ARTICLE - CHOLERA QUICKLY SPREADING

CHOLERA SPREADING IN HAITI FASTER THAN THOUGHT
(Washington Post) - By Ingrid Arnesen and Bety McKay

PORT-AU-PRINCE—Cholera is now projected to spread more than twice as fast as originally estimated across this ravaged country, with more than 425,000 cases of the potentially fatal disease expected in the first six months since it appeared, a United Nations official said.

As many as 200,000 of those cases are expected before the end of the year, with a peak before Christmas, Nigel Fisher, U.N. humanitarian coordinator in Haiti, said in an interview.

"When we were in the initial stages of planning, we had said there would be 200,000 cases over six months," he said. "Today the figures are 425,000 over six months, of which 200,000 before year's end, with a peak before Christmas."

The predictions reflect the explosive nature of the cholera epidemic, which erupted in rural Haiti in October but has since spread to each of the country's 10 regions, as well as Port-au-Prince, where more than 1.3 million displaced earthquake survivors live in crowded camps.

Officially, the disease had sickened 66,593 people and killed 1,523 as of Monday, according to the Ministry of Health. But the real number of cases is likely much higher, health officials acknowledge, partly because the systems used to count the ill aren't capturing every nonhospitalized case. Cholera is spread through contaminated water and food, and officials had predicted it would move around the country quickly because sanitation is poor and clean water is lacking.

Mr. Fisher said more resources are needed to combat the epidemic. "Funds are an element but not the only element," he said. "We have to be able to support a massive communication response. We've asked other international agencies, 'if you have resources for next year, reallocate them to cholera now and to take their capacities outside of Port-au-Prince,'" where most of the resources are concentrated.

In front of the Health and Sanitation Department in downtown Port-au-Prince Wednesday, a pickup truck, or taptap, waited with two workers wearing rubber boots and masks. Trying to avoid the onlookers, it quietly left for Carrefour-Feuilles to pick up a dead victim of cholera.

On a side street, some 70 demonstrators marched, chanting, "Celestin Cholera Marassa," Creole for "Celestin and cholera are twins."

The phrase referred to Jude Celestin, the government-backed candidate running in Sunday's presidential elections. The demonstrators tore huge Celestin posters hanging from telephone polls on their way. The scene turned into a mini-riot when a frightened driver slammed into a police car.

The tap tap climbed up a narrow street in Carrefour-Feuilles, then stopped at the intersection of Amboise Magloire and Colanger streets. The workers continued on foot up a steep path of narrow stone and mud stairs that turned into a goat path, climbing straight up the mountain through perched slum dwellings.

They disappeared, then returned 20 minutes later with a covered corpse on a makeshift stretcher. Back at the taptap, they uncovered the corpse, revealing a man in his mid-40s. They doused him with chlorine, and wrapped his head, hands and feet with blue plastic strapping.

Neighbors gathered, watching quietly from a distance. Most said they didn't know the man. Then a young man stepped forward hesitantly and identified him: his name was Jean Remy Laurent, he said.

The workers placed the corpse in a large, white garment-type bag and zipped it shut. After wrapping the chlorine-drenched makeshift stretcher, they heaved the white bag into the back of the taptap and took off.

Two little boys stood by, no more than 3 and 5 years old respectively, watching the scene. A young woman, Fabiola Gossin, stood next to them.

Asked if she knew who they were, she whispered that they were Mr. Laurent's children, and she was the family's neighbor. His wife, Benite Senatus Laurent, had left that same morning on foot to the General Hospital with the elder son. She said Mr. Laurent had died that morning. But she didn't believe he had died of cholera; she said he had only been vomiting.

At the General Hospital's cholera unit, ward after ward was filled with men, women and children all on IVs, lying or sitting, in various stages of illness. A nurse found Mrs. Laurent in the intensive care unit, in the back of the room with 15 other people suffering from acute cases. She was barely conscious.

A doctor confirmed her identity and said she had been near death on arrival, but that five liters of serum had started to help her situation.

The doctor asked Mrs. Laurent about her husband. She said "we both started to get very sick last night. My husband vomited and had diarrhea, and I did too. He couldn't move this morning. I walked to the hospital."

The doctor confirmed the case was cholera, though stool samples were still being tested. The staff and doctor said it wasn't time to tell her that her husband had died.

The doctor said the hospital was overwhelmed but coping. More than 20 adults crowded the intensive-care unit, along with at least 12 children, four of whom were in an isolation room wrapped in blue plastic sheeting. Another was on a small stretcher in the back entrance.

In the ICU waiting room, an additional 17 women and children waited. A fear is growing, the doctor said, among people of being identified with cholera, which they believe will make people shun them and not help them get to a health center.

Across town, the taptap continued on its path. The workers said they were going to pick up more corpses and take the bodies to TiTayen, a mass grave on the outskirts of Port-au-Prince.