At a glance: Haiti

Haiti cholera response broadens to include focus on prevention in local communities

© UNICEF Haiti/2010/Steinlechner

Dr. Lesly Andreey, Medical Director of the Saint-Michel hospital in the Artibonite region of Haiti, speaks to students about cholera prevention.

By Benjamin Steinlechner

SAINT-MICHEL, Haiti, 1 November 2010 – A three-hour drive up a steep, bumpy road brings two vehicles filled with oral rehydration salts, intravenous fluid and other medical supplies to Saint-Michel, a small agricultural area 300 km north of Saint-Marc, the epicentre of Haiti’s cholera outbreak.

At first sight, there is little indication that this small community high in the mountains of the Artibonite region is preparing for battle against cholera. However, Dr. Lesly Andreey, Medical Director of the Saint-Michel hospital, is all too aware of the grip cholera now has on this tiny Caribbean nation.

“There was a first case of cholera in the region last Thursday,” says Dr. Andreey. “A total of 17 people have died since, and the flow of people coming into the hospital for treatment hasn’t stopped since.”

Comprehensive response

As of Friday, the Ministry of Health had reported more than 4,700 hospitalizations and over 330 deaths attributed to cholera since the disease first surfaced here two weeks ago. In the Artibonite region, government figures suggest that children under five represent approximately one-fifth of reported cases.

Beyond the delivery of medical supplies, there is a need for mass communications and mobilization to ensure that people have the information they need to protect themselves and their families.

“Until, now response activities have focused on the south of the region of Artibonite because it’s the most affected. We now have to focus on preparing the population of neighbouring areas as the epidemic spreads quickly,” explains Mehoundo Faton, UNICEF Maternal and Child Health Manager, who is involved in an effort to assess the capacity of local health care facilities.

Hygiene-promotion sessions

In Port-au-Prince, UNICEF has been actively engaged in community information activities related to cholera prevention, sanitation and medical response. The organization has held hygiene-promotion sessions with thousands of children in more than 60 camps for earthquake-displaced people in the Haitian capital. Participants in the sessions learn about preventing waterborne diseases through proper hygiene practices.

In the city of Gonaïves, UNICEF field coordination staff met with child-protection partners and facilitated a training workshop on cholera prevention. Conducted by Save the Children, the workshop was geared toward staff working in residential care centres.

Despite these efforts, Saint-Michel resident Claudette Batiany says there is a feeling of powerlessness in her neighbourhood.

“I am really scared and sad,” she says. “I am a teacher and I can’t go to work. My neighbours have cholera. It’s terrible. I’m worried about my family.... Nobody knows what is happening.”

Informing the public

To help ensure that the situation does not deteriorate, Dr. Andreey says information is being disseminated at the community level – including sending about 85 community health workers out to help people understand how to protect themselves from cholera infection.

“This afternoon I am going to speak in front of students to tell them about prevention. They volunteered to participate in sensitizing the population about the disease,” notes Dr. Andreey. He adds that it’s important for families to know that they can protect themselves by drinking only pure, sterilized or boiled water, and by washing their hands before handling food and after using the latrine.

Michel Wisnel, 20, a student attending Dr. Andreey’s lecture, says he already uses only treated or boiled water and is very careful with his selection of food.

“I am not really scared anymore, because I have informed myself on how to avoid infection with cholera,” he explains. “What I want to do now is to learn more here today so I can share what I know with other people.”