HAITI: CHOLERA SITUATION REPORT #35 - (4 February 2011)
This report was issued by OCHA Haiti. This is the last situation report covering the cholera epidemic. Bi-weekly humanitarian bulletins covering the earthquake and cholera response will be issued starting 17 February.
The overall trend of the cholera epidemic is towards a plateau or a slow decrease in cases. The focus however remains on ensuring services are made available to people in remote areas, where an increased number of cases continue to be reported. Health Cluster partners are now focusing on developing a strategy to handle the epidemic for the months and the years to come, will focus on the establishment of cholera treatment units in every primary health center and training health workers for the treatment of cholera.
No disturbances in the cholera response were reported following the announcement of the results of the first round presidential elections on 3 February.
Health
As of 28 January, the Ministère de la santé publique et de la population (MSPP) reported 215,936 cholera cases and 4,131 deaths, with an overall fatality rate of 1, 9 per cent and four departments (Artibonite, Centre, Northwest, West) with rates below the 2, 0 per cent threshold. It is estimated that 30 percent to 50 percent of cholera cases are now seen at Oral Rehydration Points (ORP). These cases are often less severe, or are prevented from becoming severe by immediate access to services. A total of 101 Cholera Treatment Centers (CTCs), 185 Cholera Treatment Units (CTUs) and 927 ORPs are operational nationwide.
The evaluation conducted by the MSPP and the Pan-American Health Organisation/World Health Organisation (PAHO/WHO) of CTCs and CTUs in the West department, including Port-au-Prince, show the majority of facilities seem to be using proper treatment protocols and have procedures for sanitation and hygiene. Supplies available are generally sufficient for 30 days of activities although some facilities are running out of Oral Rehydration Salts (ORS) sachets.
Experts are investigating the possibility that the four cases of paralysis in cholera patients in the Northwest department may originate from medicines, food or other sources. It is likely that polio will be dismissed as the cause of these cases.
Gaps and Constraints
There is a concern that needs in remote areas are being underestimated, due to the fact that cases seen in ORPs are not counted in the surveillance system, which currently only tracks CTCs and CTUs.
Water, Sanitation, Hygiene (WASH)
Several partners are about to wind down their chlorination operations because of a lack of funding or to focus on longer-term strategies. MSF-Belgium and Oxfam-GB have announced they will stop on 1 March the chlorination of 11 wells in Port-au-Prince that provide water for approximately 374,500 people. These two NGOs intend to hand over those activities to DINEPA throughout the month of February. Oxfam GB will stop its WASH activities in temporary housing sites on 15 February and is defining its strategy for the next three years with a focus on Cap Haitien.
I. HIGHLIGHTS/KEY PRIORITIES
• The cholera epidemic is stabilizing but an increase in the number of cases in isolated areas is still reported.
• There are 215,936 cumulative cholera cases and 4,131 deaths, with a nationwide fatality rate of
1, 9 per cent and four departments notifying rates below the 2, 0 per cent mark.
• Several WASH partners are about to wind down some of their activities because of a lack of
funding or to focus on longer-term strategies.
DINEPA, in cooperation with the Ministries of Education and Health, has started preparing the second phase of distribution of 7.2 million chlorination tablets in schools and health centers. A first phase completed in the ten departments has already reached 302,700 households.
An agreement has been reached to reopen the Truitier waste disposal site in Port-au-Prince for two more months. The agreement includes providing support to the communities living in the surrounding area with a distribution of chlorine, soap and awareness raising campaigns to sensitize the population on hygiene promotion and cholera prevention.
Gaps & constraints
The disludging of latrines in CTCs and UTCs remains a major problem nationwide and the situation is worsening in some areas.
MSF-Belgium will stop its water chlorination, as well as its water distribution activities in Port-de-Paix next week. No one is taking over that responsibility.
In rural areas people continue to drink non potable water from the river due the lack of water purification systems.
There is currently a lack of communications material accompanying the distribution of chlorination products, suitable for people who can not read or write easily.
Camp Coordination/Camp Management (CCCM)
Distribution of WASH supplies and non food items as well as awareness activities are being conducted in most camps by Camp Management Operations teams.
In the West department, 49 internally displaced persons camps hosting 2,305 vulnerable households have been identified at risk of cholera contamination.
Gaps and constraints
Access to WASH facilities in camps remains problematic. In Léogane and Gressier, 75 out of 113 camps do not have access to clean water. On average, there is one latrine for 392 individuals and 39 camps hosting displaced population do not have functional latrines.
In Petit Goâve, assessments conducted by IOM indicate that 262 IDP households living in public land and 511 IDP households living on private land have no access to adequate WASH facilities as landowners often denied installation of such facilities. No proper waste disposal area has been identified so far by the mayor.
Nutrition
The MSPP has trained more than 100 staff in five departments in the management of severe acute malnutrition of cholera patients with the support of UNICEF. Nutrition partners’ response to the cholera epidemic is being carried out through the promotion and protection of adequate Infant and Young Child Feeding programmes through a network of 114 baby tents in the West and Southeast departments.
Gaps & constraints
There is still a decreased attendance in therapeutic feeding centers.
Education
The Education Cluster and partners continue their cholera prevention activities, including distribution of WASH supplies and the organization of hygiene promotion sessions, with the goal to reach over 9,600 schools nationwide over the next three months.
Mapping of schools to identify existing actors and remaining coordination gaps are ongoing in order to facilitate distribution of cholera-related items to students’ families.
UNICEF is expanding cholera prevention efforts through new partnerships with three additional NGOs to cover 450 schools, reaching 79,000 children and more than 2,000 teachers.
Gaps & constraints
Access to schools in rural and mountainous areas to conduct cholera prevention activities remains an issue.
Protection
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.
This week a third round of supply distribution for cholera prevention has been conducted in orphanages benefiting more than 3,800 children.
Two voodoo priests were murdered this week by people who accused them of "spreading the powder that gives cholera”.
Logistics
Following the decreasing demand for airlifts, the United Nations Humanitarian Air Services (UNHAS) fleet was reduced from two to one helicopter which is being used to respond to cholera alerts in remote areas.
Over the past week, the Logistics Cluster provided inter-agency transport services to 8 organisations. A total of 128 metric tons of cholera emergency supplies, hygiene kits and wash items, have been carried out from Port-au-Prince to 17 locations all over the country, including Ile de la Torture. Transport services continued also in the regions by dispatching Cholera relief items from Gonaives and Cap-Haitien to the areas in need.
Funding
As of 3 February, the cholera appeal of US$175 million is 45 % funded.
Contact Information
Head of OCHA Haiti (a.i.) Catherine Huck
Email: huck@un.org
Public Information/Spokesperson, Emmanuelle Schneider
Email : schneider1@un.org
Public Information Officer : Rachelle Elien
Email : elien@un.org
Reporting Officer: Abdourahmane Diallo
Email: diallo57@un.org / ocha.haiti@gmail.com ,
United Nations Office for the Coordination of Humanitarian Affairs, (OCHA Haiti), Boulevard
Toussaint Louverture et Clercine 18, Port-au-Prince, Haiti.
For more information on the response in Haiti, please visit:
http://haiti.humanitarianresponse.info
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