“Cholera is back”
Disadvantaged neighborhoods ravaged by gang warfare, poverty and malnutrition are the most affected
When one of Roseline Céus' twins started having acute watery diarrhea and vomiting, the 18-year-old mother picked him up with her twin sister, mustered up her courage and set out on the path to Gheskio cholera treatment centre in Bicentenaire. One of her friends joined her and together they walked steadily, with fear in their hearts.
“When I arrived here, I was lost. I was on the ground floor and the nurses told me to come up. I was going roaming around with the child. But when I realized that he was about to die, I asked a doctor for help. He put the child on serum,” she says.
The young mother knew that cholera was raging again in Haiti, and she feared for the life of her child. She had taken the twin sister with her because there was no one at home to watch her. On her way to the centre, she feared being attacked by armed men or being caught in the crossfire with her two children who are only one year old.
“My neighbourhood is not safe. There are often shootings, and you can't go out. It is difficult to find water for our needs and there is nothing like resources,” she underlines.
On October 2, 2022, new cases of cholera were confirmed in Haiti, after three years without a single case being reported. As of 25 October, 2,274 suspected cases and 52 deaths have been reported by the Ministry of Public Health and Population (MSPP). The resurgence of cholera occurs in a context of insecurity characterized by war of armed groups and social unrest linked to fuel price hikes. As a result, patients find it difficult to get to health centers and medical personnel to report to work safely.
“There are a lot of children here today, but these are the ones who were able to arrive. With lack of access to services due to fuel shortage and insecurity, you cannot imagine how many people are dying inside anywhere,” Dr Marie Marcelle Deschamps, Deputy director of Gheskio.
The Gheskio cholera treatment center located at Bicentenaire in Port-au-Prince, is at the heart of disadvantaged neighborhoods ravaged by gang warfare, poverty and malnutrition. The already fragile nutritional situation is further aggravated by inflation, soaring food prices, widespread poverty and low purchasing power as well as the current cholera epidemic, putting the lives of thousands of malnourished children at risk.
In Cité Soleil, where the first cases of cholera were reported, one in five children suffers from severe or moderate acute malnutrition. And malnourished children are three times more likely to die of cholera. Since the start of this new wave of cholera, one in three people suffering from symptoms of the disease is under the age of five.
"When you are unable to get safe drinking water by tap in your own home, when you don’t have soap or water purifying tablets, and you have no access to health services, you may not survive cholera or other waterborne diseases. The devastating impact of fuel restrictions and violence has made children the main victims of the outbreak,” says Bruno Maes, UNICEF Haiti Representative.
Cholera is spreading fast, and it has already gone beyond the limits of the metropolitan area of Port-au-Prince. Suspect cases are reported in the Center, in Artibonite and in Nippes. The Commune of Cité Soleil has reported the biggest number of people showing symptoms of the disease, but it is advancing rapidly in all poor neighborhoods where access to clean water and soap remains limited. With insecurity and lack of fuel, garbage piles up in the streets of several neighborhoods in the Haitian capital, increasing the risk of cholera to spread.
“Cholera is back. We have gone from the first 10 cases a day to nearly 50 cases a day. We have one centre in Bicentenaire and another one in Tabarre where we receive cholera patients, and we work closely with UN agencies like UNICEF,” Dr Deschamps clarifies.
UNICEF supports the MSPP and other partners such as Gheskio, Médecins du Monde (MDM) Argentina, Doctors Without Borders or the National Directorate for Drinking Water and Sanitation (DINEPA) in fuel, chlorine, hygiene kits, water purification tablets, soap, and in medical supplies such as oral rehydration salts and personal protective equipment (PPE). With MSPP and DINEPA, UNICEF also deploys mobile health clinics and water trucking in Cité Soleil, to serve the most vulnerable women and children.
UNICEF provides fuel and medical supplies to nine cholera treatment centres out of the 16 opened so far in the metropolitan area of Port-au-Prince to care for women and children.
Many children are at risk of losing their lives to cholera unless concrete steps are taken to stop the spread. UNICEF estimates that it will need US$22 million for a specific cholera response of. So far, this request remains unfunded.