REUTERS/Siphiwe Sibeko

By Emma Rumney and Stephen Eisenhammer

BEIRA, Mozambique (Reuters) – Dozens of fragile patients poured into a clinic in the wrecked Mozambican port city of Beira on Wednesday, as the government said it had confirmed the first five cases of cholera in the wake of deadly Cyclone Idai.

A general view of houses seen from the air near Nhamatanda village, Beira, Mozambique, following Cyclone Idai, March 26, 2019. Picture taken March 26, 2019. REUTERS/Siphiwe Sibeko

A general view of houses seen from the air near Nhamatanda village, Beira, Mozambique, following Cyclone Idai, March 26, 2019. Picture taken March 26, 2019. REUTERS/Siphiwe Sibeko

Thousands of people were trapped for more than a week in submerged villages without access to clean water after the cyclone smashed into Mozambique on March 14, causing catastrophic flooding. Relief efforts have increasingly focused on containing outbreaks of waterborne and infectious diseases.

In Munhava in central Beira, doctors and nurses at a newly set up treatment center said they are treating around 140 patients a day for diarrhea. Many of the patients arrive too weak to walk.

A Reuters reporter saw two men carrying an unconscious woman from a rickshaw into the clinic, trying to cover her naked body with a sheet.

Inside, those too ill to sit lay on concrete benches attached to intravenous drips. Mothers were perched on plastic chairs in the courtyard, trying to get their children to drink rehydration salts from green cups.

“He won’t take it,” said Marisa Salgado, 22, holding her boy, aged 1-1/2, who stared with glazed eyes.

It was the second time she had been to the clinic this week, Salgado said. Her child’s diarrhea returned as soon as she got home, despite the chlorine solution nurses gave her to purify their water.

“I’m scared. I don’t know what to do,” she said.

Cholera is endemic to Mozambique, which has had regular outbreaks over the past five years. About 2,000 people were infected in the last outbreak, which ended in February 2018, according to the World Health Organisation (WHO).

But the scale of the damage to Beira’s water and sanitation infrastructure coupled with its dense population have raised fears that an epidemic now would be difficult to put down.

A relative writes the name of a one-year-old child who died at a health centre dealing with water borne diseases onto a a cross in Beira, Mozambique, March 27, 2019. REUTERS/Mike Hutchings

A relative writes the name of a one-year-old child who died at a health centre dealing with water borne diseases onto a a cross in Beira, Mozambique, March 27, 2019. REUTERS/Mike Hutchings

Ussene Isse, national director of medical assistance at the Health Ministry, said he expected cholera to spread beyond the five cases confirmed as of Wednesday morning.

“When you have one case, you have to expect more cases in the community,” he told reporters. Health workers are battling 2,700 cases of acute diarrhea, which could be a symptom of cholera, Isse added.

Health workers apply the same treatment for acute diarrhea or cholera, with severe cases requiring rapid rehydration through intravenous fluids.

Such diseases are another threat in the aftermath of Idai, which tore through Mozambique and into neighboring Zimbabwe and Malawi, killing more than 700 people and displacing hundreds of thousands of others.

Cholera is spread by faeces in sewage-contaminated water or food, and outbreaks can develop quickly in a humanitarian crisis where sanitation systems are disrupted. It can kill within hours if left untreated.

GRAPHIC: Cyclone Idai’s destructive path – https://tmsnrt.rs/2HxKqdk

CHILDREN DYING

Lin Lovue, 27, said he had rushed his son to the clinic late on Tuesday after a day of diarrhea. Within an hour of getting there, the child died.

“The biggest challenge is organization,” said a coordinator at the clinic who did not want to be named. “The health system was completely broken after the storm and we have to re-establish capacity fast.”

Medical charity Medecins Sans Frontieres (MSF), which runs the emergency center at Munhava, has set up two others in Beira and is providing consultations via mobile clinics in several neighborhoods.

Outside the clinic, two medics dressed in blue overalls lifted the body of a 1-year-old child wrapped in a white bag on to the back of an open-top truck. The father laid his child down on a bamboo mat as someone wrote the baby’s name on a wooden cross.

The WHO is sending 900,000 doses of oral cholera vaccine to affected areas from a global stockpile. The shipment is expected to arrive in Mozambique later this week.

For now families, like that of Nelson Vasco, are being given a chlorine solution to purify their water. Three of Vasco’s children were discharged on Wednesday after recovering from severe diarrhea.

Vasco and his wife and mother carried the frail children on their backs as they walked through the mud to reach their two-room house in Goto, a poor community in central Beira.

Their home lost its roof in the storm and although Vasco managed to salvage some of the metal sheeting, the rain still comes in. But the biggest danger right now is the water from the mains supply.

