In Haiti latrines can make a difference between life and death. “If we are to truly combat cholera, we need to implement long-term solutions, like water treatment systems and latrines,” says Cate Oswald, from Partners in Health (PIH).The cholera epidemic is a symptom of Haiti's long history of water insecurity. Without access to sanitation systems human waste seeps into the soil, contaminating local water sources. Cholera causes rapid dehydration and electrolyte imbalances, and leads to death in up to 50% of untreated cases.
Haiti's Cholera Epidemic
Haiti's first cholera epidemic in a century began last October. As of 4 April, 274,418 Haitians had fallen ill and 4,787 had died, according to the Pan American Health Organization (PAHO), the regional arm of the World Health Organization (WHO). Clinics run by Partners in Health report that patients treated and hospitalized for cholera have more than quadrupled from 3,932 in April to 14,425 in June 2011. One-quarter of Haitians live next to rivers, where the Vibrio cholerae bacterium seems to thrive. The long absence of epidemics means there is probably no natural immunity, and the strain causing the current epidemic is particularly virulent.
Desperately Needed: Health Workers, Resources, Antibiotics, Funding
During the early phases of the cholera outbreak many international organizations and NGO's partnered with the Ministry of Health to set up Cholera Treatment Centers and Oral Rehydration Posts reports Dr. Louise Ivers, Senior Health and Policy Advisor for PIH. This summer as the number of cholera cases spikes again, many organizations have downsized, or retreated from the Central and Artibonite departments citing lack of funds for treatment and prevention. This leaves Zanmi Lasante (PIH's Haitian sister organization) in crisis mode. Community Health Workers spend hours on foot to reach isolated places, providing oral rehydration solution, distributing water purification tablets, disinfecting houses, while resources and staff are constantly short.
Vaccination Campaign Essential to End Cholera Epidemic
At the beginning of the epidemic last year cholera vaccination was considered, but deemed impractical due to limited global supply and issues of fairness. A course of vaccination requires two doses. A group of medical and public health experts including Dr. Paul Farmer insist that a universal vaccination campaign is essential to end the crisis. In an article published on May 31st in the open-access journal PLoS Neglected Tropical Diseases the authors recommend to start a rational vaccination strategy immediately by targeting the most vulnerable populations. Last December, Haiti's Ministry of Health decided not to vaccinate anticipating social friction if NGO's were to administer the vaccine to select groups.
Interfaith Groups and Voodoo Religious Communities Spread Prevention Message
In a recent event Rara music groups from Voodoo religious communities mobilized Haitians to protect themselves against cholera. Using the theme “Ann pwoteje tèt new kont kolera'' (“Protect us from cholera” in Creole), the Rara groups competed to receive awards for most enthusiastic performance and how to communicate cholera prevention. Approximately 4000 members of religious groups have been trained by UNICEF and its partners to demonstrate hand washing, distribute sanitation kits and prepare oral hydration salts. They are expected to reach more than two million people even in remote areas. The event was organized by multiple partners including the Haitian Ministry of Health, UNICEF Haiti, the International Medical Corps, and the National Confederation of Haitian Voodoo.
Sources:
- Public Library of Science. "Cholera in Haiti: Universal vaccination campaign is essential to ending crisis, experts say." ScienceDaily, 1 Jun. 2011. Web. 23 Jul. 2011.
- Donald G. McNeil, Jr., Use of Cholera Vaccine in Haiti is now Seen as Viable, New York Times, December 10, 2010
- Jean Panel Fanfan, UNICEF Mobilizes Haitian "Rara" for Cholera Prevention, UNICEF, Haiti - at a Glance, June 27, 2011.
- Vicki Brower, Nature News, Vaccination Would Curb Haitian Cholera, April 11, 2011.
- Partners in Health, In Haiti Latrines Can Make a Difference between Life and Death, July 14, 2011.
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