ARTICLE - AN APOCALYPSE SCENARIO

CHOLERA EPIDEMIC: AN APOCALYPSE SCENARIO
(HaitiLibre.com)

First Scenario:
At the beginning of the epidemic, the World Health Organization (WHO) had estimated that the number of infected people could reach 270,000 over several years, causing approximately 10,000 deaths, taking as its' model, the Peruvian epidemic of 1991.

Recall that the Peru cholera epidemic, which had spread over 16 countries, and was eradicated in 2005, has infected nearly a million people and took more than 10,000 lives in 14 years.

Second scenario:
The situation in Haiti worsened rapidly and the experts reviewed their epidemic model for Haiti; basing it this time on the cholera outbreak of Zimbabwe in August 2008. They estimated that the epidemic in Haiti could infect 200,000 people and cause more than 10,000 deaths in the next 6 to 12 months if there was no improvement. A warning given by Dr. Ciro Ugarte, of the Pan American Health Organization (PAHO), a branch of WHO, was stressed however; that this was the "darkest" scenario.

Recall that in Zimbabwe, with a population of 12 million inhabitants, cholera had infected 89,000 people and caused 4,000 deaths (mortality rate nearly 5%), within the first 8 months (although the WHO acknowledges that these figures were under-estimated).

It took 2 years and nearly a billion dollars to control the epidemic in the African country, which had a water distribution system superior to that of Haiti.

Third scenario:
60,240 cases of infection and treatment; of which 25,248 have required hospitalization and 1,415 deaths in 39 days here in Haiti (assessment of November 20th, 2010), health experts now propose a third scenario because the spread of the epidemic in Haiti is not comparable to any previous epidemics in the world.

In this third apocalypse scenario, Dr. Jon Andrus, assistant director of the Pan American Health Organization (PAHO) now estimates that there could be up to 400,000 cases of cholera in Haiti within the next 12 months, of which 200,000 may be in the next 3 months.

"We work with key partners to refine these preliminary estimates in order to improve and maintain a sustainable response to the epidemic. Given the extremely poor sanitary conditions (58% of the population lacks access to safe drinking water) that existed a long time before the quake, and were worsened after the hurricane and with the cholera epidemic, we expect to see the number of cases continue to increase ", He added that "the epidemic has not yet reached its peak. We do not know when it might occur".

Mr. Nigel Fisher, the coordinator of the UN humanitarian action in Haiti, citing figures in circulation, said the reality was close to 2000 dead and 60,000 to 70 000 cases, due to difficulties faced in obtaining accurate statistics of the impact of the epidemic in remote and isolated areas of the country. He stressed how important it is to conduct accelerated implementation of programs for access to water and sanitation.

"Beyond financial resources, we need more doctors and more nurses," he said, stating that the epidemic will continue to spread over the months or even years to come.

Mr. Fischer stated that all departments of Haiti have been affected. He recalled that a person could be affected by the infection and then be a vehicle of infection for several days before the effects of the disease become evident. The person may even be an asymptomatic carrier of the infection (without any symptoms) and infect others.

The UN has launched ten days ago a call for 164 million dollars (121 million euros), but only 6.8 million (4.14%) have been funded so far. "The funding is too low. This is a situation of extreme urgency, a matter of hours. The epidemic does not wait and continues to evolve," said the spokesman for the Office for the Coordination of Humanitarian Affairs (OCHA), Elisabeth Byrs.

She also added that it was urgent to replenish stocks of equipment and drugs and replace staff that are exhausted recalling that it is necessary to have an average of "130 people to take care of a cholera treatment center with 100 beds.

Among health experts that seem to have great difficulty in modeling the evolution of this "unprecedented epidemic" which is particularly virulent and rapid in Haiti and that the international community seem uninterested in the plight of Haitians by not bringing the financial assistance of this extreme urgency demanded by the UN, what remains as a hope for Haiti ? A miracle ? It is true that if our country had natural resources other than its endemic poverty, the situation would probably be very different in the eyes of donors.