By Bob Coen
ARTIBONITE, Haiti, 26 October 2010 – The worst is not yet over for Haiti. Ten months after a powerful earthquake devastated the country, a cholera epidemic has spread fear and misery. The outbreak is the country’s biggest medical crisis in recent years. At L‘Estere Medical Centre here in the country’s Artibonite Department, north of Port-au-Prince, the flow of new patients doesn’t seem to stop.
|VIDEO: 25 October 2010 - UNICEF correspondent Priyanka Pruthi reports on efforts to contain the cholera outbreak in Haiti's Artibonite region. Watch in RealPlayer|
Saint-Jacques Destin stands in line holding his two-year-old niece, Jackson. Tears run down her cheeks as she sobs with pain from stomach cramps.
“Our whole family was sick with diarrhea, but our village is very far away, so it’s not easy to get here,” explains Mr. Destin. “We ended up having to use a motorbike taxi, but both Jackson’s father and mother died before we could get here”
Health centres overwhelmed
So far, over 280 deaths have been reported out of the more than 3,800 confirmed cases in Haiti’s first cholera epidemic in a century. Hospitals and health centres throughout the region have been overwhelmed with patients suffering from acute diarrhoea.
|A child being treated for cholera cries outside a medical centre in L’Estère, a town in Haiti's Artibonite Department.|
“Since Wednesday, they have admitted more than 400 patients at this health post,” said UNICEF Emergency Health Specialist Chantal Umutoni. “At the moment, we don’t have breakdown statistics, but in the hospital I can say … that children under 18 may represent 30 to 40 per cent of admitted patients.”
Teams of Cuban doctors have been called in to help local health authorities treat the sick with medical supplies provided by UNICEF. Many patients are even being treated out in the open. Some lie unconscious on mattresses with intravenous drips attached to outside walls or trees, while others moan with convulsions of pain.
Stemming the spread
Cholera is a highly virulent waterborne bacteria that causes massive and painful diarrhoeal dehydration. It affects both children and adults and, left untreated, can kill within hours. Many communities in this area do not have access to safe water, and cholera is easily transmitted through contaminated water, food and contact. Even before the earthquake, Haitians’ access to water and sanitation was among the worst in the world – a situation that is now greatly exacerbated by ruined infrastructure.
|At a medical centre in L’Estère, located in Haiti's Artibonite Department, a girl receives fluids intravenously to treat the dangerous levels of dehydration that accompany cholera.|
Today, stopping the spread of the epidemic is an urgent priority for UNICEF, together with its UN and non-governmental partners, and the Government of Haiti.
In the village of Potenau, hundreds of villages turn out for supplies of free soap, water purification tablets and oral rehydration salts supplied by UNICEF and distributed by the French NGO ACTED. The distribution is an example of the coordinated action that will be crucial in containing the epidemic.
“In any of these humanitarian crises, coordination is absolutely key,” explains Nigel Fisher, Deputy Chief of the UN mission in Haiti, who visited the village as part of his tour of the cholera zone on Monday. “UNICEF is coordinating the water and sanitation cluster, which is absolutely critical to manage cholera,” he added.
Another critical issue is information. Because this is the country’s first cholera epidemic in living memory, most Haitians had never heard of the disease until now. So UNICEF and its partners have mounted public information campaigns.
|A woman lies beside her son, who is receiving treatment for cholera at a medical centre in L’Estère, Artibonite Department, Haiti.|
Along with the distribution of supplies, health workers are giving out information and holding demonstrations on simple steps, such as handwashing with soap, that can prevent infection and the spread of the disease.
“This will allow people to know how to avoid sickness, and it will reduce the numbers of infected people,” says UNICEF Field Coordinator Frank Kashando, who is overseeing the distribution at Potenau, “because everyone who has the knowledge passes it on to others who were not informed. And over time, we hope that the whole population will be informed so that we can contain this epidemic while the health workers can concentrate on those who are already sick.”
Drop in death rate
If the cholera infection is caught in time and patients receive proper treatment at health centres, most of them will recover. “The case load is increasing but the death rate has actually gone down a bit, which shows that the response has been quite effective,” says Nigel Fisher. But he warns that more illness and deaths may come: “Frankly, we have been focusing on the areas of high contamination. We need to go everywhere, because this is going to spread, unfortunately.”
However, through the continued joint efforts of its partners – as well as the work of the medical teams on the ground – UNICEF hopes this epidemic will be contained quickly and further loss of life will be averted.