Cholera Still a Threat in Haiti
Cholera Still a Threat in Haiti
As Haitians continue to struggle against many obstacles in improving and developing their country, cholera and sanitation remain challenges to many development efforts.
Since the cholera epidemic started in October, there have been a total of 252,640 confirmed cases. MSH integrated its response, where appropriate, with the national response that was coordinated by the Ministry of Health. Following the earthquake, MSH’s USAID-funded Santé pour le Développement et la Stabilité d’Haíïti (SDSH) Project found that provision of basic health care through mobile kiosks in the settlement camp tents were an effective way to provide services and messages. Educational messages and oral rehydration solution (ORS) therapy are now being delivered via these kiosks. In addition, SDSH distributed cots, buckets, bleach, bottled water, and ORS to combat the disease.
Some SDSH supported facilities were so overwhelmed by the influx of cholera patients, they began to miss their other targets for other health outcomes such as HIV & AIDS services, antenatal care visits, which they are held accountable for through the performance-based financing mechanism that SDSH uses to improve service delivery and quality. Facilities that were overwhelmed by cholera, now have specific cholera treatment centers which were set up as a result of the national response, in coordination with the Red Cross, Medicines sans Fronteirs, and other relief organizations.
Although the initial cholera panic may be over, it is very clear that health officials here are continuing to educate Haitians on the danger of cholera, how to prevent it, and how to treat it. Posters hang in all health facilities that I visited, and billboards along the roads explain in Creole how to keep from getting cholera. Cases seem to come and go in waves.
It is not surprising that Haiti is struggling with a cholera epidemic. The sanitation situation in most areas, unfortunately, is terrible. Garbage litters the streets, clogs drainage areas, and fills waterways. I would imagine that deeper into some of the settlement camps would yield dismal sanitation conditions. Public health certainly focuses on the provision and delivery of curative and preventative health care services. However, public health cannot exist in a vacuum: it must include roads, jobs, food security, and improved sanitation. Without access to clean water, transportation, and proper nutrition for Haitians, many of our health interventions will fail.
Improved sanitation will be critical to ensure that Haiti can continue to avoid regular and widespread outbreaks of the disease. Adequate sanitation services including latrines, access to clean water, and soap for hand and food washing will be essential. Many of these services are available as a result of ongoing earthquake relief efforts, but they will have to be effectively integrated in a development strategy for Haiti to truly improve sanitation, as well as health, and the country in general.
Kate Dilley, MPH is an Administrative Coordinator at Management Sciences for Health.