1. Close up, tap dripping
2. Close up, saline drip in foreground of clinic
3. Med shot, child suffering from cholera
5. Med shot, girls in market area
6. Wide shot, women sitting on ground in market area
7. Close up, woman sitting
9. Pan right, of meeting room
10. SOUNDBITE (French) Dr. Elie Fokzia –Regional Health Delegate, Tandjilé Region:
“We’ve had two outbreaks of cholera. The first was Oct 2010, which lasted one month. The second wave of cholera was detected on 25th March in the same village. Since March to mid-June we’ve had 467 cases. There were 51 deaths mainly the old and the young children.”
11. Close up, patients hand
12. Med shot, patient
13. SOUNDBITE (French) Jessica Donoyer: Programme manager WASH CHOLERA Action Contre la Faim:
“The epidemic of 2010 never really ended. So the epidemic we have in 2011 is a continuation with a very short space between them. It’s a very short period between the two outbreaks. Since March there has been a resurgence.”
14. Close up, saline drip and patient in background
15. Close up, mother and child patients
16. Wide shot, people in field
17. SOUNDBITE (English) Dr Marzio Babille, UNICEF Representative, Chad
“The climate change impact in Chad, in Central Africa and Cameroon in Central Africa implied an alternate of drought in floods. Cholera therefore presents itself in Central Africa and particularly in Chad today as an important public health threat that has to be tackled urgently and immediately.
18. Wide shot, boy pushing wheel barrel
19. Wide shot, street with motorcycles passing by
20. SOUNDBITE (French) Jessica Donoyer: Programme Manager WASH CHOLERA Action Contre la Faim:
“The zones that are sensitive to cholera are the border areas with Cameroon, Niger and Nigeria. It’s the entire cross border region around the river and Lake Chad. There are very few development projects in that area.”
21. Med shot, man stirring sprayer
22. Tilt down, man pouring medicine to be sprayed
23. Wide sot, man spraying people
24. Close up, foot being sprayed
25. Med shot, man being sprayed
26. SOUNDBITE (French) Dr. Elie Fokzia, Regional Health Delegate, Tandjilé Region:
“It’s a problem caused by a lack of hygiene. Here we call it ‘the disease of the dirty hands. People here need to have access to clean areas and portable water, and not defecate out in the open. The contamination is very quick - even flies can carry bacteria that causes Cholera.”
27. Wide shot, baby washing clothes
28. Wide shot, woman carrying bucket of water
29. Med shot, girl pushing water pump
30. Med shot, water being pumped
31. Wide shot, girl walking with bucket on her head
32. SOUNDBITE (English) Dr Marzio Babille UNICEF Representative, Chad
“Enhancing community dialogue should be looked at; systems in other ways should go to people and not under the usual expectation waiting for people to go to systems.”
33. Close up, water in dam
34. Wide shot, kids in dam
35. Wide shot, people walking down road
36. Wide shot, kids at dam’s edge
37. Wide shot, kids in dam
38. SOUNDBITE (English) Dr Marzio Babille UNICEF Representative, Chad:
“The concern is the combination of water borne diseases such as cholera and floods. We are approaching a rainy season. The combination of the two imply directly misplacement of people, destruction of property, increase disease and increase mortality levels. So it is absolutely important to link climate change impact to poverty.”
39. Close up, bowl and clothes on wall
40. Wide shot, kids at dam
41. Wide shot, woman washing clothes in dam

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Storyline

Cholera has resurged across Chad finding its host amongst the poorest and most vulnerable, the old and very young. A silent killer that remains dormant until after heavy rains, re-infecting communities once again.

In Chad a task force on disasters and crisis has been set up to manage a second wave of the cholera epidemic that started in October 2010.

The new outbreak has rocked the capital N’Djamena with over 1000 cases recorded since March this year, and over 6000 certified cases country wide.

Dr Fokzia is the regional health supervisor at the hospital in Tandjile and explains the situation in his region.

SOUNDBITE (French) Dr. Elie Fokzia –Regional Health Delegate, Tandjilé Region:
“We’ve had two outbreaks of cholera. The first was Oct 2010, which lasted one month. The second wave of cholera was detected on 25th March in the same village. Since March to mid-June we’ve had 467 cases. There were 51 deaths mainly the old and the young children.”

Emergency workers in the capital N’Djamena believe that the first outbreak never really disappeared.

SOUNDBITE (French) Jessica Donoyer, Program manager ‘WASH CHOLERA Action Contre la Faim:
“The epidemic of 2010 never really ended. So the epidemic we have in 2011 is a continuation with a very short space between them. It’s a very short period between the two outbreaks. Since March there has been a resurgence.”

The extreme climate conditions have changed the ecology of the cholera virus causing it to multiply and spread a lot faster through water sources.

SOUNDBITE (Englic) Dr Marzio Babille UNICEF Representative, Chad:
“The climate change impact in Chad, in Central Africa and Cameroon in Central Africa implied an alternate of drought in floods. Cholera therefore presents itself in Central Africa and particularly in Chad today as an important public health threat that has to be tackled urgently and immediately. “

According to experts in the field, the epidemic in the country’s capital is out of control. Although government and partner agencies are better equipped this time, a regional solution is required.

SOUNDBITE (French) Jessica Donoyer, Program Manager “WASH CHOLERA Action Contre la Faim”:
“The zones that are sensitive to cholera are the border areas with Cameroon, Niger and Nigeria. It’s the entire cross border region around the river and Lake Chad. There are very few development projects in that area.”

It’s a thankless task for these young men who have not been paid in months, yet play a vital role of burying the dead and disinfecting homes on the front lines of the cholera epidemic.

SOUNDBITE (French) Dr. Elie Fokzia –Regional Health Delegate, Tandjilé Region:
“It’s a problem caused by a lack of hygiene. Here we call it ‘the disease of the dirty hands. People here need to have access to clean areas and portable water, and not defecate out in the open. The contamination is very quick - even flies can carry bacteria that causes cholera.”

The disease of “dirty hands”, as it is known in Chad, is a water and sanitation issue. When only 52 percent of people have access to improved drinking water, and only 16 percent to improved sanitation, this is a critical public health issue and education is vital.

SOUNDBITE (English) Dr Marzio Babille UNICEF Representative, Chad:
“Enhancing community dialogue should be looked at, systems in other ways should go to people and not under the usual expectation waiting for people to go to systems.”

UNICEF’s response is far reaching from actively promoting behaviour change, to distribution of life saving prevention and treatment kits as well as piloting community led sanitation and water projects.

SOUNDBITE (English) Dr Marzio Babille UNICEF Representative, Chad:
“The concern is the combination of water borne diseases such as cholera and floods. We are approaching a rainy season. The combination of the two imply directly misplacement of people, destruction of property, increase disease and increase mortality levels. So it is absolutely important to link climate change impact to poverty.”

It’s not difficult to contract cholera when a contaminated river, dam or well is the only source for washing, fishing, bathing and ablutions.