ARTICLE - EXTRAORDINARY CHOLERA EPIDEMIC

HAITI FACING EXTRAORDINARY CHOLERA EPIDEMIC: EXPERT
(AFP) - By Stephane Jourdain

PORT-AU-PRINCE — Haiti is facing an "unusual" cholera epidemic that could be more severe than figures suggest, according to a French cholera expert who is advising Haitian health authorities.

And determining who is to blame for bringing the disease here won't help solve the crisis, he added.

The outbreak, which threatens to overwhelm Haiti as it struggles to recover from January's cataclysmic earthquake, has left nearly 1,200 dead and prompted riots in several cities including the capital as citizens accuse the United Nations of importing the cholera.

But doctor Gerard Chevallier, who is advising Haiti's Health Ministry, warned that the country needs to focus on trying to halt the spread of the disease detected in Haiti one month ago.

"The mechanics of the epidemic are unusual, swift and severe," Chevallier told AFP in an interview. "The whole country is not affected, but the epidemic will spread."

Officials say 1,186 people have died and nearly 20,000 people have been treated in hospital, but Chevallier noted that in such epidemics, especially in impoverished nations like Haiti, the toll is "under-assessed" and almost always higher than the official figure.

"Reports are imperfect. There are areas where people die and nobody knows," Chevallier said.

"Two thirds of the territory is accessible only on foot."

Chevallier is working with a French team seeking to provide Haitian authorities with tools that allow for a more complete and reliable picture of the epidemic.

"The challenge is to know exactly, every day, what has happened the night before. It is fundamental to know how many cases, how many deaths, how many people treated" in each area in order to provide an appropriate response.

Chevallier said that after meeting Friday with Haiti's health minister, it became clear vaccinating Haiti's 10 million people was not feasible.

"It would take months to get results and would delay the public health response," he said.

A more important priority was "securing potable water points in areas where there is fecal matter."

Cholera is often transmitted via contaminated water and causes diarrhea that can kill within hours. With rehydration a critical part of treatment, obtaining and distributing large amounts of safe water is vital.

More than a million Haitians have been living in unsanitary conditions since the earthquake, including hundreds of thousands crammed into tent cities in Port-au-Prince.

Demonstrators launched violent protests against UN peacekeepers whom they blame for the crisis, accusing Nepalese members of UN mission MINUSTAH of being the cause of the epidemic.

A UN spokesman said Friday that MINUSTAH was "ready to participate in any investigation of the origin of the epidemic."

But Chevallier was dismissive, stressing that knowing the origin does nothing to stop the current crisis.

"What sets the development of the epidemic is the environment, not the strain."