HAITI: CHOLERA SITUATION REPORT #30
(ReliefWeb) - Source: United Nations Office for the Coordination of Humanitarian Affairs (OCHA)
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I. HIGHLIGHTS/KEY PRIORITIES
As of 18 December 2010, the Ministère de la santé publique et de la population (MSPP) has reported 2,761 deaths and 70,865 hospitalized cases due to the cholera outbreak.
There is an increase of cholera cases and fatality rates in the South-East department.
The major gaps and constraints identified by the Health Cluster include community mobilization for cholera prevention and prompt treatment; access to clean water and latrines; access to health care; and coordination.
Map: Haiti: Cholera Treatment Centers (CTCs) and Units (CTUs) Snapshot (as of 29 Dec 2010)
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This report was issued by OCHA Haiti. The next report will be issued on or around 2 January 2011.
II. SITUATION OVERVIEW
The MSPP has reported 2, 761 deaths and 70 865 hospitalized cases, with an overall fatality rate of 2.1 per cent nationwide.
The fatality rates have decreased in most departments since 1 December, except in South-
East where it went from 12,9 per cent to 13,8 per cent between 11 and 18 December.
III. HUMANITARIAN NEEDS AND RESPONSE
The Panamerican Health Organization/World Health Organization (PAHO/WHO) continues to provide support to health, hygiene promotion and social mobilization activities. It has supported the development, printing and distribution of 97,000 posters and 150,000 laminated pages containing guidance on cholera prevention and treatment in Creole. These documents were developed in conjunction with the Ministry of Health. A course on cholera management has also been developed for community and religious leaders and will be delivered by the Government of Haiti. Over 500 health professionals have already been trained by PAHO/WHO in cholera
In the Artibonite department, the Association of Mayors, with the support of the Ministry of Interior, has set up communal brigades to assess the cholera situation due to an increase in cholera cases that has been reported in the mountainous area of the Mornes. Due to a decrease in cholera cases, MSF Spain is reducing its presence in the Lower Artibonite.
Gaps and constraints
The major gaps and constraints identified by the Health Cluster include:
1) community mobilization for cholera prevention and prompt treatment of the disease;
2) access to clean water and latrines in health facilities including cholera treatment centers and units CTCs/CTUs);
3) access to health care; and
There is an urgent need for massive mobilization activities to promote prevention and early treatment. In addition, controlling the epidemic will depend on the level of access to safe water and basic sanitation and implementation of hygiene measures.
With only 40% of the population having access to health care, health partners, including those working outside the UN Health Cluster system, are working with Haitian authorities to set up various types of facilities to care for all stages of cholera treatment.
Considering the number of partners active in the response – 27 partners in the Health Cluster –, coordination is crucial.
The mission of the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) is to mobilize and coordinate effective and principled humanitarian action in partnership with national and international actors.
Water, Sanitation, Hygiene (WASH)
The Ministère des travaux publics et de l’intérieur is preparing a 30-day plan to improve the water, sanitation and hygiene conditions in public markets throughout Port-au-Prince. These activities will be coordinated with Health Cluster and WASH Hygiene & Sanitation sub-clusters. Two to six sanitations agents will conduct hygiene promotion activities and supervise water and sanitation activities, including cleaning of market areas, removal of solid waste and management of public latrines.
Information collection for the localization of additional septage disposal sites is on-going at the departmental level while collection of information about access to sanitation at CTCs in Port-au-Prince has resumed by the Direction nationale de l’eau potable et de l’assainissement (DINEPA) after data collection was stopped due to fuel shortages.
Training activities are also ongoing and 963 people, mainly sanitation agents, have been trained in eight departments from 20 to 24 December by the Institut national de santé communautaire en Haïti (INSCAH).
Gaps and constraints
MSF-Holland has identified a critical link between power outages, disruptions in water supply and increased cholera cases in Mariani, Bertil, Bizoton, Archachon and Riviere Froid areas of Carrefour, which warrants four emergency interventions:
· Placement of emergency fuel stocks in pumping stations to ensure continuity of water supply in the event of electrical malfunctions.
· Increased hours of pumping to maintain higher water levels in the reservoirs.
· Adjustment of the chlorination dosage to achieve an appropriate level of free residual chlorine at the end-user points of the water network.
