Authorities in Cameroon say they are struggling to contain a cholera outbreak in an overcrowded refugee camp on its northern border with Nigeria. In the past week, three people have died in the Minawao refugee camp and at least 81 have been infected from the bacteria, which spreads through dirty water and food. The camp was designed to hold fewer than 15,000 refugees but currently has more than five times that number.

The camp located on Cameroon’s northern border is home to 76,000 Nigerians who have fled Boko Haram terrorist attacks.

Helen Ngoh, spokesperson for UNHCR Cameroon says the U.N. body needs support to contain the ongoing wave of infections and to prevent future outbreaks in the refugee camp.

“In Minawao specifically UNHCR needs at least 450,000 U.S. dollars to be able to increase portable water supply and also to be able to cover an existing gap of 900 latrines and to be able to improve waste management in the camp as well. All of these needs are extremely urgent at this point,” she said.

UNHCR says it is investigating suspected cases and treating patients free of charge. The refugee agency says it is also finding out if the disease has spread to host communities.

Ngoh said several hundred humanitarian workers have been deployed to the camp and host communities to educate refugees on prevention measures, which she said are basically respecting hygiene rules.

Nigerian refugee Special Bulama is among aid workers raising awareness about the outbreak and teaching civilians good hygiene practices.

Bulama says he has personally spoken about the disease to scores of families in the camp.

“We are telling the refugees to take care of themselves, they must boil water before they take [drink], they must wash their hands with Sabulu [soap], keep their latrines very safe because flies can take this disease to their food or to their water. We are telling them to help us to avoid this problem of cholera,” he said.

Cameroon’s Ministry of Public Health has confirmed the outbreak. Government health officials say at least 22 people have died of cholera in several villages on Cameroon’s northern border with Nigeria and Chad. Humanitarian workers and health officials say many more people may be infected or are feared dead in difficult to access villages within the past two weeks.

The U.N. reports that up to October, more than 1,000 cases of cholera were reported in Nigeria.

Cameroon says hospitals in border localities are overwhelmed.

Officials in Cameroon say they are engaged in discussions with Nigeria and Chad to jointly combat cholera, a bacterial infection that causes severe diarrhea and dehydration, usually spread through contaminated water. It can be fatal if not treated.

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