Cholera in Haiti: MSF calling on all actors to step up response by MSF / UN News / AlertNet 9:41pm 23rd Oct, 2010   Nov. 18, 2010    Cholera in Haiti: MSF calling on all actors to step up response.    Port-au-Prince, Haiti - Critical shortfalls in the deployment of well-established measures to contain cholera epidemics are undermining efforts to stem the ongoing cholera outbreak in Haiti, says the international medical humanitarian organization Médecins Sans Frontières (MSF).    Despite the huge presence of international organizations in Haiti, the cholera response has to date been inadequate in meeting the needs of the population. According to national authorities, the epidemic has already caused more than 1,100 deaths and sickened at least 20,000 people nationwide.    “MSF is calling on all groups and agencies present in Haiti to step up the size and speed of their efforts to ensure an effective response to the needs of people at risk of cholera infection,” said Stefano Zannini, MSF head of mission in Haiti. “More actors are needed to treat the sick and implement preventative actions, especially as cases increase dramatically across the country. There is no time left for meetings and debate – the time for action is now.”    The following actions must be prioritized:    # Reassuring a population frightened by a disease that is completely unknown in the country, including by publicly communicating the low risk and positive benefits of having properly-run cholera treatment centers in close proximity to communities;    # Providing safe, chlorinated water to affected and at-risk communities nationwide, in addition to blanket distributions of soap;    # Building latrines and safely removing waste on a regular basis;    # Ensuring waste management and removal at medical facilities, in order to prevent contamination;    # Establishing waste disposal sites close to urban areas in appropriate and controlled environments;    # Establishing adequate oral rehydration points in areas where cholera cases are appearing;    # Maintaining a safe and efficient network for referral of severe cases to cholera treatment centres;    # Ensuring safe removal and burial of dead bodies.    Since the beginning of the epidemic, MSF has set up more than 20 cholera treatment facilities throughout the capital, Port-au-Prince, in the Artibonite region, and in the north of Haiti. MSF teams working around the clock have treated more than 16,500 people from October 22 to November 14. Over 240 tons of medical and logistical supplies have been brought into the country and MSF has more than 1,000 Haitian staff dedicated to cholera treatment, working alongside 150 international staff.    “Cholera is an easily preventable disease,” said Caroline Seguin, MSF emergency medical coordinator. “It may be new to Haiti, but the ways to prevent and treat it are long established. Without an immediate scale up of necessary measures by international agencies and the government of Haiti, we alone cannot contain this outbreak.”    12 November 2010    United Nations agencies and their partners have appealed for $164 million to support Haiti’s efforts to fight the deadly cholera outbreak that has already claimed several hundred lives in the small Caribbean nation.    The funds sought for the Cholera Inter-Sector Response Strategy for Haiti will go towards getting additional doctors, medicines and water purification equipment to respond to the epidemic, which has spread quickly since it was first confirmed on 22 October.    According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), over 12,000 Haitians having been hospitalized so far, and over 800 people have died from the disease, which is spread by contaminated food and water.    Up to 200,000 cases of cholera are expected to be reported over the next 6 to 12 months in Haiti, which is also dealing with the aftermath of January’s devastating earthquake and flooding in the wake of Hurricane Tomas, which struck the country last weekend.    “A major effort has already been made, but the sheer quantity of relief items that need to be delivered in the days and weeks ahead is going to require more logistical and financial support for the Government by all humanitarian agencies and donors and very close coordination,” said Nigel Fisher, UN Humanitarian Coordinator in Haiti.    “Without this the epidemic could well outrun our efforts,” he said.    Five out of the ten departments, or administrative divisions, that make up Haiti have been directly affected by cholera since the outbreak.    Nearly half a million water tablets, soap and oral rehydration salts are being distributed, targeting areas where cholera has already been detected. Cholera treatment centres – an essential first line of response – are now open in 15 urban centres across the country, including seven in the capital, Port-au-Prince.    The bulk of the appeal – around $89 million – will be used for water, sanitation and hygiene, while $43 million will be used for health, and $19 million for efforts in the camps housing people displaced by the earthquake.    Oct 2010    Haiti battles cholera epidemic. (Alertnet)    Quake-hit Haiti and its aid partners are fighting to stem a cholera epidemic that has killed hundreds of people and sickened many thousands, as health officials said they expect to see many more cases before the outbreak is contained.    Although the main outbreak area was initially in the north of Port-au-Prince, which bore the brunt of the Jan. 12 earthquake, humanitarian agencies are on high alert in the attempt to prevent the disease from spreading to crowded survivors camps in the capital.    The cholera epidemic was the worst medical emergency to strike the poor, disaster-prone Caribbean nation since the devastating earthquake that killed up to 300,000 people.    It was also the first cholera epidemic in Haiti in a century, the World Health Organization said. Officals hold grave fears of the consequences for Haiti"s capital, where 1.3 million earthquake homeless people are living in tent cities.    Health teams were closely monitoring the survivor camps and oral rehydration liquids were being prepared for quick use.    The Pan American Health Organization, the regional office for the WHO, said it had deployed medical teams, medicines and clean water to the outbreak zone, to deal with more cases of the virulent diarrheal disease. If left untreated, it can kill victims in hours through dehydration.    "We expect it to get bigger, we have to expect that," PAHO Deputy Director Jon Andrus told a briefing in Washington.    One humanitarian worker who visited the main hospital in Saint-Marc called it a horror scene. "The courtyard was lined with patients hooked up to intravenous drips. It had just rained and there were people lying on the ground on soggy sheets, half-soaked with feces," David Darg of a U.S.-based humanitarian organization.    Darg said villagers in the countryside around Saint-Marc were begging for clean water.    The central region is Haiti"s breadbasket and took in tens of thousands of fleeing survivors from the January quake.    Besides medicines and rehydration fluids, the United Nations and aid agencies were rushing clean drinking water and chlorine to purify water to affected areas.    "Now the emphasis has to be on treatment, containment and potentially mass vaccination," Dr. Peter Hotez, president of the Sabin Vaccine Institute and chair of the George Washington University Department of Microbiology, Immunology, and Tropical Medicine, told Reuters. He said PAHO needed to consider the viability of an anti-cholera vaccination program in Haiti.    The U.S. government Centers for Disease Control and Prevention said it was sending a team of epidemiologists, health communicators and a cholera laboratory expert to assist the Haitian authorities in fighting the outbreak.    "We are just at the beginning," Rob Quick of the CDC"s Waterborne Diseases Prevention Branch said.    It was not clear whether the outbreak would affect the presidential and legislative elections scheduled for Nov. 28 but Haitian Health Minister Alex Larsen appealed to candidates in cholera-affected areas to suspend public rallies.    "Unless the epidemic really gets out of control and incapacitates a huge part of the country, I would think that elections would go on as scheduled," Hotez said, noting that cholera was not transmitted by person-to-person contact but through contaminated water and food.    Announcing a national emergency prevention program, Larsen urged people to wash their hands, not eat raw vegetables, boil all food and drinking water, and avoid bathing in and drinking from rivers. The Artibonite River, which irrigates all of central Haiti, was believed to be contaminated.    Larsen urged people not to panic, saying the deadly dehydration caused by cholera could be treated by drinking boiled water mixed with sugar and salt. Visit the related web page
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