12 November 2012 Last updated at 11:42

In pictures: Cholera in Freetown Sierra Leone

With the end of the rainy season, Sierra Leone’s worst outbreak of cholera in nearly 15 years has finally begun to recede. The crisis has focused attention on the dire living conditions in the slum areas of Freetown, where the disease hit hardest.

Kroo Bay has grown rapidly, swelled by an influx of rural migrants during the civil war into a sprawling shanty town of around 6,000 people. At the edge of the settlement lies a vast rubbish dump, extending out into the Atlantic Ocean.

Sanitary conditions in the slum are extremely poor, with few clean toilets. Many people simply defecate in the open, often near the banks of the stream that flows through Kroo Bay.

Every year during the height of the rainy season the river bursts its banks, flooding the low-lying land on which the settlement is built. Chief Pa Alimammy Kamara complained that little had been done to prevent the flooding. “We need them to build concrete walls along the river banks,” he explained.

Pigs wander unchecked along the stream, foraging for food in its rubbish-filled waters. Just a few metres downstream, children play and swim, while others urinate along the banks.

Though water wells have been installed in Kroo Bay, these are not immune from contamination. Unicef estimates that up to 42% of Sierra Leoneans do not have access to clean drinking water.

In such conditions, cholera spreads rapidly through the slums. Though it is easily treatable if addressed early, it is frequently fatal in Sierra Leone, where health facilities are not easily accessible, and awareness of the disease is low.

In August President Koroma announced a national emergency as cholera deaths increased sharply with the intensification of the rainy season. The disease has so far killed over 280 people this year.

The government, in conjunction with aid agencies, has worked hard to contain the spread of the disease. But until the sanitary situation is addressed seriously in the slums of Freetown and other parts of the country, cholera will remain a significant threat.

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In pictures: Cholera in Freetown Sierra Leone

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