Friday, October 22, 2010


(The New York Times) - By Donald G. McNeil Jr.

A cholera outbreak in a rural area of northwestern Haiti has killed more than 150 people and overwhelmed local hospitals with thousands of the sick, the World Health Organization said Friday, increasing long-held fears of an epidemic that could spread to the encampments that shelter more than a million of Haitians displaced by the January earthquake.

Even as relief organizations rushed doctors and clean-water equipment towardthe epicenter ‹ the Artibonite, a riverine rice-producing area about three hours north of the capital, Port-au-Prince ‹ Haitian radio reported that cholera cases had surfaced in two other areas: the island of La GonĂ¢ve, andthe town of Arcahaie, which lies closer to the capital.

In addition, a California-based aid group, International Medical Corps, said they had confirmed cases in Croix-des-Bouquet.

Relief agencies had long feared a major outbreak of diarrheal diseases, particularly among people living in crowded, unsanitary tent cities, and, as in the case in Artibonite, drinking from rivers.

But the appearance of cholera ‹ which dehydrates and kills victims more rapidly than most other diarrheas ‹ was a surprise. Haiti and the rest of the Caribbean has not seen the vibrio cholerae bacteria, which lives in human intestines, for at least 50 years.

Like most population centers in Haiti, Artibonite has absorbed thousands of those displaced by the earthquake, which killed an estimated 200,000.

Television images showed hospital corridors, hallways and even parking lots there filled with victims lying down, getting intravenous fluids as crowds of screaming relatives were kept outside.

"People are all over on the floor", said Charles Henry Baker, a Haitian presidential candidate, who appeared on Reuters TV after touring a hospital. "We need help and we need quick help."

Dr. Michel Thieren, senior program officer in Haiti for the Pan-American Health Organization, a W.H.O. affiliate, said the best hope for minimizing casualties was a public education campaign to tell people to drink only clean water, and a bigger effort to get clean water to everyone.

Cholera has circled the globe in waves since it first appeared in India in 1816. It killed tens of millions of people during the 19th century, and the globe is now in the grip of what is considered the seventh pandemic; a strain presumed similar to the one in Haiti appeared in South America in1991.

Victims can lose as much as 10 quarts of water a day through diarrhea and die because their electrolytes get out of balance, causing a heart attack, or their blood gets so thick that their organs shut down. It can be fought by rehydrating victims with intravenous fluids and water with salts and sugars. It can be headed off by trucking in clean water or huge filters that can clean local water.

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