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Coordination during Cholera Outbreak Response: Critical Insights from Yemen

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  • 1 Independent Consultant, Medical Epidemiologist, Geneva, Switzerland;
  • | 2 Microbiology Department, Kingston Hospital NHS Foundation Trust, Kingston upon Thames, London, United Kingdom;
  • | 3 Public Health Department, Local Health Unit N. 2 “Marca Trevigiana”, Treviso, Veneto, Italy;
  • | 4 Infectious Diseases Department, Sassari University Hospital, University of Sassari, Sassari, Italy;
  • | 5 Division of Water Resources Engineering, Lund University, Lund, Sweden

ABSTRACT.

Within the humanitarian arena and since the introduction of the humanitarian reform process in 2005, the cluster approach was introduced to strengthen the cooperation and accountability between agencies working in the same field. Such an integrated approach is particularly needed and relevant in emergencies like cholera, especially in countries undergoing internal conflicts like Yemen. Several areas of concern have been identified during the past field experiences, which include dysfunctional cooperation as a result of different mandates as well as the relationship between nongovernmental organizations and their donors. Control of environmental health services is, for instance, the responsibility of several clusters/agencies and stakeholders, which usually results in a complicated and sometimes confusing approaches to address gaps and barriers. As far as the drinking water quality monitoring and surveillance are concerned, sampling and testing and compilation of data are usually carried out by many agencies included in the health and water sanitation and hygiene (WASH) clusters. We believe that the cluster theoretical approach for emergency response remains a turning point for the humanitarian arena. However, lessons from the recent past, especially in the management of a cholera outbreak in fragile settings, may serve as a serious reflection on roles and dynamics within the blurred border between health and WASH. Specifically, cluster leads in the field have the responsibility for ensuring that humanitarian actors working in their sectors remain actively engaged in addressing crosscutting concerns such as the environment.

Author Notes

Address correspondence to Saverio Bellizzi, Avenue Appia 20, 1211 Geneva 27, Switzerland. E-mail: saverio.bellizzi@gmail.com

Authors’ addresses: Saverio Bellizzi, Independent Consultant, Medical Epidemiologist, Geneva, Switzerland, E-mail: saverio.bellizzi@gmail.com. Giuseppe Pichierri, Microbiology Department, Kingston Hospital NHS Foundation Trust, Kingston upon Thames, London, United Kingdom, E-mail: giuseppe.pichierri@nhs.net. Luca Cegolon, Public Health Department, Local Health Unit N. 2 “Marca Trevigiana”, Health, Treviso, Veneto, Italy, E-mail: l.cegolon@gmail.com. Catello Mario Panu Napodano, Infectious Diseases Department, Sassari University Hospital, University of Sassari, Sassari, Italy, E-mail: catellopanunap@hotmail.it. Osama Ali Maher, Division of Water Resources Engineering, Lund University, Lund, Sweden, E-mail: osama.ali_maher@tvrl.lth.se.

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