Like most in this community of mud-brick homes, the family do not have running water, instead buying it from a neighbor who does. But they now worry it has been contaminated.

The death toll in Mozambique from Cyclone Idai has risen to 468, Mozambican disaster management official Augusta Maita said. That takes the total number of deaths in Mozambique, Zimbabwe and Malawi to 707 people, with many more missing.

(Additional reporting by Manuel Mucari in Maputo and Stephanie Ulmer-Nebehay in Geneva; Writing by Alexander Winning and Joe Bavier; Editing by Louise Heavens, Janet Lawrence and Frances Kerry)

Flooding expected to worsen in Carolinas after Florence’s departure

Emergency personnel and local media drive through flooded streets to assess the damage caused by Hurricane Florence, in Spring Lake, North Carolina, September 17, 2018. Spc. Austin T. Boucher/U.S. Army/Handout via REUTERS

By Anna Mehler Paperny

KINSTON, N.C. (Reuters) – Flooding from rain-swollen rivers was expected to worsen across the Carolinas on Thursday and the next couple of days in the aftermath of Hurricane Florence, which killed 36 people in three states, forecasters said.

Twenty flood gauges showed some level of flooding in North Carolina, South Carolina and Virginia, where some major waterways, well above their flood stages, were expected to rise through the weekend before they crest, the National Weather Service said.

“People in flood prone areas or near waterways need to remain alert as rivers crest and stay above their banks in coming days,” North Carolina Governor Roy Cooper said in a written statement. “Stay alert and stay safe.”

Touring the area on Wednesday, U.S. President Donald Trump warned South Carolina that “water is coming your way.”

“Now it looks nice but it’s really the calm before the storm,” he said.

Florence dumped up to 36 inches (91 cm) of rain on parts of North Carolina and many areas remained cut off by floodwaters and inundated roads. The slow-moving storm made landfall on Friday as a Category 1 hurricane.

In Lenoir County, North Carolina, where the rising Neuse River has flooded some roads, emergency medical workers have been running a “mobile disaster hospital,” which provides urgent care to residents cut off from the nearest hospital.

Tripp Winslow, medical director of North Carolina Emergency Medical Services, helped set up the mobile emergency room during a downpour on Saturday night. They have received 20 to 30 patients a day so far, he said, but expect to be busier as the river crests.

“Once we get isolated we expect to see more,” he said. “No pun intended, it’s a fluid situation.”

Members of the National Guard work on a long sand bag flood barrier being built by the South Carolina Department of Transportation on U.S. 501 to lesson damage to roads anticipated from floods caused by Hurricane Florence, now downgraded to a tropical depression, in Conway, South Carolina, U.S. September 19, 2018. REUTERS/Randall Hill

Members of the National Guard work on a long sand bag flood barrier being built by the South Carolina Department of Transportation on U.S. 501 to lesson damage to roads anticipated from floods caused by Hurricane Florence, now downgraded to a tropical depression, in Conway, South Carolina, U.S. September 19, 2018. REUTERS/Randall Hill

MANY STILL WITHOUT POWER

At least 36 deaths have been attributed to the storm, including 27 in North Carolina, eight in South Carolina and one in Virginia.

Some 2,600 people had been rescued by boat or helicopter in North Carolina alone since the storm made landfall, and about 10,000 people remain in shelters, according to state officials.

More than 121,000 customers were without power across North Carolina, and more than 2.1 million customers across the southeast United States were affected by the storm, according to utilities.

Duke Energy Corp started to return its Brunswick nuclear power plant in North Carolina to service on Thursday. The company shut both reactors at the 1,870-megawatt facility before Florence hit the coast near the plant in Southport, about 30 miles (48 km) south of Wilmington.

One megawatt can power about 1,000 U.S. homes.

As floodwaters continue to rise, concerns are growing about the environmental and health dangers lurking in the water.

The flooding has caused 21 hog “lagoons,” which store manure from pig farms, to overflow, creating a risk that standing water will be contaminated, according to the state’s Department of Environmental Quality. North Carolina is one of the leading hog-producing states in the country.

Several sewer systems in the region also have released untreated or partly treated sewage and storm water into waterways over the last week, local media reported.

Experts have said that climate change has increased the likelihood of more massive, sluggish storms like Florence, capable of dropping record amounts of rain and touching off catastrophic flooding.

(Reporting by Anna Mehler Paperny in Kinston, North Carolina; Additional reporting by Jeff Mason in Conway, South Carolina, Brendan O’Brien in Milwaukee, and Scott DiSavino in New York; Writing by Joseph Ax; Editing by Larry King and Bill Trott)