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A medical treatment tent in Beira, Mozambique. Photo: Yasuyoshi Chiba/AFP/Getty Images

Cholera has returned in the aftermath of the deadly Cyclone Idai that devastated large swaths of southern Africa on March 15.

Why it matters: Catastrophic events have the potential to reverse health, education and income gains in countries like Mozambique and Malawi, which are among the poorest in the world. Approximately half the population in both countries live below the official poverty lines, and many lack access to safe water and toilets.

Background: If untreated, cholera can be fatal. When clinics and hospitals have been destroyed following natural disasters and people are living in close proximity to each other, early detection and treatment are challenging but critical.

What's happening: 1.8 million are need of urgent assistance, with 128,000 living in shelters at 154 sites across Mozambique, Malawi and Zimbabwe. At least 750 people are estimated to have been killed, but that number continues to climb as bodies are discovered.

  • Mozambique was already dealing with floods that had displaced 60,000 people — pushing many into crowded shelters — when the cyclone hit, destroying homes, clinics and schools in its path.
  • In Beira, Mozambique's fourth largest city, the primary water treatment facility was severely damaged by the storm. At least 1,052 people have been infected by cholera, and one person has reportedly died from the disease.
  • Other diseases such as typhoid may also break out. Standing water is a breeding ground for mosquitoes, which transmit malaria.

Where it stands: The WHO has requested $13 million for medical supplies and disaster response in areas cut off by flooding. It has shipped 900,000 doses of cholera vaccine to Mozambique, and a vaccination campaign is set to begin in Beira on April 3.

  • USAID has sent a disaster assessment response team and committed $7.3 million to the region.
  • NGOs such as Save the Children and MSF are also actively engaged in fundraising and support, with the latter operating a hospital to treat cholera patients in Mozambique.

The bottom line: Though the international donor community has begun responding to the crisis, the specter of cholera death raises further alarm. And with such wide devastation, rebuilding will be a long process.

Tanvi Nagpal is the director of the International Development Program at Johns Hopkins School of Advanced International Studies.

Go deeper

Updated 46 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Health: Large coronavirus outbreaks leading to high death rates — Coronavirus cases are at an all-time high ahead of Election Day — U.S. tops 88,000 COVID-19 cases, setting new single-day record.
  2. Politics: States beg for Warp Speed billions.
  3. World: Taiwan reaches a record 200 days with no local coronavirus cases.
  4. 🎧Podcast: The vaccine race turns toward nationalism.
58 mins ago - Health

States beg for Warp Speed billions

A COVID-19 drive-thru testing center yesterday at Hard Rock Stadium in Miami Gardens. Photo: David Santiago/Miami Herald via AP

Operation Warp Speed has an Achilles' heel: States need billions to distribute vaccines — and many say they don't have the cash.

Why it matters: The first emergency use authorization could come as soon as next month, but vaccines require funding for workers, shipping and handling, and for reserving spaces for vaccination sites.

Court rules Minnesota absentee ballots must be received by 8 p.m. Election Day

An election judge drops a ballot in a ballot box at a drive through drop-off for absentee ballots in Minneapolis. Photo: Stephen Maturen/Getty Images

An appeals court on Thursday ruled that Minnesota absentee ballots must be received by 8 p.m. on Election Day to be counted.

Why it matters: The ruling, which comes just five days before the election, blocks the state's plan to count absentee ballots arriving late so long as they're postmarked by Nov. 3 and delivered within a week of the election. Now those ballots must be set aside and marked late.

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