5-20-06, 10:45 am

LUANDA, 19 May 2006 (IRIN) - Supermarkets in the Angolan capital, Luanda, are struggling to meet the demand for bottled water as citizens try to protect themselves from cholera.

At least one major oil company has banned its employees from eating out or buying fish.

On Friday, the World Health Organisation (WHO) reported 'a total of 36,721 cumulative cases and 1,335 deaths in 11 out of 18 provinces'. Approximately half of the cases - 18,835 – were registered Luanda. 'It's following the commercial roads - the truck routes,' WHO analyst Jordi Sacristan said.

At a cholera treatment centre in the poor Cazenga area of the capital, where cholera was first detected, the smell of chlorine to combat the disease is everywhere. Tents give temporary shelter and stretchers substitute for beds, but there is a sense of order despite scarce resources.

'When the outbreak first started we were in the middle of it here ... there were beds by the ditches,' said Dr Zola Messo, who runs the centre, pointing to the irrigation canals that surround the facility. 'The number of cases is increasing but we opened two more [care centres] nearby.'

Overcrowding and appalling sanitation in the country's many slums, or 'musseques', help the disease to spread quickly. The residents are mainly internally displaced persons who fled the country's devastating 27-year civil war, which ended in 2002.

'Many people fled to Luanda during the war, looking for security,' said Jose Van Dunem, Angola's Vice-Minister for Health. 'They created worse slums without drinking water [where] the disease spreads fast. We need information, sanitation and education to reorder the slums.'

Cazenga was on the front line of the cholera attack earlier this year, and it's not hard to see why: potable water is scarce, and for many the only source is from one of the numerous potholes scattered along the main road.

Heavy rains have exacerbated the situation - Cazenga is pocked by large, stagnating puddles left over from last week's downpour. Children play next to the water, women sell fruit and one resident tends a small vegetable patch close by.

Although the worst of the epidemic seems to have passed, conditions are still dangerous, particularly for the vulnerable young. An IRIN visit to a small treatment centre near the satellite town of Viana was punctuated by the cries of a grieving mother. She brought her sick child in for emergency treatment but was told that it was too late. Her son died as we left the doctors' tent.

'It started in the least-developed suburbs of Luanda and spread,' Pierre-Francois Pirlot, the United Nations Development Programme (UNDP) Resident Representative said last month.

This is the first serious outbreak to hit Luanda in over 10 years, and the interior of Angola has not seen cholera for even longer: people rarely travelled during the war and the disease was confined to the slums of the capital. Ironically, government efforts to rehabilitate the country's crumbling infrastructure are allowing the disease to spread.

'This is a price of development, but it is a pessimistic view,' said Van Dunem. 'Cholera follows the water ... and bad health. In the slums some people get water from road-potholes ... [this] creates the best conditions for spreading.'

Van Dunem called for a better quality and quantity of drinking water, and better education.

'Preventative measures - sanitation and water distribution - have been deployed, but far less than is necessary for the magnitude of the outbreak,' said David Noguera, coordinator of the response by the medical charity, Medecins Sans Frontieres, to the cholera emergency said. 'We would be really happy with more but, up to now, few things are happening.'

In the grounds of another treatment centre in Cazenga, Dr Katerina Oapanha, who works for Luanda's Provincial Ministry of Health, gently admonished some reclining male patients: 'Its not nice being here, is it? When you go home you make sure that you treat the water and tell others.' The men nod their heads.

There are signs that the government's message is getting through. 'I am going home today, I feel better,' said Adriano Costa, a young patient in Cazenga who admitted to drinking bad water. 'When I return home I will treat water to drink, and when my children bathe - it's worth the effort.'

Angola, sub-Saharan Africa's second largest oil producer after Nigeria, is currently in the middle of a multibillion-dollar reconstruction boom fuelled by record high oil windfalls. Yet according to the UNDP, despite its oil wealth most citizens still subsist on less than US$1 a day.