Responding to a Cholera Outbreak in Haiti

Haiti has struggled with a cholera epidemic since October 2010. The disease originated in Mirebalais in the Centre Department, but within a two-month period it had spread to all 10 departments in Haiti. By the end of 2011, more than 7,000 people had died and some 500,000 were infected.

Cholera had been absent in Haiti for almost a century. As a result, Haitians had no natural immunization against the disease and did not know how to prevent, recognize and treat it. Since 80 per cent of the population has little access to potable water and sanitation, the bacteria quickly spread. Humanitarian actors were already responding to the January 2010 earthquake, but they diverted much-needed financial and human resources to confront this new crisis.

At the start of the rainy season in April 2011, a new cholera outbreak was reported in Thiotte, in the Sud-Est Department. The Cholera Treatment Center, run by Save the Children, was quickly overwhelmed with new cases. MSF-Spain had mobilized significant resources during the first phase of the epidemic. But the organization left the area in February 2011, when the epidemic showed robust signs of stabilizing.

Within 48 hours of the outbreak being reported, an inter-agency mission comprising OCHA, Save the Children and WHO deployed with medical and sanitation supplies. It took four hours to drive the 100km from Jacmel to Thiotte due to road conditions that had deteriorated during the rainy season. 

When the team arrived in Thiotte, it found 72 patients in the 25-bed centre. Many patients were lying on the floor, and a patient who had died remained in the facility. This increased the risks of contamination and trauma. To resolve the issue of responsibility for the removal and burial of bodies, OCHA facilitated discussions with the mayors of Thiotte and Grand Gosier, where most of the patients were from.  

With each day, medical supplies grew critically low. But the number of patients continued to increase, including 98 new patients on the seventh day of the outbreak. At this critical point, OCHA called for contributions. Several national and international organizations responded with humanitarian supplies and support teams. Locally collected medical stocks were quickly dispatched, and chlorination and prevention campaigns were carried out. Within days, these efforts showed results: more lives were saved and the number of new patients reduced.

Rowan Cody, PAHO/WHO Field Coordinator, said: “During the response to the cholera epidemic in the Sud-Est Department, OCHA was particularly helpful in liaising with communities, authorities and partners, both at the community and departmental levels. OCHA’s rapid response capacity in emergency situations was a key factor in helping us control cholera outbreaks and improving treatment.”

In mid-2011, the number of cases peaked at 1,300 per day. But since then, the epidemiological trend has steadily declined nationwide. By early 2012, the Ministry of Public Health and Population was recording an average of less than 80 new cases per day. However, this decline will have to be monitored closely when the rainy season starts in mid-March. According to estimates from PAHO/WHO, 200,000 additional people could contract the disease in 2012 if material and human resources are not fully mobilized.

 

An assessment mission on the road between Jacmel and Thiotte in Haiti. © OCHA