06 May 2011
It’s beginning to look like rain.
What’s good news for some is tragic for others.
In Haiti, the coming rainy season means more are likely to die from the spread of cholera via and increase in flowing, dirty water.
Since October, the United Nations said Thursday, more than 3,500 Haitians have died from the “severe, acute, dehydrating diarrhea that can kill children and adults in less than 12 hours.”
Nearly 300,000 other Haitians have been sickened by the bacteria, and the numbers of sick and dying continue to increase.
The first cases were reported on Oct. 22, 2010 and the disease began spreading rapidly.
On Wednesday, the UN released a special, 32-page report, the result of an investigation of how the epidemic started. The UN concluded the epidemic is the result of a “confluence of circumstances, and not the fault of any group or individual.”
The death rate from cholera should be less than one percent, the UN said, but it is 1.7 percent in Haiti.
Part of the problem is cholera has not been seen in Haiti in almost 100 years, the UN said, and health workers did not know how to treat it properly.
“It is important to mention that cholera cots were not seen in any of the three hospitals visited,” the UN report states. “Cholera cots are designed to minimize fecal contamination in cholera wards and to measure fluid loss easily. All three cholera units visited were equipped with regular or small portable beds only.
Cholera patients thus defecated in the bed itself, or were asked to walk to the toilet. Asking cholera patients to walk puts them at risk of orthostatic hypotension, a decrease in blood pressure that can be fatal in cholera patients. Hospital staff reported walking on feces in cholera units. In addition, neither hand washing facilities with running water nor hand cleansing products for patients or relatives in these units were evident. Thus, intra-hospital transmission could have been a source of cholera for families, visitors, other patients, and health staff.”
Among the solutions for the problem in Haiti, the UN says, are:
- Training health workers, especially at the treatment center level;
- Scaling-up the availability and use of oral rehydration salts at the household and community level in order to prevent deaths before arrival at treatment centers; and,
- Implementing appropriate measures (including the use of cholera cots) to reduce the risk of intra-facility transmission of cholera to health staff, relatives, and other patients.
- To prevent the spread of cholera, the United Nations and the Government of Haiti should prioritize investment in piped, treated drinking water supplies and improved sanitation throughout Haiti. Until such time as water supply and sanitation infrastructure is established:
- Programs to treat water at the household or community level with chlorine or other effective systems, handwashing with soap, and safe disposal of fecal waste should be developed and/or expanded; and,
- Safe drinking water supplies should continue to be delivered and fecal waste should be collected and safely disposed of in areas of high population density, such as the spontaneous settlement camps.
- The international community should investigate the potential for using vaccines reactively after the onset of an outbreak to reduce cholera caseload and spread of the disease.
Haiti may not get what it needs.
“An appeal for $175 million launched by humanitarian agencies last year to respond to the epidemic has received only 48 per cent of the requested funding.” Sylvie van den Wildenberg, spokesperson for the UN Stabilization Mission in Haiti, said in a news released emailed Thursday to journalists.