At a glance: Haiti

UNICEF and partners work to keep a cholera outbreak at bay in Haiti's capital

By Sabine Dolan

PORT-AU-PRINCE, Haiti, 29 October 2010 – In the Rue Oswald Durand, Port-au-Prince’s heavily earthquake-damaged downtown area, a truck blares hygiene-promotion messages in Creole: “Wash your hands with soap before eating and after you go to the bathroom. Eat only cooked or peeled foods.…”

This is just one of the city’s vulnerable neighbourhoods, but it contains two heavily populated slums, Cité de Dieu and Cité de l’Eternel, and a camp that houses more than 5,000 people displaced by the earthquake here last January. Running through the camps and slums, a narrow canal of brown, stagnant water is covered with trash and human waste. 

“They’re telling us to avoid cholera by washing our hands and drinking treated water, but we need so much more,” says Ramon Lebrun, 36. “We’re living among dust, raw sewage, mud and stinking water, which is not good.”

Makeshift treatment centres

At the nearby health centre run by Gheskio, a Haitian non-governmental organization, tents are being set up to act as cholera treatment posts. The Gheskio centre offers medical services  to the entire neighbourhood.

© UNICEF/NYHQ2010-1363/Ramoneda

A woman carries food she is selling through a tent settlement in Port-au-Prince, the Haitian capital, where earthquake survivirs live in close quarters and often unsanitary conditions.

“With the support of UNICEF, we are setting up two larger tents to accommodate 100 patients a day,” explains Dr. Jean W. Pape, founder and director of the NGO. “We feel that may not be sufficient, but this is a first start, and if we need to accommodate more patients, we’ll have to expand.”

Treatment centres are now being prepared across the Port-au-Prince metropolitan area. For anyone suffering from diarrhoea, oral-rehydration stations will provide care 24 hours a day. In addition, intermediary admittance centres will be operating within existing health structures, and cholera treatment will be available to those in need of hospitalization.

Cause for concern

Experts fear that the cholera outbreak in Haiti has yet to reach its peak. As the toll rises, so does the concern that cholera may spread to the capital any day.

© UNICEF/NYHQ2010-1363/Ramoneda

A girl whose familiy was displaced by the January 2010 earthquake studies outside her tent in the town of Petit-Goave, near Port-au-Prince, Haiti.

So far, the epidemic has affected more than 4,600 people and killed over 300, primarily in the Artibonite region north of the capital. In the overpopulated, post-quake urban environment of Port-au-Prince, a cholera outbreak would be devastating.

“This will be much worse, because the population is much more dense,” says Dr. Pape. “And the population having access to potable water and to toilet accommodation is very, very limited in this large city – particularly after the earthquake, where a lot of the water supply has been destroyed.”

UNICEF prepares for larger outbreak

UNICEF and its partners have been working closely with the government on urgent preparations in case of a large outbreak, with a focus on safe water, cholera-adapted health services and hygiene promotion.

“UNICEF is implementing a plan with private water companies, the Port-au-Prince water utility and the Red Cross, to distribute Aquatab chlorine tablets to people at all distribution points throughout the city’s metropolitan area,” says UNICEF Water, Sanitation and Hygiene Chief Mark Henderson.

Disseminating community-based cholera awareness and prevention messages to a population unfamiliar with this disease has been a priority. In the camps of Jacquet Toto Prolonge in the Pétionville district, teams of health workers have been mobilizing the community and going door to door in the camps as they work to familiarize people with precautions they can take to protect themselves from waterborne disease.

In their rounds, the team visited the tent of Françoise Exama, 43, a mother of eight who has lived in a camp since the earthquake. She says access to water remains limited, but at least now she understands some of the basic things she can do to protect her family from cholera  – and where to get help if the symptoms appear.