Choléra : réhydrater d’abord, partir ensuite

Cholera kills by drying the body out, sometimes within hours. The thing that saves people is fluid, and the fluid has to start at home, before and during the journey. A person who reaches a treatment centre still drinking almost always survives.

What it looks like

• Sudden watery diarrhoea, in large amounts, often pale and cloudy like rice water.
• Vomiting, usually without much stomach pain and usually without fever.
• Rapid weakness, cramps in the legs, and a sunken look to the eyes.

Start ORS immediately, then go

Oral rehydration salts, mixed exactly as the sachet says, in treated water. Give a cup after every loose stool for an adult, and small sips constantly for a child. Keep giving it in the taxi. If there is no sachet, half a small spoon of salt and six level small spoons of sugar in one litre of safe water will do until you reach a sachet, but use the sachet when you can get one.

Go to a treatment centre now if

• The eyes look sunken, or a baby has no tears when crying.
• The skin stays pinched when you lift it.
• Very little urine, or none.
• Too weak to sit, or drowsy.
• Vomiting everything, so the fluid cannot go in.

Protect the rest of the house

• Wash hands with soap after any contact with the person or their clothes.
• Disinfect soiled clothing and bedding, and the latrine, with chlorine.
• Drink only boiled or treated water, everyone, for the duration.
• Tell the health centre. Cholera is notifiable, and one reported case is what brings the response that protects the quarter.

What not to do

• Do not stop fluids because the diarrhoea continues. The fluid is the treatment, not the cause.
• Do not give antidiarrhoeal tablets to a child.
• Do not wait to see whether it settles.