PIH responds to cholera outbreak in Haiti

	Treating patients in the courtyard at l'Hopital Saint Nicholas. Photo courtesy of David Darg, Operation Blessing International.
	Providing clean water in the Artibonite. Photo courtesy of David Darg, Operation Blessing International.

A cholera epidemic has broken out in the lower Artibonite region of Haiti. As of Friday morning, October 22, more than 2,000 cases and 140 deaths had been reported. PIH has rushed clinical reinforcements and supplies to the region and has mounted a massive community education and mobilization campaign. Community health workers are fanning out throughout the area to distribute oral rehydration salts and soap and to warn people of the need to drink only clean or purified water and wash their hands frequently—the two keys to preventing further spread of the disease.

Starting on Tuesday evening, patients suffering from acute watery diarrhea began arriving at Hôpital Saint Nicolas in St. Marc, which PIH operates in partnership with the Haitian Ministry of Health. By Thursday evening the hospital in St. Marc was overflowing with over 500 patients, of whom 12 had died. Another 437 patients were taken in between 6:00 Thursday evening and 5:00 Friday morning. Other hospitals in the Lower Artibonite region—including PIH facilities in Petite Riviere and Verettes—also reported large numbers of patients with similar symptoms and high mortality rates.

Although the diagnosis of cholera was not confirmed until Friday morning, PIH, the Ministry of Health, and other partner organizations had already launched urgent treatment and prevention efforts. The most effective treatment for both cholera and other acute diarrheal diseases is oral rehydration; and prevention hinges on providing access to clean water.

Zanmi Lasante dispatched reinforcements for both the clinical and community outreach efforts from our team in Port au Prince and our facilities in the Central Plateau. And several longstanding partner organizations have rallied to support PIH and the Ministry of Health on both fronts. Operation Blessing, which has worked closely with PIH to provide clean water in settlements around Port-au-Prince, rushed to St. Marc to help. Two branches of Médecins Sans Frontières (MSF-Spain and MSF-Belgium) deployed clinical team reinforcements to St. Marc and Petite Riviere, where they are taking the lead in setting up systems to separate cholera cases from non-cholera cases.

Lack of access to clean water has long been a major threat to public health throughout Haiti. Zanmi Lasante has worked with partner organizations to combat the problem on many fronts:

• at the household level—by building and supplying filtration systems to households in isolated areas;
• at the community level—by constructing spring caps and piping water to kiosks for use by local residents; and
• at the national and international level—by advocating for changes of policy and commitment of resources to make clean water available to all as a fundamental human right. In a study published in 2007, PIH documented the damage to public health caused by a 10-year delay in disbursing loans that had already been approved for construction of water improvement projects in several Haitian communities, including St. Marc. Learn more.

As we work urgently to treat cholera patients and halt the epidemic before it can spread to the crowded settlements around Port au Prince, PIH will continue to emphasize that strengthening public infrastructure, especially the water supply, must be a top priority in post-earthquake reconstruction efforts.