Placing communities in Cameroon at the heart of cholera prevention efforts is the basis of a new initiative between Médecins Sans Frontières (MSF) and Cameroon’s Ministry of Health (MoH). The project – launched in November 2024 in Djoungolo, a neighbourhood of the country’s capital, Yaoundé, that has been regularly affected by cholera – addresses factors that contribute to the resurgence and transmission of the disease to strengthen prevention capacities often already in place.
“We had already introduced community cleaning days in each neighbourhood to clear drainage channels, clean the areas in front of homes and public spaces,” says Simon Ahanda, neighbourhood chief in Djoungolo. “Residents were already mobilised to fight diseases linked to poor sanitation.”
Listening to communities before taking action
Since October 2021, Cameroon has experienced recurring cholera outbreaks. While emergency responses treat patients and reduce the risk of death, additional measures are needed to prevent the disease from returning. Underlying causes include limited access to safe drinking water; inadequate sanitation infrastructure; poor waste management; and inadequate hygiene practices. It is in this context that MSF chose to develop a different approach, based on community involvement.
Our teams held consultations with residents, community leaders, health authorities, and other local stakeholders. The discussions identified community priorities, the challenges communities face, and existing measures. The consultations showed that communities had already identified several challenges and developed local initiatives that needed strengthening. This approach is part of the Patients and Populations as Partners (PPP) approach and made it possible to adapt project activities to the realities on the ground.
“We could not come in with ready-made solutions,” says Frida Tebere, MSF’s PPP manager. “Patients and communities know their realities, their challenges and the problems they face every day better than anyone.”
“Our role is to listen, create dialogue and build solutions together with them,” says Tebere.
Solutions adapted to the local context
Community consultations helped guide project activities towards concrete priorities including improving access to safe drinking water, strengthening hygiene and sanitation practices, supporting the early detection of suspected cases, and promoting better understanding and adoption of prevention measures.
MSF is supporting the promotion of good hygiene practices, the rehabilitation of seven water points, and the establishment of a chlorine production unit to improve access to safe drinking water. The use of chlorine caused concern among communities. Discussions showed that the concern was based on the practicality of chlorine use – the correct dosage and how to store treated water – and not on treating water itself.
The project developed a strategy centred on model households. These are volunteer families who are trained in chlorine use and, having gained practical experience, then share their knowledge with neighbours.
“At first, we had concerns about using chlorine,” says a member of a model household. “After the explanations and demonstrations, we understood how to use it correctly. Today, we also show other families how to treat their water.”
Continuously strengthening community capacities
More than 1.2 million people have been reached through awareness-raising activities since 2025. Approximately 5,000 households are targeted each month in the Djoungolo health district.
Community engagement is a key component of the project. Participation goes beyond awareness-raising. At some sites, communities also help secure worksites and equipment during the rehabilitation of water points. This involvement strengthens local ownership of the infrastructure and aims to create the conditions necessary for its continued use and sustainability.
The project also supports health facilities and communities through a chlorine production unit intended to supply health facilities and households for water treatment. MSF remains ready to support the response to future cholera outbreaks, including through free patient care, strengthening the capacities of healthcare workers, supporting peripheral health facilities when needed, and contributing to preventive or reactive vaccination campaigns.
The objective is therefore to create a continuum between prevention, preparedness and response: strengthening community involvement and health facilities, while maintaining the capacity to respond rapidly as soon as a cholera case is confirmed.
Collective responsibility for sustainable prevention
In a context where humanitarian needs are increasing while available funding is declining, cholera prevention cannot rely on a single organisation. The experience in Djoungolo shows that communities never start from scratch. They already have knowledge, initiatives, and solidarity mechanisms that can contribute to preventing the disease. The role of health organisations is therefore not only to provide expertise, but also to identify, strengthen, and support solutions that already exist locally.
In Djoungolo, preventing cholera is not simply about providing safe water, chlorine, or awareness messages. It is about enabling people to understand the risks, participate in decision-making, and have the means to take action. Prevention becomes more sustainable when communities are not simply recipients of a response, but full partners in shaping it.
Distributed by APO Group on behalf of Médecins sans frontières (MSF).
