DOMINICAN REPUBLIC RESTRICTS ENTRY FROM CHOLERA-STRICKEN HAITI
DAJABON, Dominican Republic – Dominican authorities barred Monday the entry of thousands of Haitian merchants and buyers on their way to take part in the traditional binational market that was suspended because of the cholera epidemic affecting Haiti.
The provincial director of the Public Health Ministry, Rafael Salas, told the press that this is an official government measure adopted to protect the population from the outbreak of cholera detected last week in Haiti that has already taken 253 lives.
Migration authorities said that it will only allow entry into the country for students and Haitians with Dominican visas, who have previously observed such hygienic measures as washing their hands, at points established by the Public Health Ministry on the border.
The suspension of the traditional binational market in Dajabon sparked complaints from Haitian merchants, many of whom came to the border from Port-au-Prince and remote areas.
The Dominican Republic also blocked Sunday the entrance to its territory to Haitian clergy who were going to take part in a meeting for peace in both countries, religious sources said.
Dominican authorities had announced a series of measures on the Haitian border due to the outbreak of cholera.
Among the measures was a ban on sales of food cooked in Haiti at the binational market.
While no suspected cases of cholera have been reported up to now in the Dominican Republic, Health Minister Bautista Rojas Gomez said that a unit has been set up in the national laboratory to diagnose the deadly disease, the press said Monday.
Monday, October 25, 2010
ARTICLE - RUSH TO STEM SPREAD
IN HAITI, RUSH TO STEM THE SPREAD OF CHOLERA
(New York Times) - By Denise Grady
The cholera epidemic in Haiti is likely to grow and persist, and will probably reach the Dominican Republic, health officials said on Monday, as they rushed to distribute medical supplies in hopes of keeping ahead of the disease’s spread.
“Now that cholera has established itself with a strong foothold in Haiti, it is clear to us that it will not go away for several years,” said Dr. John Andrus of the Pan American Health Organization at a news briefing Monday in Washington.
Efforts at prevention — mainly, providing clean water, soap and better sanitation — will bring the number of cases down but will not eradicate the bacteria, he said. Once the bacteria find their way into the right environment, like the brackish water of an estuary, cholera-causing microbes — Vibrio cholerae — can live on for a long time.
As of Sunday, there were 3,015 known cases and 253 deaths in Haiti. But the actual number of cases could be much higher, Dr. Andrus said, because about 75 percent of infected people have no symptoms. They can carry the bacteria for two weeks and shed them back into the environment, where they can infect others, which is most likely to occur when sanitation is poor and clean drinking water not available.
By far the most common way the disease is spread is through contaminated water. Person-to-person spread is far less of a risk because people need to swallow a large dose of bacteria to get sick. Dr. Robert Quick, a medical epidemiologist at the Centers for Disease Control and Prevention in Atlanta, said that water could be easily disinfected just by boiling it or using chlorine products made for that purpose.
Why the disease has suddenly appeared in Haiti is a mystery, experts say. It has not been there in decades, not even when an epidemic that started in Peru in 1991 affected much of Latin America. An infected person could have brought the bacteria in from another country, or it could have arrived in food or even on board a ship that discharged infected wastes into a local waterway. Once it landed, the squalid conditions were ideal for its spread.
Dr. John Mekalanos, chairman of microbiology and molecular genetics at Harvard Medical School, said he expected to receive samples of the bacteria from colleagues in Haiti and to sequence its genome. Comparing the results with other samples from past outbreaks in different locations should give researchers some clue about where this strain came from, he said.
Dr. Quick said that the disease usually began with watery diarrhea, and that people might not feel very sick at first. If they start taking oral rehydration solutions at that early stage, they can replace the lost fluid and recover within a few days. But if the treatment is delayed, the risk rises sharply. As the disease progresses, more fluid and electrolytes are lost, and vomiting starts. Then a person may not be able to keep the oral solutions down, and may need intravenous treatment. Without fluids, the end can come quickly.
“Basically, with severe cholera you go into shock, and without rehydration you develop kidney failure and other organ failure,” Dr. Quick said.
But even people with severe cases have been saved by rehydration, Dr. Quick emphasized. “People appear to be on death’s doorstep, but then they get fluids and their eyes open and they do fine,” he said.
One question that has been debated is whether people in Haiti’s refugee camps and slums should have been given cholera vaccine, or should be given it now. In the early aftermath of the earthquake, the more likely threats were epidemics of measles and diphtheria, so the focus was on vaccines against those diseases, said Donna Eberwine-Villagrán, a spokeswoman for the Pan American Health Organization.
She and Dr. Quick said that vaccine experts were still discussing whether to use cholera vaccine now, in areas that have not yet been affected. Once an epidemic has taken hold, it is usually too late to start vaccinating.
Dr. Quick said: “You need to mobilize people for a vaccination campaign. You need to have vaccine there, in optimal conditions, and you need to be able to provide two doses 7 to 14 days apart. You get protective immunity seven days after the second dose.”
And cholera vaccine is relatively expensive — $10 for two doses. Right now, health workers are scrambling to make sure rehydration solution is widely available. It costs pennies.
