In response to a request for assistance from the Angolan government due to an ongoing cholera outbreak, CADUS deployed a technical assistance team as part of a joint EMT mission with Arbeiter-Samariter-Bund, Malteser International and the Robert Koch Institute.

In January 2025, Angola’s Ministry of Health reported the first cholera outbreak in almost two decades to the WHO. Since January 7, 2025, cholera has been spreading from the capital Luanda to other provinces throughout Angola. By the end of March, 9,965 official cases and 383 deaths had already been reported. Children, young people and people with generally poor health are particularly affected. The mortality rate is rapidly rising to an alarming 3.8%.

Employees at a health center in the province of Benguela test their water for chlorine content. Photo: CADUS

Following a renewed request for assistance from the Angolan government to the WHO, CADUS sent an emergency team to Angola as part of a joint EMT mission, together with colleagues from the EMTs of the Arbeiter-Samariter-Bund and Malteser International as well as emergency personnel from the Robert Koch Institute.

The aim of the mission: to contain and stop the cholera outbreak through a combination of IPC (Infection Prevention and Control) training and WASH (Water, Sanitation and Hygiene) interventions. CADUS was responsible for the technical component of the targeted intervention in local health facilities. We installed new and efficient water filtration systems and repaired the necessary WASH infrastructure with the involvement of local staff.

The water tanks must also be regularly tested for their chlorine content to ensure safe drinking water. Photo: CADUS

A crucial and elementary component for the care of cholera patients and stopping the outbreak: the supply of clean water. Clean water and adequate sanitation are human rights and vital.

After arriving in Benguela, it quickly became clear that the originally defined locations were already adequately supplied. Although there is a need for IPC training, there is no acute support in the area of WASH. Above all, emergency response means being flexible and reacting proactively to changes and challenges. Thanks to the existing international and local network, we were able to quickly identify new starting points with colleagues from UNICEF, who have been working on the structural improvement of the water and sanitation supply on the ground for years.

The structure of the local water supply system is explained to our team and possibilities for improvement are discussed together. Photo: CADUS

For us, it was a long way to Muhaningo, about three hours off-road from Benguela. A rural village, just before the sea, where several rivers meet and flow into the sea. The water supply there had completely collapsed. During the first visit, it became clear that the water source that supplied the village and the people in the surrounding area with drinking water came directly from the rivers that flow from the large urban areas to the sea.

In an area without a functioning wastewater structure, the river is also used to dispose of wastewater. The river is used to irrigate fields, wash clothes, bathe and also to obtain drinking water. However, the infrastructure required for this was either no longer available or was defective. Despite the adversities on site and the lack of logistical support, a new water filtration system with additional chlorination was put back into operation at the discharge point in the middle of the village, right next to the school.

Rapid test tubes can be used to test for the presence of E. coli bacteria. Black means that the water is contaminated. Fortunately, the liquid was no longer discolored after our measures. Photo: CADUS

The restored system now supplies the village and the surrounding area with filtered and chlorinated water again. The system was designed in such a way that no complex operating or maintenance processes are required in order to ensure its longevity and thus a reliable supply over a long period of time.

In Muhaningo, our team has restored the local water supply. Photo: CADUS

As soon as the work in Muhaningo was completed, the team moved on. A few kilometers outside the city of Benguela lies the Graça hospital – a central point of contact for medical concerns of all kinds. To protect the remaining patients from contracting cholera, a CTC (Cholera Treatment Center) was set up in the hospital garden. Patients suspected of having cholera were directly isolated, treated and cared for there.

First water withdrawal from the tap after the repair work. Photo: CADUS

Our first water test showed that there is not enough clean water here either.
You will soon find out how our mission at Graça Hospital continued in the second part.