Cholera could spread in Haiti

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Oct 26 2010: With patients dying within three hours of becoming infected with an unknown strain of cholera, UNICEF and partners have rushed emergency supplies to help combat and contain the outbreak.

The outbreak has occurred in the southern part of the Artibonite region, about one and a half hours north of the capital city of Port au Prince.

The death toll so far exceeds 150 people with more than 1,500 infected and being treated at medical centres. About 150,000 people live in affected region.

UNICEF’s New Zealand executive director Dennis McKinlay says UNICEF and its partners are working swiftly to contain the disease.

“The concern is that the cholera outbreak could extend to both the camps that have been set up for refugees from the January earthquake, where people live very closely confined - and the earthquake-affected areas of Port-au-Prince,” he says.

 “Children under five are amongst the most vulnerable due to the severe dehydration caused by diarrhoea.”

Local health authorities say the deaths typically occur within three to four hours of the symptoms, particularly at community levels.

UNICEF sources in Haiti say this is the first time the disease has appeared in the country for over a century.  The origin of the outbreak remains unknown and is being investigated by the World Health Organization and the United States Centre for Disease Control.

Cholera is not endemic in Haiti therefore the local people do not know how to react or handle it. UNICEF’s health and communications teams are currently developing a rapid campaign to explain to those in the affected area what to do.”

“It’s fortunate the outbreak was not during the monsoon season, or the summer, but as Haiti is hot for most of the year, the cholera outbreak is of real concern, because it spreads so rapidly, and is so deadly.”

UNICEF quickly dispatched specialized water and sanitation, health, and logistics teams to help efforts on the ground. These supplies will complement prepositioned the stocks.

In order to help manage and contain the spread of the outbreak, UNICEF teams are conducting assessments and advising on patient isolation and management of treatment as well as training of the local staff, who are unfamiliar with this disease.

Along with its partners, UNICEF’s water and sanitation teams have been coordinating assessments to develop action plans in chlorinating wells and intensifying hand washing with soap promotions.

Safe drinking water and sanitation facilities were inadequate or inexistent in Haiti prior to the earthquake. Sanitation coverage was only 17 per cent, and half the rural population practiced open defecation.

Cholera is a highly infectious abdominal disease that spreads through contact with contaminated water or food. Symptoms include severe and profuse watery diarrhoea, vomiting and abdominal pains. If not treated, patients can die from severe dehydration. The disease can be prevented by proper hygiene and sanitation practices, including provision and use of safe drinking water.

The human face of a cholera epidemic - children are the worst hit

Sisters Val Voyalant , 10, and Cledna, 3, live in the small community of Pisto south of Dessaline and near the Artibonite River. They were brought to Claire Heureuse by their mother, Francina Davariste. The two lie quietly on a hospital gurney against the back wall of an open room. Intravenous tubes feed their arms with a concentrated saline solution. Francina carries a wet cloth to wipe away the sweat from her daughters’ faces.

“I sit with them always,” she says. “The small one, she vomits. She’s very sick.”

Francina left her four other children with relatives in the nearby community of Pisto. One other child, a small boy of seven, is in the Saint Nicholas hospital at Saint-Marc, also infected with cholera. Francina hopes he’s okay.

Young and old lie dazed and distracted on makeshift beds spilling into the hospital courtyard. They rest immobile, tied to intravenous bottles filled with saline solution to combat dehydration. Tired relatives stand by holding the bottle a loft. Men, women, and children alike lie wrapped with diapers to stem the constant flow of bodily fluids.

The uninfected, mostly family members and local and international volunteers, mill about the hospital’s crowded courtyards, many with their noses filled with cotton believing this alone will protect them from infection.  The hospital gates open regularly to admit more of the infected, some arriving in the back of pickups, others on motorbike sandwiched between mother and father.

If you want to help UNICEF's work in Haiti, please donate to our Haiti Emergency Fund.

Photos copyright © UNICEF & Marco Dormino.