Situation report (sitrep) based on incomplete and contradictory data

Verified: bridge cut and access by canoe (observed by the team); 412 households and 2,060 people registered; stock of 400 kits; teams safe.

Unverified: 23 cases and 2 deaths (direct medical source, but no laboratory confirmation: refer to "suspected cases"); NGO X announcement (a commitment, not yet delivered: "planned from D+5"); NGO X's 250 kits (to be confirmed: location, availability).

Contradictory: 600 families according to the site manager versus 412 households registered: the gap may be explained by ongoing registration or by an estimate; write "412 households registered at 5 p.m.; local authorities estimate up to 600 families; registration ongoing". 10 deaths according to WhatsApp versus 2 according to the nurse: the rumour is not repeated; it is reported to health coordination and cross-checked with the central office of the health zone. The word "cholera" must not be used before confirmation.

Water: Kabalo-Gare 14,000 / 1,190 = 11.8 L/p/d; Mulolo 6,500 / 870 = 7.5 L/p/d; total 20,500 / 2,060 = 10.0 L/p/d, below the Sphere benchmark of 15 L/p/d. Need 2,060 × 15 = 30,900 L/d; deficit 10,400 L/d. With NGO X's 8,000 L to Kabalo-Gare from D+5: total deficit 2,400 L/d, but Kabalo-Gare would rise to 22,000 / 1,190 = 18.5 L/p/d while Mulolo would remain at 7.5 L/p/d, and it is in Mulolo that the diarrhoea cases are. The trucking should be requested to serve Mulolo first (need 870 × 15 = 13,050 L/d, deficit 6,550 L/d).

Latrines (1 per 50 people): Kabalo-Gare 1,190 / 50 = 23.8, i.e. 24; Mulolo 870 / 50 = 17.4, i.e. 18; total 42; existing 11; deficit 31 (15 and 16). Mulolo: 435 people per latrine.

Kits: need 412; available 400 + 250 (to be confirmed) = 650, i.e. 238 in reserve, which would not be enough if the 600 families are confirmed and others arrive.

Diarrhoea: attack rate in Mulolo 23 / 870 = 2.6% in 48 hours; case fatality rate 2 / 23 = 8.7%, far above the target of less than 1% for cholera if that diagnosis is confirmed: it suggests inadequate or late case management.

Example of the expected structure and content:

Highlights: 412 households (2,060 people) registered on two sites after the rains, figure rising; 23 suspected cases of acute watery diarrhoea and 2 deaths in Mulolo in 48 hours, samples pending; road access cut, canoe only.

Situation: dated and sourced facts; gap between registered figures and the local estimate flagged as such.

Needs and gaps: water 10 L/p/d on average and 7.5 L/p/d in Mulolo, deficit of 10,400 L/d; 31 latrines missing; case management and confirmation of the diagnosis; kits covered for registered households.

Response: what has been done and is planned, by whom (NGO X trucking from D+5, kits available).

Constraints: access, canoe transport capacity, rainy season.

Next steps: samples sent within 24 hours; trucking redirected to Mulolo; chlorination and oral rehydration points; kit distribution; emergency latrines; update at D+4 at 5 p.m.

The marker rewards: figures and sources, the distinction between facts and estimates, a clear priority given to Mulolo, the absence of jargon and rumour, and actions with an owner and a deadline.

Messages: (1) "2,060 people registered, possibly more; access is only possible by canoe." (2) "Mulolo is the critical point: 7.5 litres of water per person per day, 2 latrines for 870 people, 23 suspected cases of diarrhoea and 2 deaths in 48 hours." (3) "Kits are available; the gaps are water, sanitation and case management."

Decisions: (1) redirect NGO X's trucking to Mulolo as a priority and identify a partner to cover the rest of the water deficit; (2) designate a lead health actor for case confirmation and the opening of a rehydration point within 24 hours.

I object to publishing the figure of 10 deaths and the word "cholera": they are a rumour and an unconfirmed diagnosis. A public error would damage the agency's credibility, could cause panic and stigmatisation of the site, and would be used against humanitarian action. I propose a message based on verified facts: "cases of acute watery diarrhoea reported, response under way, water and sanitation needs".

With the authorities, I do not withhold public health data from coordination reports: accountability and the response depend on it. However, case and death figures are communicated publicly by the Ministry of Health or in agreement with it; the agency may use the official figures, citing the source. I refer the matter to the head of office and to health coordination for a common communication line.