FREETOWN— Last year Sierra Leone had one of the worst cholera outbreaks in history - with 23,000 reported cases. The United Nations says close to 300 people died. Some measures have since been put in place to prevent another epidemic of what can be an easily preventable and treatable water-borne infection.
As heavy rain beats down on a market in the east part of Freetown, Adamsay Kamara rushes to cover her basket of bananas for sale. This is how the single mother makes a living at the market which is near her community of Mabela - a slum area of about 20,000 people.
Mabela was the first community to be hit with cholera in the Freetown area last year and from there it spread.
Kamara said people from international government agencies have since come to talk to her community about cholera prevention and local community volunteers continue to spread the message.
Still, she's concerned another outbreak will occur.
Kamara said she saw four people fall sick and go to the hospital from her community this week and she worries they have cholera.
Patrick Okoth, a water, sanitation and hygiene specialist for UNICEF, said things have improved since 2012 in that there is a consistent cholera task force comprised of international agencies and ministry of health staffers.
"We are so many players, here and there, but through the government we have been able to bring that under one roof. So we are having a consistent cholera task force coordination, which is meeting on a weekly basis, and we are doing that now even when cases are low," said Okoth. "And that has helped us review cases as they come or reports as they come and we're able to focus our intervention based on the areas of interest."
Okoth noted that medical supplies were brought in too late last year but that this year measures have been put in place to see that supplies are already in communities across the country. "So, as I speak now, we have the basic response supplies in districts which can be used at any time," he said.
Okoth said in addition to these measures, health care workers are now better trained to detect and treat cholera and UNICEF has been working to improve water facilities across the country.
August is the worst month for rain and the time when cholera can peak.
Doris Ganda, a community health officer in Murray Town - a western area of Freetown said she is only seeing one or two cases per week as opposed to last year where she easily saw more than 10 cases a day. She said one thing that is new and has helped is the time it takes to diagnose cholera. “We have rapid test kits, to test for cholera. We collect the sample, send to a surveillance unit, they do analysis and give us the feedback," Ganda said.
The use of text messages is another new tactic.
Raymond Alpha is a health education and training officer for the Red Cross in Freetown. He said there is now a system that sends text messages to people across the country on cholera prevention.
"So this system helps us send key messages, for instance just last week, we sent messages to almost the entire nation, telling them it is the rainy season: beware of cholera," Alpha stated. "So this is another system that has proved quite effective in helping us prevent a repeat of what we saw last year."
But officials do not want to be overly optimistic.
Sierra Leone Health Minister Miatta Kargbo said while things have definitely improved in terms of prevention more still needs to be done to strengthen labs in the country with better testing equipment to speed the diagnosis and treatment of cholera.