Tuesday, October 26, 2010


(AP) - By Jacob Kushner

Efforts focused on conditions in tent cities

PORT-AU-PRINCE, Haiti — Health authorities and international aid workers scrambled yesterday to keep a cholera outbreak in Haiti from spreading to the squalid camps in Port-au-Prince, where 1.3 million earthquake survivors live.The outbreak has already killed 250 people and made more than 3,000 sick. Five cholera patients have been reported in Haiti’s capital, heightening worries that the disease could reach the sprawling tent slums where abysmal hygiene, poor sanitation, and widespread poverty could rapidly spread it.

Government officials said yesterday that all five apparently got cholera outside Port-au-Prince, and they voiced hope that the deadly bacterial disease could be confined to the rural areas where the outbreak originated last week. Health Ministry director Gabriel Timothee said tightly limiting movement of patients and careful disposal of bodies can stave off a major medical disaster.

If efforts to keep cholera out of the camps fail, “the worst case would be that we have hundreds of thousands of people getting sick at the same time,’’ said Claude Surena, president of the Haiti Medical Association. Cholera can cause vomiting and diarrhea so severe it can kill from dehydration in hours. Doctors Without Borders issued a statement saying some Port-au-Prince residents were suffering from watery diarrhea and were being treated at facilities in the capital.

Cholera infection among the patients had not been confirmed, however, and aid workers stressed that diarrhea has been common in Port-au-Prince since the Jan. 12 earthquake. Aid workers say the risk is magnified by the extreme poverty faced by people displaced by the earthquake, which killed as many as 300,000 people and destroyed much of the capital city.

Haitians living in the camps risk disease by failing to wash their hands, or scooping up standing water to wash fruits and vegetables.

“There are limited ways you can wash your hands . . . in slums like we have here,’’ said Michel Thieren, an official with the Pan-American Health Organization in Haiti. “The conditions for transmission are much higher.’’

Aid workers are coaching thousands of impoverished families on how best to avoid cholera.

Various aid groups are providing soap and water-purification tablets and educating people in Port-au-Prince’s camps about the importance of washing their hands. Aid groups also began training more staff about cholera and where to direct people with symptoms. The disease had not been seen in Haiti for decades, and many people don’t know about it.

Members of one grass-roots Haitian organization traveled around Port-au-Prince’s camps booming warnings about cholera from speakers in the bed of a pickup truck.

“Many people have become sick,’’ announced Etant Dupain, in front of the Champs de Mars camp by Haiti’s broken national palace. “If you have a family member that has diarrhea, bring them to the hospital immediately. Have them use separate latrines.’’

Relief workers said additional supplies were being flown in, in anticipation that the number of cases would increase sharply. In a promising development, aid group Partners in Health said hospital management was improving in the city at the center of the initial outbreak, St. Marc, which is about a 60-mile drive northwest of the capital. Just 300 patients were hospitalized on Saturday, a number that has decreased by the end of each day.

A cholera treatment center in St. Marc is expected to be functional within the week, and efforts were ongoing to make clean water available in rural communities, especially those where rivers were the only source of water.

Some health specialists were hopeful that they will be able to control the outbreak of cholera in impoverished Haiti.

“In a way, it couldn’t have happened at a better moment than now because everyone is on the field — lots of [non-governmental organizations], lots of money. We haven’t had any hurricanes so far this fall but people are here, and people are prepared,’’ said Marc Paquette, Haiti director for the Canadian branch of Medecins du Monde.

Cholera is an acute bacterial infection that results in a severe form of diarrhea that quickly dehydrates and causes death unless victims are treated, primarily with plenty of water and antibiotics, at the onset. Medical officials said it is possible that some people suspected of having cholera have diarrhea caused by less dangerous germs.

Officials have prepared for months for waterborne diseases in Haiti, which has long-standing sanitation problems. But they were not specifically ready for cholera, which last appeared in Haiti 50 years ago. There are an estimated 3 million to 5 million cholera cases and 100,000 to 120,000 deaths every year worldwide, according to the World Health Organization. Outbreaks have been reported this year in Cameroon, Chad, Niger, Nigeria, Pakistan, Papua New Guinea, and Zambia.

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