In July 1994, a cholera epidemic struck the Hutu people in Goma, Zaire, Africa, who had become refugees as a result of the Rwandan genocide. French military bulldozers gathered corpses killed by the cholera epidemic for mass burials.

　　In July 1994, in Goma, Zaire, Africa, a deadly cholera epidemic struck Hutus who had become refugees as a result of the Rwandan genocide. French bulldozers gathered the corpses of those killed by the cholera epidemic for mass burials. A severe cholera epidemic spread through the refugee camps. Many of the cholera victims' corpses were piled in the desolate volcanic wilderness, exposed and rotting in the hot African sun. Other swollen corpses littered the landscape, desperately trying to stave off the worst epidemic in world history. The only relief was the excavation of mass graves, signaling the apocalyptic scope of the crisis. An estimated 1.2 million refugees streamed across the Zaire border.

 　In the Rwandan genocide (also known as the Genocide against Tutsis in Rwanda), which broke out between April 7 and July 15, 1994, Rwanda's Hutu majority, located in Middle East Africa, killed as many as 800,000 people, mostly Tutsis from the minority group. The genocide, which broke out in the capital city of Kigali by Hutu nationalists, spread throughout Rwanda with shocking speed and brutality. Civilians were incited to take up arms against their neighbors by local officials and the Hutu-power government. By the time the Tutsi-led Rwandan Patriotic Front seized control of Rwanda in a military offensive in early July, hundreds of thousands of Rwandans had died and some 2 million mainly Hutu refugees had fled the country, exacerbating the situation into a full-scale humanitarian crisis. It was Rwandan citizens who cooperated with and supported the genocide. Many Tutsis and moderate Hutus were handed over and killed by their neighbors, who were inflamed by anti-Tutsi sentiment. Most of the refugees, Hutus fearing reprisals from the newly empowered Tutsi rebel government, were packed into disease-ridden refugee camps in neighboring Burundi, Tanzania, Uganda, and former Zaire.

 　In July 1994, cholera, the worst epidemic disease, broke out among nearly one million Rwandan refugees in Goma, in eastern Zaire, Africa. The UN High Commissioner for Refugees estimated that nearly 12,000 people died in the epidemic. The Bangladesh International Diarrhea Research Center sent a medical team to Goma. During their nearly two-week stay, they worked with UNICEF and the Zaire Ministry of Health to conduct epidemiological assessments, operate a temporary treatment center, and provide technical assistance to other health personnel in the management of cholera and dysentery. A microbiology laboratory was established in Goma to identify the pathogens responsible for the epidemic and their drug susceptibility. Medical teams visited a number of temporary treatment facilities in two of the five camp sites and provided technical advice to health care providers. Treatment facilities in Goma, where an estimated 200,000 refugees were affected by the epidemic, were also visited. Cholera deaths at treatment centers were also much higher than expected.

 　The overall case fatality rate at treatment centers was nearly 15%. Laboratory investigations identified the initial outbreak as cholera resistant to tetracycline and doxycycline antibiotics; by the first week of August, the number of cholera cases had declined, but the number of dysentery cases increased rapidly. It was mainly caused by dysentery bacillus type 1, which was resistant to most dysentery medications except mecillinam. Inadequate rehydration therapy and inexperienced health personnel did not prevent deaths. The medical team took over the operation of the Katindo Temporary Treatment Center in Goma, which had the highest case fatality rate (14.5%) and reduced the fatality rate to less than 1%.