(New York Times) - By Denise Grady
The cholera epidemic in Haiti is likely to grow and persist, and will probably reach the Dominican Republic, health officials said on Monday, as they rushed to distribute medical supplies in hopes of keeping ahead of the disease’s spread.
“Now that cholera has established itself with a strong foothold in Haiti, it is clear to us that it will not go away for several years,” said Dr. John Andrus of the Pan American Health Organization at a news briefing Monday in Washington.
Efforts at prevention — mainly, providing clean water, soap and better sanitation — will bring the number of cases down but will not eradicate the bacteria, he said. Once the bacteria find their way into the right environment, like the brackish water of an estuary, cholera-causing microbes — Vibrio cholerae — can live on for a long time.
As of Sunday, there were 3,015 known cases and 253 deaths in Haiti. But the actual number of cases could be much higher, Dr. Andrus said, because about 75 percent of infected people have no symptoms. They can carry the bacteria for two weeks and shed them back into the environment, where they can infect others, which is most likely to occur when sanitation is poor and clean drinking water not available.
By far the most common way the disease is spread is through contaminated water. Person-to-person spread is far less of a risk because people need to swallow a large dose of bacteria to get sick. Dr. Robert Quick, a medical epidemiologist at the Centers for Disease Control and Prevention in Atlanta, said that water could be easily disinfected just by boiling it or using chlorine products made for that purpose.
Why the disease has suddenly appeared in Haiti is a mystery, experts say. It has not been there in decades, not even when an epidemic that started in Peru in 1991 affected much of Latin America. An infected person could have brought the bacteria in from another country, or it could have arrived in food or even on board a ship that discharged infected wastes into a local waterway. Once it landed, the squalid conditions were ideal for its spread.
Dr. John Mekalanos, chairman of microbiology and molecular genetics at Harvard Medical School, said he expected to receive samples of the bacteria from colleagues in Haiti and to sequence its genome. Comparing the results with other samples from past outbreaks in different locations should give researchers some clue about where this strain came from, he said.
Dr. Quick said that the disease usually began with watery diarrhea, and that people might not feel very sick at first. If they start taking oral rehydration solutions at that early stage, they can replace the lost fluid and recover within a few days. But if the treatment is delayed, the risk rises sharply. As the disease progresses, more fluid and electrolytes are lost, and vomiting starts. Then a person may not be able to keep the oral solutions down, and may need intravenous treatment. Without fluids, the end can come quickly.
“Basically, with severe cholera you go into shock, and without rehydration you develop kidney failure and other organ failure,” Dr. Quick said.
But even people with severe cases have been saved by rehydration, Dr. Quick emphasized. “People appear to be on death’s doorstep, but then they get fluids and their eyes open and they do fine,” he said.
One question that has been debated is whether people in Haiti’s refugee camps and slums should have been given cholera vaccine, or should be given it now. In the early aftermath of the earthquake, the more likely threats were epidemics of measles and diphtheria, so the focus was on vaccines against those diseases, said Donna Eberwine-Villagrán, a spokeswoman for the Pan American Health Organization.
She and Dr. Quick said that vaccine experts were still discussing whether to use cholera vaccine now, in areas that have not yet been affected. Once an epidemic has taken hold, it is usually too late to start vaccinating.
Dr. Quick said: “You need to mobilize people for a vaccination campaign. You need to have vaccine there, in optimal conditions, and you need to be able to provide two doses 7 to 14 days apart. You get protective immunity seven days after the second dose.”
And cholera vaccine is relatively expensive — $10 for two doses. Right now, health workers are scrambling to make sure rehydration solution is widely available. It costs pennies.
BIOSURVEILLANCE UPDATE - 5
OPERATIONAL BIOSURVEILLANCE
UPDATES:
Gonaive: 10 more cases discovered
Mirebalais: 50 cases discovered in a prison
Arachaie: 5 more cases
Carrefour & Croix des Bouquets: unknown number of cases, but officially acknowledged
Although officials believe no transmission has occurred in Port au Prince, there are too many reports indicating suspect cases inside the city to know this definitively.
We raise the question about the medical capacity situation in Gonaive and Mirebalais.
Lack of acknowledgement by both media and officials of the situation in Lafito noted. The question of introduction to " Camp Obama" and Cite Soleil is once again raised.
All samples to the best of our knowledge have tested negative from Leogane and Nippes Department in the Southern Peninsula
Serious concern about loss of containment noted.
Significant social anxiety and some isolated reports of unrest related to access to safe drinking water in the St Marc region.
LAFITO/LAFITEAU: A NEW FOCUS OF TRANSMISSION?
The HEAS community of partners has highlighted several times now a steady trickle of suspect cases with three fatalities reported in Lafito / Lafiteau, which remains of strategic response importance given proximity to the IDP settlement known as "Camp Obama" and Cite Soleil.
We urge immediate investigation of this site by the Health and WASH Clusters given the implications for futher introductions of cases to Port au Prince. Official public health reporting to-date has emphasized Arachaie, which is closer to St Marc, however it has been apparent that Lafito is also an important site to monitor.
