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Rush to contain cholera outbreak

A young girl afflicted with cholera lies in a bed at the crowded St. Nicholas Hospital in Saint Marc, in the Artibonite region of Haiti, where Cuban doctors and doctors with Médecins Sans Frontières are treating those infected UN Photo/Sophia Paris
The world has to get better at prevention and forecasts of climate-sensitive diseases like cholera
Medical staff and supplies are being rushed to Artibonite department, where five cholera treatment centres are being erected to complement the main hospital and clinics, in a bid to prevent the disease from reaching the capital, Port-au-Prince.

If cholera were to spread to the hundreds of poorly equipped camps in and around Port-au-Prince holding 1.3 million people, the result “would really be a catastrophe”, said Ian Greenwald, chief medical officer for a Duke University team of doctors, which visited the camps after the 12 January earthquake. “The amount of severe illness and death that could result is significant.” Artibonite is just 100km from the capital.

As of 25 October, the UN Office for the Coordination of Humanitarian Affairs reported that “40 percent of the population along the River Artibonite [the source of the outbreak] have been reached with oral rehydration salts, water purification tablets” and soap.
The US ambassador to Haiti, Kenneth Merten, issued a disaster declaration on 22 October, which is intended to speed up the delivery of US funding and medical supplies to the country.

A team of 16 officials from the Centers for Disease Control and Prevention in Atlanta, Georgia, will be in place by the end of the week, in addition to 21 already in-country, said Lola Russell, CDC spokeswoman. Even though the number of deaths slowed by the middle of the week, the Pan American Health Organization said that cholera cases “are likely to increase in number and to appear in new areas of the country”.

Sanitation crisis

Cholera is an acute infection of the small intestine that is contracted primarily by ingesting water contaminated by infected faeces. Of great concern is Haiti’s significant water and sanitation problem; even before the earthquake, 45 percent of the population lacked access to safe water and 83 percent did not have adequate sanitation facilities.

In a report on Haitian sanitation issued in July this year, six months after the earthquake, the International Federation of the Red Cross and Red Crescent Societies said the “earthquake has made a bad situation so much worse”.

The IFRC reported on several of its successes, including the fact it had “built almost 2,700 latrines in camps across Port-au-Prince, and each day produces and distributes 2.4 million litres of clean water”. But it also described a frightful situation that required international attention. The existing waste disposal facility for Port-au-Prince, at Truitier, just outside the city, is described by an interviewee as “worse than hell”. It is a “huge area of stinking and slowly smoking garbage”, where “both solid and human waste – including faeces in plastic bags, a commonly used option in Haiti – is indiscriminately dumped”.

Drainage problems

In a study of more than 100 of the 861 temporary camps in and around the capital issued on 4 October, Mark Schuller of York College in New York and the Faculté d'Ethnologie, Université d'État d'Haïti, found that “sanitation and drainage for rainwater was a serious issue.
“On the morning following a rainstorm it is common to find large pools of standing, muddy water – often stretching 20 yards [18.3m] – over which mosquitoes, flies, and other potential disease vectors circle,” the report said. Forty percent of the camps are without water and 30 percent do not have toilets of any kind.

But even in those camps with bathroom facilities, the conditions can be grim. Schuller’s report says that in a camp at Place de la Paix, in the Delmas 2 neighbourhood, there are only 30 toilets for 30,400 people. The row of toilets was “next to the trash receptacles, which was next to the water distribution and the site for the mobile clinic”.


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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