Yemen is fighting a cholera outbreak in the southeastern province of Hadramout, with local and international health bodies carrying out an emergency vaccination campaign.

Outbreaks in the remote Hajjar district usually last from April to September and cases vanish in the following months. But this year the district’s main hospital reported receiving new cases of cholera in October, November and December for the first time in decades.

UNICEF, the World Health Organization (WHO) and health authorities in Yemen, alarmed by the increase in cases, joined forces to carry out an emergency cholera vaccination campaign in Hajjar from Dec. 20-25.

“The continuing arrival of new cases to the hospital is a source of concern to us and it is an indication that cholera is endemic in Hajjar,” Abdullah Awadh Bahendi, the director of Hajjar’s main hospital and the director of the Health Ministry’s district office, told Arab News.

The campaign targeted 40,000 people in the district’s rural and urban regions.

Hundreds of posters and leaflets were distributed and trucks roamed around broadcasting messages about the campaign’s significance.

Health worker Nashwa Mubarak said awareness activities that took place before or during the campaign had yielded fruit as most Hajjar residents took the vaccine with little objection.

“As a woman, I target women who would not accept male visitors and I also convince hesitant women,” she said.

Health officials said they had registered at least 250 confirmed cases of cholera and one related death in Hajjar since April, compared to 520 cases and six deaths in 2019.

The WHO said that health facilities had recorded 167,278 suspected cases with 48 associated deaths from Jan. 1 to Aug. 2 this year. The highest numbers of cases were reported in the western province of Hodeidah, 26,936, followed by Sanaa with 24,593.

Health officials in Hajjar attribute the regular resurgence of cholera to crumbling sewage and drinking water systems, in addition to seasonal gatherings of people during the harvest of date palm trees.

Houses discharge sewage in the open or to small holes close by. Flash floods and heavy rains have largely destroyed sewage and water systems in urban areas, prompting people to use polluted water.

“The rains and floods have devastated water pipelines,” Bahendi said. “The cholera reemerges when people turn to unclean water.”

He added that the latest humanitarian interventions from the Health Ministry and international organizations had helped to reduce the number of cholera cases.

“Reasons behind cholera outbreaks have nothing to do with the war. We demand building sewage and water systems for Hajjar which would help ending cholera.”

Floods isolate villages due to their rough geography, making it difficult for health workers to reach the sick.

Bahendi suggested building several health centers in remote villages along with rehydration corners for dealing with mild cases of cholera and equipping health centers with staff and ambulances.

Residents in Hajjar said fixing water and sanitation systems should be a priority and that they had no choice but to drink unclean water because they could not afford to buy processed bottled water.

Suleiman Ahmed, who is 48, said he contracted the disease after drinking unclean water or eating contaminated food.

“I cannot afford to buy clean water,” he said from his hospital bed in Hajjar. He added that the hospital’s directors had advised him to boil water before drinking it or cooking with it if he could not afford to buy bottled water.

Khaled Al-Kaledi, the head of the health department at the Hadramout office of the Health Ministry, said the office had classified Hajjar as a high-risk district due to the high number of cholera cases compared to other areas in the province.

He added that officials, including him, had taken the vaccine to convince the public it was safe.

“People’s reactions with the campaign are amazing,” he said.