· Ensuring the availability of an emergency repair team to address breakdowns quickly, minimizing the duration of any interruptions in water supply.
As of 1 January 2011, the Italian NGO COOPI, which is providing 20,180 liters of water per day to 17,091 people, will discontinue water trucking to seven camps in the Port-au-Prince metropolitan commune of Tabarre. The WASH Cluster is requesting support from other WASH actors and donors to ensure provision of drinking water in Tabarre.
In the South Department, the management of dead bodies remains a huge challenge, particularly in Les Cayes where at least 64 corpses remained several weeks at the hospital because the population was opposed to the burial of the corpses in a mass grave.
Camp Coordination/Camp Management (CCCM)
Camp Management Agencies (CMAs) and Camp Management Operations (CMO) teams continue to monitor the situation in camps.
Awareness campaigns are also on-going. A cholera prevention day organized by the AMI Foundation focused on environmental sanitation, rubbish collection and disposal, hand-washing demonstrations, coloring books and painting activities for children, theatre and music. The camp population showed great interest and engagement in the activities while appreciating the initiative.
Needs and constraints
WASH items, awareness activities, installation and desludging of latrines, and provision of drinking water remain an urgent need in IDP sites.
Cholera cases continue to be reported in residential centers (orphanage, day-care center, and transitional center). An orphanage in Arcahaie reported 30 cases of cholera among children with disabilities, of whom six died, or a fatality rate of 20%. Another residential center in Croix de Bouquets reported one cholera death and 10 cases currently being treated in CTCs.
A new phase of supply distributions in residential care centers has started in Kenskoff and Croix de Bouquets.
During the last three days, UNICEF, with the support of the Logistics Cluster, has distributed soap, Clorox, water purification tablets, education and communication materials to 98 centers hosting more than 6,000 children. UNICEF also organized a training on cholera for 50 civil agents of the Child Protection Brigade who will be deployed at border areas, the airport and camps.
Separation of children due to the cholera epidemic continues to be reported. Efforts to raise awareness on the issue are being stepped up by child protection partners.
Over the last week, the Logistics Cluster supported DINEPA country-wide distribution plan of water purification tablets by air and road to eight departments.
The Logistics Cluster also offered to relevant authorities to establish a customs bonded warehouse dedicated to incoming medical supplies for cholera response in Port-au-Prince airport. This offer was not accepted and and similar proposals will be discussed with harbour authorities to expedite incoming sea shipments in the near future. Organisations expecting sea consignments should contact the Logistics Cluster team at the following email address :
Port operation actors will participate in the next Logistics Cluster meeting on 4 January.
Upon request from the Centre des operations d’urgence nationale (COUN), the Logistics Cluster made its GIS capacity available to the Office for the Coordination of Humanitarian Affairs (OCHA) and WHO/PAHO in order to coordinate the mapping of cholera treatment sites throughout the country. A country-wide map of CTCs and CTUs has been produced and is available on Reliefweb (Reliefweb.int) and www.haiti.humanitarianresponse.info
Since 16 December, the Logistics Cluster provided road transportation services and delivered 348 metric tons of health and WASH items by trucks. The United Nations Humanitarian Air Service (UNHAS) airlifted 77.5 metric tons of health and WASH items on behalf of multiple partners to fourteen different locations in the country.
There is an increased demand for storage from various humanitarian actors. The storage site in Croix des Bouquets, which is used by 18 organisations, will remain open for three additional months until the end of March 2011.
In addition, the earthquake response support is still ongoing with deliveries of 135 metric tons of rehabilitation material, food and storage equipment to remote locations in the Nippes department and the mountains of the Ouest Department.
In its support to hygiene promotion activities, IOM has published three editions of the Chimen Lakay newspaper and circulated over 100,000 copies nationwide. The fourth edition is on cholera stigmatisation and scheduled to be published in January.
Head of OCHA Haiti (a.i.) Jolanda Vand Dijk
Head of Communications (a.i), Maurizio Giuliano
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OCHA Haiti Spokesperson: Emmanuelle Schneider
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Reports Officer: Abdourahmane Diallo
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United Nations Office for the Coordination of Humanitarian Affairs, (OCHA Haiti), Boulevard
Toussaint Louverture et Clercine 18, Port-au-Prince, Haiti.