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At a glance: Haiti

UNICEF steps up efforts to contain cholera in Haiti's Artibonite Department

© UNICEF/2010/Dormino
Two sisters lie on a bed at the hospital of Dessalines in Haiti's Artibonite Department, where UNICEF, the government and other partners are responding to a cholera outbreak that has resulted in over 250 reported deaths.

By Douglas Armour

SAINT-MARC, Haiti, 25 October 2010 – Val Voyalant , 10, and her sister Cledna, 3, live in the small community of Pisto, south of Dessaline and near the Artibonite River, the region most affected by the current cholera outbreak in Haiti. The two lie quietly on a hospital gurney against the back wall of an open room. Intravenous tubes feed their arms with a concentrated saline solution.

The girls’ mother, Francina Davariste, carries a wet cloth to wipe away the sweat from their faces. “I sit with them always,” she says. “The small one, she vomits. She’s very sick.”

Ms. Davariste left her four other children with relatives in Pisto. One other child, a small boy of seven, is in Saint Nicholas hospital at Saint-Marc, also infected with cholera. Ms. Davariste hopes he’s okay.

Strained resources

The two girls are in L’Hopital Clair Heureuse, about 40 km north of Saint-Marc, where health officials are accepting only the most severe cases of cholera for treatment. Milder cases are being treated with antibiotics and given preventative care information before being sent home.

© UNICEF/2010/Dormino
A girl waits in line with her mother to receive medical treatment at Saint Nicolas hospital in Saint-Marc, 70 km north of the Haitian capital, Port-au-Prince.

It’s a simple but necessary response to overwhelming need. As the response to the cholera outbreak grows, the resources of hospitals and health centres in outlying areas of Haiti are being stretched.

“We have 35 hospital beds, but we now have 61 patients spread throughout the hospital,” Dr. John Fequier, director of Claire Heureuse, said late last week. Only five years out of medical school, Dr. Fequier is quick to admit he has never seen anything like this.

Although the source of the cholera outbreak has not been positively identified, Dr. Fequier notes that a common factor with the majority of his patients is their exposure to water from the nearby Artibonite River.  The Government of Haiti is now testing water at several river locations.

Understanding needs

“This is important to know,” says UNICEF Emergency Health Specialist Dr. Chantal Umutoni. “But at this point, with the disease spreading among family members and within communities, the more important thing is to coordinate an effective response. This includes isolating and treating those already infected and sensitizing communities about how they can protect themselves from getting the disease.”

© UNICEF/2010/Dormino
A father carries his baby to be treated for cholera at Saint Nicolas hospital in Saint-Marc, located in Haiti's Artibonite Department.

UNICEF teams have been visiting several hospitals in areas near the Artibonite River to assess, with other agencies, the impact of cholera on hospital and health care facilities.

“It’s important,” says Dr. Umutoni, “to determine what [the facilities’] capabilities are and how many cholera cases they have, so we can assess what resources they will need. This is important in terms of planning a regional response to this disease.”

Mounting toll

Only days after the Government of Haiti confirmed that mounting cases of acute diarrhoea were caused by cholera, the death toll has risen above 250 and more than 3,000 have been hospitalized.

© UNICEF/2010/Dormino
A girl surffering from cholera holds IV fluids at the hospital in Dessalines, Artibonite Department, Haiti.

At L’Hopital Generale de la Reference in L’Estere, 14 km from Dessaline, four local doctors are working alongside six medical staff from Cuba in an environment that can at best be called makeshift. Piles of powdery cement, buckets of water, shovels and other building materials – all part of the health facility’s expansion – have been put aside as officials focus on the emergency at hand. Here, too, the cases are mounting.

L’Estere is one of five major treatment centres whose capacity will be reinforced as a result of a coordination meeting last week involving the Ministry of Health and major response partners, including UNICEF. Smaller, more remote health units will care for milder cases. UNICEF has agreed to help build the hospital’s capacity.

Hygiene and sanitation

UNICEF is also coordinating with partners to distribute water-purification chemicals, antibiotics, diarrhoeal-disease kits and oral rehydration salts.

Cholera is a highly infectious abdominal disease that spreads through contact with contaminated water or food. Symptoms include severe and profuse watery diarrhoea, vomiting and abdominal pains. If not treated, patients can die from severe dehydration. The disease can be prevented by proper hygiene and sanitation practices, including provision and use of safe drinking water.



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