Cholera in Rural Haiti

Photo by John Carroll


I am working in southwest Haiti right now.

I admitted three patients to the hospital this morning with possible cholera...I am not sure if they have it or not, but their history is consistent with cholera.

The cholera treatment centers in Port-au-Prince definitely have many fewer customers than the horrible months of November and December.

And the cholera cases in Cite Soleil this week at St. Catherine's Hospital are miniscule compared to several months ago. The MSF director in Soleil told me several days ago that their daily admissions are down to about 10 per day versus over 200 per day in November. I attribute this success to the hard work of Doctors Without Borders and their public health officers.
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See this article:

UN: Cholera eases in Haiti but rural deaths high
(AP) February 18, 2011

GENEVA (AP) Haiti's cholera outbreak appears to be diminishing nationwide
but the death rate in rural areas remains alarmingly high, the United
Nations said Friday.

The mixed picture comes from Haitian government figures citing 231,070
reported cases and 4,549 deaths since the epidemic began in October.

National mortality rates from cholera are down to 2 percent, from as high as
9 percent earlier, but in some rural areas, more than one-in-ten people who
contract the disease die.

In Haiti's Sud Est region, the mortality rate hit 10.7 percent as of Feb. 9,
while in Nippes it was 6.7 percent and in the Grande Anse region, 5.9
percent. The rate should be under 1 percent, according to the World Health
Organization.

"It's there (in rural areas) that we absolutely have to strengthen our
efforts," said Elisabeth Byrs, a spokeswoman for the U.N. humanitarian
coordination office. "For that we need money."

The U.N. also is concerned about the possible spread of the disease during
Haiti's upcoming Carnival season.

The U.N. has asked for $175 million to deal with Haiti's cholera outbreak,
much of which is distributed to local partners and non-governmental
organizations to carry out aid work. So far, however, donors have provided
only $80 million.

The U.N. itself has been accused of inadvertedly starting the cholera
epidemic in Haiti through bad sanitation, a claim the global body has sent
experts to Haiti to investigate.

The World Health Organization said Friday it was trying to keep the
anti-cholera efforts in Haiti from collapsing.

"Even if many NGO's are leaving for different reasons, there is an exit
strategy," WHO spokeswoman Fadela Chaib said. "WHO is working with the
Ministry of Health to replace the NGOs that were running these cholera
centers."

The U.N. health agency won't rest until Haiti's mortality rate for cholera
has been further reduced, she said. "We are not giving up on getting it
under 1 percent."

But as things stand now, cholera "will be a disease for the months and years
to come in Haiti" despite it being previously unknown to generations of
Haitians, she said.