ARTICLE - CHOLERA CRIPPLES HAITI

CHOLERA CRIPPLES HAITI, TWO YEARS AFTER QUAKE
(USA TODAY) - By Donna Leinwand Leger

Two years after an earthquake leveled Port-au-Prince, Haiti is in the grip of one of the most devastating cholera outbreaks in modern history, health authorities said Friday.

More than half a million people have become ill with the disease and at least 7,000 have died since the outbreak began in October 2010, said Jon Andrus, deputy director of the Pan American Health Organization. Health providers report about 200 new cases a day. He expects that number to increase when Haiti's rainy season begins in April.

The disease has spread across the island of Hispaniola to Haiti's neighbor, the Dominican Republic, which has reported 21,000 cases and 363 deaths from cholera, he said.

Haiti's outbreak "is one of the largest cholera epidemics in modern history to affect a single country," Andrus said.

On Jan. 12, 2010, a magnitude-7.0 earthquake struck 16 miles west of Port-au-Prince, the Haitian capital. The Haitian government estimates 316,000 people died in the quake and the dozens of aftershocks that followed. The earthquake left 1.5 million people homeless, and many people still live in tents in squalid camps around the capital.

In February, Haiti's Health Ministry, with help from Partners in Health, a U.S.-based aid organization, will begin vaccinating 100,000 people in a Port-au-Prince slum and a rural commuity with an oral cholera vaccine, said Louise Ivers, senior health and policy adviser for Partners in Health.

Cholera is a water-borne disease. In Haiti, where most people lack public sewage systems or sanitary latrines, people often drink from the same water source they use to bathe and defecate.

People ill with cholera develop severe diarrhea and, without immediate treatment, can become dehydrated. The rapid dehydration can cause shock, which can lead to death.

Ivers, who lives in Haiti, said people in rural areas often live several hours from a water pump that draws from a clean water source. Many people cannot afford to buy soap to wash their hands or fuel to boil the water and kill the cholera organism, she said.

"We have the luxury in the United States of potable water at our fingertips," Ivers said. "It's not a question in Haiti of ignorance. It's access."

Since the earthquake, international aid organizations have attempted to restore clean water to the country and build sanitation services, but the efforts fall far short of the need, Andrus said.

"We, as partners, have failed to ensure that every resident has access to safe water and sanitation," he said. "Safe water and sanitation must be a priority."

Building the water and sewer plants and the plumbing that could deliver clean water and treat waste could cost $1.1 billion, he said. Haiti needs "major investments for decades" in sanitation, he said.

Community public health officials have educated Haitians about the symptoms of infection so more people know when to seek help and cholera centers have the supplies they need, Ivers said.

"There's some good news: The fatality rate is going down," Ivers said.

Early in the outbreak, 10% of people who became ill died, she said. Now, the death rate is 1% or less, she said.

But, she cautioned: "In April, things will potentially get much worse."