by Lori, the procrastinator

Though my answers are a bit later than Licia’s, I hope that you’ll forgive me.

We’ve heard less about the cholera outbreak in Haiti. Does this mean it is not as big of a problem as it was?

Though our decreasing numbers are following the national trend, there are still new cases daily. As of March 15, there were 261,985 cases reported nationwide.  Deaths numbered 4737 – a 1.8% mortality rate.  This decreased national mortality rate is encouraging, but isolated outbreaks are still occurring.

Here is an excerpt of the latest OCHA (Office for the Coordination of Humanitarian Affairs -UN) Humanitarian Bulletin (10-25 march 2011):

Localised outbreaks of the new cholera cases have been reported in Grande Anse, Center, West, South-East and South.  An epidemiological alert unit has been creasted in Grande Anse due to recurrent under reporting from Cholera Treatment Centers (CTCs) and Cholera Treatment Units (CTUs).  The department, at the southern tip of the country, has the highest mortality rate nationwide (5.4 per cent) after South East (8 per cent).

Most of the agencies in the Center department are implementing long term projects and will be able to respond to cholera outbreaks.  however, some areas are lacking health personnel, particularly in the commune of Cerca la Source.

The number of new cases is also increasing in rural areas of the West department where there are no health centers and limited access by road.  With the support of the French Red Cross, the Direction sanitaire de l’Ouest (DSO) has deployed health teams to every mountainous communal sections of the department.

The departure of NGOs from CTCs and CTUs due to the overall downward trend of the epidemic has raised concern about the capacity of local staff and health structures to cope with a possible increase in the number of cases, especially in view of the imminent rain season.  Health partners continue to monitor the situation and are ready to resume their operations if needed.

Funds available in the North-West department have dried up.  As a results, the community component of the response led by “brigadiers” has almost come to a halt.  Awareness campaigns or distributions of Oral Rehydration Salts (ORS) have been discountinued.

Some CTCs and CTUs in the South-East department have been handed over to the Ministere de la sante publique et de la population (MSPP), as part of a long term strategy to respond to the cholera epidemic. But the inability of the MSPP to pay staff salaries has prompted medical personnel to threaten to go on strike.

Also noted in the same bulletin is the fact the 47% of Haitians lack access to safe drinking water and 83% of Haitians do not have access to basic sanitation services.  The community group is planning to continue their outhouse project (2 seater for 3-4 families) to try to help decrease the spread of cholera in our area.  You will be hearing about this in the near future.

I’ll try to due an update on our cholera site here in Cazale soon.  It is still a problem.  People just aren’t as scared of it now because they understand it – prevention, mode of transmission, treatment.  When an unknown deadly disease is sweeping though the country, fear and lack of education are your some of your biggest challenges.  The treatment of cholera isn’t that difficult. Transportation to a treatment facility is.  Lack of roads are deadly when death can be 1-2 hours after onset. There are now 217 CTCs and 642 CTUs available throughout the country.  Treatment is more readily available now than in November.  Other news has made the headlines, but cholera is still present and a problem.

Also, has clinics like yours been setup in the tent cities like “Canaan” and “New Jerusalem”?

There are larger NGOs assigned to each camp.  I really don’t think that you will find a set-up like ours.  We developed what the clinic does after looking at the needs of the people in our area.  A tent city is different.  From what I’ve heard some are a bit more mobile and sporadic.  Others are fixed sites.  I really don’t have enough information or experience at these sites to fully answer this.

What are the constant reoccurring items needed most by the clinic?

Vitamins, soap, anti-fungal cream, antibiotic cream, A&D ointment, tylenol, ibuprofen, antacids