One confirmed case of cholera and 14 suspected cases have been reported in the Hagadera refugee camp in Dadaab, eastern Kenya - numbers that have the potential to spike as Somali refugees inundate already overstretched camps, says the International Rescue Committee (IRC) and the Norwegian Refugee Council (NRC).

"Emergency teams with the IRC and NRC are working around the clock to contain this outbreak," says Kellie Leeson, IRC country director. "However, the spread of cholera is hard to prevent when people are living in congested conditions and don't have enough clean water or adequate sanitation. There is an urgent need to allocate more land here to house and help refugees from Somalia."

An average of 5,000 Somalis are streaming into Dadaab every month — fleeing ongoing violence at home. Most arrive dehydrated, exhausted and hungry, which make them more susceptible to disease. Hagadera, one of three camps in Dadaab, was originally designed for 50,000 people, but is now home to 90,000 refugees making the pressure on existing resources intense.

"Good sanitation is vital to prevent disease outbreaks and there is a pressing need for at least 34,000 family latrines across Dadaab's camps," says Mohamed Mechmache, NRC's country director. "More land and funding is urgently required if agencies are to respond immediately and effectively."

Both the IRC and NRC are members of an emergency rapid assessment team set up to respond to the current outbreak.

In Hagadera, the IRC is treating cases at a special isolation ward and is working closely with UNHCR to set up a separate recovery ward. The IRC is also transporting extra fluids, zinc (used in the treatment of diarrhea), cholera beds and infection control items such as soap, gloves and facemasks to the camp. The IRC's four health posts and hospital are carrying out rapid tests for cholera on site, with suspected positive samples being sent to Nairobi for final confirmation.

At the same time, IRC community health workers are going from shelter to shelter to identify further potential cases. They are also educating households on simple steps to prevent further spread of the water-borne disease, such as washing hands with soap, using latrines, and purifying water.

NRC is the leading shelter and sanitation agency across Dadaab's three camps. Since November 2008, NRC has built and repaired more than 3,000 household, communal, school and hospital latrines in Dadaab and plans to reach around 13,000 latrines by the end of 2009, but only if adequate land and resources are forthcoming.

Currently, NRC is scaling up staff numbers to monitor areas in Hagadera that have a history of cholera and to assess potential breakouts. Since the beginning of February 2009, NRC has already repaired 50 overflowing latrines in the areas that currently have outbreaks, as well as providing emergency latrines to support the expansion of isolation wards.

To date, more than 244,000 Somalia refugees have fled ongoing violence at home and sought shelter in Dadaab. More than 62,000 Somalis arrived in Kenya in 2008 alone. These numbers show no imminent sign of decreasing, as Somalia has not had a functioning government since 1991 and Islamist militias control much of the country, despite the recent election of new president Sheikh Sharif Ahmed.

Contact Details:

IRC Kenya Country Director, Kellie Leeson: +254 733 605 639 kellie.leeson@theirc.org

IRC Regional Media Manager, Joanne Offer: +254 737 800 028 jo.offer@theirc.org

NRC Head of Field Office Dadaab, Jennifer Worthington +254 727 526 548 ho_dadaab@som.nrc.no

NRC Kenya/Somalia Country Director, Mohamed Mechmache + 254 725 964 431 representative@som.nrc.no

Note to Editors:

• Cholera is a potentially fatal disease if patients do not get prompt treatment. It can kill within hours. • Since 1st January 2009, the IRC has been running a hospital and four health posts in Hagadera camp, providing around 90,000 refugees and 12,000 local people with essential healthcare, nutritional feeding programs and HIV/AIDS services. IRC teams have years of experience in refugee healthcare in Kenya, having worked in Kakuma refugee camp since 1992. • NRC started operations in Dadaab in February 2007. NRC provides shelter in Ifo and Dagahaley camps, and is the lead agency for sanitation in all three camps. NRC also started camp management training and youth education projects in October 2007.