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At a glance: Haiti

Step by step towards a Haiti free from cholera

By Cornelia Walther

On 9 October, during the World Bank Group’s Annual Meetings, the World Bank hosted Haiti: Clean water, improved sanitation, better health, in collaboration with the Government of Haiti, the United Nations and development partners. This event brought together the international community to combat waterborne diseases like cholera in Haiti and invest in water, sanitation and health in the areas of the country most vulnerable to waterborne diseases and most in need of water and sanitation improvements.

Effective response measures have brought a major reduction in the number of cholera cases in Haiti between 2011 and 2013. UNICEF continues to support treatment and prevention efforts, following on the Government's aim to eliminate the disease within a decade.

© UNICEF Haiti/2014/Walther
Stephanie and her mother at the cholera treatment centre in Petite Rivière de l'Artibonite

PETITE RIVIERE DE L'ARTIBONITE, Haiti, 7 October 2014 – Stephanie has had diarrhoea for three days. Her mother Asseline Jean-Louis has brought the 22-month-old girl to the health centre in Petite Rivière de l'Artibonite. It’s been a long dusty walk in the 35 ˚C heat from their home in the commune of Dessalines.

“I had six children, once,” says Ms. Jean-Louis. “One of my sons died in 2010. He had diarrhoea and vomited. We never knew what had made him sick.”

Rapid diagnosis, rapid treatment

When the pair first arrived at the health centre, a rapid diagnostic test confirmed that cholera was the cause of Stephanie’s acute watery diarrhoea. The little girl was immediately placed in the health centre’s Cholera Treatment Centre. She had intravenous treatment and was given oral rehydration solution.

Stephanie doesn’t particularly like the taste of the solution. But she gulps it down, sensing that it helps make her feel better.

“I am glad my little one is getting better,” says Ms. Jean-Louis. “Yesterday she was too weak to even sit up.”

Amid outbreak, reason for optimism

Since the beginning of the cholera outbreak in October 2010, there have been 706,089 suspected cholera cases in Haiti, with 8,592 cholera-related deaths reported as of 30 August 2014. At present, 250 new cases are registered per week – every hour one person gets sick.

The Departments of Centre, North and Artibonite continue to have the highest cholera rates, accounting for 68 per cent of all suspected cholera cases so far in 2014.

However, there is reason for optimism. Concerted national and international efforts have resulted in a steady reduction in the number of people affected by, and dying from, cholera over the past three years. The number of suspected cholera cases decreased from 352,033 cases in 2011 to 101,722 cases in 2012 and 56,174 cases in 2013.

From January to August 2014, there was a 76 per cent reduction in the number of suspected cases compared with the same period in 2013.

Early detection, early treatment – and clean water

When detected and treated early, cholera is not a death sentence. The quick, simple and efficient treatment that Stephanie had restored her health relatively quickly.

© UNICEF Haiti/2014/Walther
An outreach worker from Action Against Hunger explains the use of Aquatabs to residents of Petite Rivière de l'Artibonite during a sensitization session.

Along with early access to treatment, good hygiene and safe water are of the essence in the fight against the disease.

Though enough water is available in Haiti, it is estimated that just over one in three people (half of rural Haitians) does not have access to safe drinking water, and nearly two in five people living in rural areas practise open defecation.

To address the cholera epidemic, in 2013, the Government of Haiti launched a 10-year plan for the elimination of cholera. The plan includes response to the disease and, in the longer term, elimination of the disease by extending water and sanitation infrastructure to rural areas.

In July 2014, the Prime Minister, together with United Nations Secretary-General Ban Ki-moon, launched a five-year national sanitation campaign, aiming to support communities in high-risk areas to set up simple, efficient latrines.

Partners in ending cholera

From the beginning, UNICEF has been working hand in hand with the government and communities to realize the right of every Haitian child to health. The goal is to respond to all suspected cholera cases within 48 hours through mobile teams, delivering an emergency hygiene package, conducting sensitization campaigns and household decontamination visits. The organization provides technical and financial support to the Ministry of Public Health and Population (MSPP). Six partner NGOs are deployed across the departments of the country to support MSPP, and UNICEF facilitates coordination and constant follow-up of critical domains.

In addition, UNICEF supported the Government of Haiti to vaccinate more than 100,000 people in 2013 and approximately 184,500 people in 2014. A national technical committee, led by MSPP and supported by UNICEF, the World Health Organization (WHO)/Pan American Health Organization (PAHO) and the United States Centers for Disease Control and Prevention (CDC), was established in late May 2014 to design and coordinate the campaign. The campaign targeted high-risk cholera areas to try and disrupt the chain of transmission during the next dry season, which will help to reduce the number of cases, especially during the critical wet season.



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