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At a glance: Haiti

In Haiti’s cholera crisis, breastfeeding is the best protection for children

By Cornelia Walther

As diarroeal diseases like cholera continue to affect thousands in Haiti – particularly in areas with low access to clean water and adequate sanitation – the need for exclusive breastfeeding for infants is especially urgent. 

ARTIBONITE, Haiti, 2 September 2015 – “Steve is my fourth child. He just reached his ninth month and has never been sick. Like all my children, I only gave him my milk during the first six months after his birth,” says Roselene, 25, who lives in the commune of Saint Michel d’Attalaye, an area of Haiti’s Artibonite department heavily affected by the cholera crisis since 2010.

© UNICEF Haiti/2015/Walther
A view of Saint Michel d’Attalaye, in Haiti's Artibonite department

“Many people in our neighborhood got sick with cholera, but none of my children,” she says.

Steve’s good health is proof of the dual protection provided by exclusive breastfeeding. Breastmilk provides all the nutrients and fluids that a baby needs for the first six months of life, while also protecting against infection. At the same time, it protects from waterborne diseases that derive from contaminated water and utensils that may be used to prepare infant formula.

Not all children are as lucky. The registry at the Saint Michel d’Attalaye cholera treatment centre indicates that a large number of patients are children, a fact confirmed by hospital director Dr. Dorcenat Michelot.

“About 50 percent of those who are registered with diarrhoeal diseases, including cholera, are children,” Dr. Michelot says. “And the large majority of these children are less than 1 year old. Poor hygiene is a major problem we have here.”

In areas lacking access to clean water and sanitation infrastructure, children are particularly at risk of waterborne diseases that cause diarrhoea, and the antibodies provided by breastmilk can make the difference between life and death: Children who are exclusively breastfed for the first six months of life are 14 times more likely to survive than children who are not breastfed. Furthermore, Roselen’s decision to give her son the colostrum – the milk produced in the first days following the baby’s birth – provided additional protective antibodies and growth factors.

Reducing risk

Steve and Roselene are an exception to the rule in Haiti, where only an estimated 40 percent of children under 6 months are exclusively breastfed – similar to the global rate of 38 per cent. This statistic is particularly worrying, as Haiti is also home to the largest cholera epidemic in the Western hemisphere. According to the Ministry of Health, around 18,000 suspected cases were registered between January and the end of June 2015.

© UNICEF Haiti/2015/Walther
Roselene and her son Jean await their turn for a routine health check at the clinic in Saint Michel d’Attalaye.

Cholera mostly affects families in communities where access to clean water and sanitation are insufficient and hygiene is poor. These areas are often characterized by overcrowding and high population movements. Therefore, children who grow up in these conditions are at higher risk of diarrhoeal diseases.

Breastfeeding reduces the inequity factor of these diseases by reducing a child’s contact with contaminated water, while also providing all the nutrients, vitamins and minerals an infant needs for the 6 months of life. Children who are exclusively breastfed rarely contract cholera.

UNICEF partner organization Action Contre la Faim is well aware of the important role of mothers in fending off cholera in the first months in a child’s life, and the NGO systematically targets midwives in their community outreach activities on cholera. 
Gerta Charlecin, 42, is a nurse and midwife who has been working at Saint Michel d’Attalaye’s maternity clinic for the past four years. She has two children, both of them now grown up.

“I promote exclusive breastfeeding at work, and I practiced it at home,” she says. “Every day proves that there is no other way to go when you want to raise strong, healthy children.”

Giving children the best start in life begins with breastfeeding – one of the smartest and most cost-effective ways we have of supporting healthy, well-nourished children and sustainable growth.



UNICEF Photography: Breastfeeding and work

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