Women hold children with cholera symptoms as they wait for treatment at the St. Nicholas hospital in Saint Marc, Haiti.
Even as a myriad of tent cities remain amid the rubble of post-earthquake Haiti, one of the few successes the international community and the Haitian government could point to was the lack of any major outbreaks of disease. But this week's reports of cholera is causing alarms as the numbers of people falling ill and dying grow. The country's health ministry is reporting at least 200 confirmed deaths and more than 2,300 cases related to cholera in the bucolic Artibonite region, just north of the earthquake stricken capital of Port-au-Prince.
Cholera is primarily contracted through contaminated drinking water. The bacterial illness causes severe diarrhea and vomiting which leads to serious dehydration and organ failure. Haiti has not seen an epidemic of cholera for more than a century. "One of the biggest challenges is that Haiti is not particularly familiar with this disease. There is not much resistance in the population," says Imogen Wall, spokeswoman for the U.N. Office for the Coordination of Humanitarian Affairs.
But it's not certain that the cholera outbreak is a result, nine months after the fact, of the catastrophic Jan. 12 earthquake. So far, the disease has not struck the camps of earthquake victims concentrated in the capital of Port-au-Prince. And while Haiti's National Department of Water Supply and Sanitation (DINEPA) says the source of the disease has yet to be confirmed, many suspect it to be the Artibonite River, which communities with limited access to potable water often use. The reports of cholera rose after heavy rains overflowed the banks of the Artibonite River, which is also Haiti's central drainage system. "We know that it's affecting the community that is near the river. And we are in the middle of informing the people in the region," says Jean-Francois St. Felix, social affairs coordinator for DINEPA.
One advantage Haiti has, says Wall, is that post-earthquake fears about the outbreak of diseases led the international community to stockpile medical supplies in the country. As a result, she says Haiti has enough antibiotics to treat 100,000 cases of cholera. Meanwhile, international aid agencies like Oxfam have mobilized teams to parachute into the region to set up water, sanitation and hygiene programs in the most heavily affected zones. "In the rural areas, they need more support because they have so little in terms of toilets and proper infrastructure," says Julie Schindall, an Oxfam spokeswoman. "We have to get people educated about how to prevent this disease with practices like hand washing, not just simply quarantining people off."
Cholera is a preventable disease when handled with education and intense mobilization. Radio announcements are now explaining proper hygiene practices like hand washing to prevent further spread of the disease. The International Red Cross has started a text messaging campaign warning people about the outbreak and informing them to drink only safe water sources.
Isolating the Artibonite outbreak from the rest of Haiti is a key strategy; 20 members from Doctors Without Borders will be establishing centers in the port city of St. Marc, which is 55 miles north of Haiti's capital "The challenge lies in obtaining enough ambulances to transport these cases to the proper isolation sites," says Walls.
There is some comfort that the outbreak has not yet hit Port-au-Prince, the densely populated capital of 3 million people, and its many camps of earthquake victims. Wall says that tent camps are being vigilantly tracked by humanitarian aid agencies. The greater concern is for the pre-existing slum areas of Port-au-Prince like Cite Soleil. "Those in the camps have better access to international aid and clean water than those in the slum areas," says Wall.