UPDATE & CORRECTION: ANTIBIOTIC RESISTANCE PROFILE OF THE 01 CHOLERA STRAIN IN HAITI
Thanks to Haitian officials' rapid response to our query, the National Laboratory (LNSP) and CDC have officially confirmed the strain is NOT resistant to doxycycline. It is sensitive to doxycycline, cipro, and tetracycline but resistant to ampicillian and bactrim.
UPDATES:
Gonaive: 10 more cases discovered
Mirebalais: 50 cases discovered in a prison
Arachaie: 5 more cases
Carrefour & Croix des Bouquets: unknown number of cases, but officially acknowledged
Although officials believe no transmission has occurred in Port au Prince, there are too many reports indicating suspect cases inside the city to know this definitively.
We raise the question about the medical capacity situation in Gonaive and Mirebalais.
Lack of acknowledgement by both media and officials of the situation in Lafito noted. The question of introduction to " Camp Obama" and Cite Soleil is once again raised.
All samples to the best of our knowledge have tested negative from Leogane and Nippes Department in the Southern Peninsula
Serious concern about loss of containment noted.
Significant social anxiety and some isolated reports of unrest related to access to safe drinking water in the St Marc region.
LAFITO/LAFITEAU: A NEW FOCUS OF TRANSMISSION?
The HEAS community of partners has highlighted several times now a steady trickle of suspect cases with three fatalities reported in Lafito / Lafiteau, which remains of strategic response importance given proximity to the IDP settlement known as "Camp Obama" and Cite Soleil.
We urge immediate investigation of this site by the Health and WASH Clusters given the implications for futher introductions of cases to Port au Prince. Official public health reporting to-date has emphasized Arachaie, which is closer to St Marc, however it has been apparent that Lafito is also an important site to monitor.
UPDATE & CORRECTION: ANTIBIOTIC RESISTANCE PROFILE OF THE 01 CHOLERA STRAIN IN HAITI
Thanks to Haitian officials' rapid response to our query, the National Laboratory (LNSP) and CDC have officially confirmed the strain is NOT resistant to doxycycline. It is sensitive to doxycycline, cipro, and tetracycline but resistant to ampicillian and bactrim.
BIOSURVEILLANCE UPDATE - 4
OPERATIONAL BIOSURVEILLANCE
HELPFUL COMMENTS FROM WHO REGARDING IMPROVED PREPAREDNESS FOR CHOLERA FROM "WHO"
USEFUL COMMENTS FOR IMPROVED PREPAREDNESS
Training of health workers is an essential element for preparedness, especially in high-risk areas. Emergency supply needs should be evaluated in the light of the particular situation:
– likely attack rate in refugee camps, with high-risk populations (because of malnutrition), is 5-8%;
– in open settings, an attack rate of 0.2% might be used;
– in rural communities of 5000 people or less, the attack rate might reach 2%.
Emergency stocks of basic supplies should be prepared so that they can be mobilized quickly.
**** ANTIBIOTIC RESISTANCE PROFILE OF CHOLERA IN HAITI ***
We have an unconfirmed rumor of the cholera strain in circulation being doxycycline-resistant and cipro/cotrimoxizole sensitive. The entire response grid would find this information crucial. We have sent queries to obtain confirmation.
HELPFUL COMMENTS FROM WHO REGARDING IMPROVED PREPAREDNESS FOR CHOLERA FROM "WHO"
USEFUL COMMENTS FOR IMPROVED PREPAREDNESS
Training of health workers is an essential element for preparedness, especially in high-risk areas. Emergency supply needs should be evaluated in the light of the particular situation:
– likely attack rate in refugee camps, with high-risk populations (because of malnutrition), is 5-8%;
– in open settings, an attack rate of 0.2% might be used;
– in rural communities of 5000 people or less, the attack rate might reach 2%.
Emergency stocks of basic supplies should be prepared so that they can be mobilized quickly.
**** ANTIBIOTIC RESISTANCE PROFILE OF CHOLERA IN HAITI ***
We have an unconfirmed rumor of the cholera strain in circulation being doxycycline-resistant and cipro/cotrimoxizole sensitive. The entire response grid would find this information crucial. We have sent queries to obtain confirmation.
Sunday, October 24, 2010
ARTICLE - STRUGGLE TO CONTAIN CHOLERA
HAITI STRUGGLES TO CONTAIN CHOLERA OUTBREAK AS DISEASE CREEPS TOWARD CAPITAL
(The Toronto Star) - By Jennifer Wells
PORT-AU-PRINCE—The contradictions are inescapable.
Just as Haiti’s health officials prepared to present their update on the status of the country’s cholera epidemic Sunday – 253 dead, 3,015 hospitalized — a Jedco Services truck pulled up across the street to ream out the stinking port-a-potties that line the Champs de Mars displacement camp.
Champs de Mars remains a petri dish of seething, seeping unsanitary conditions. Are there wash stations by the toilets? No. How about dispensers of hand sanitizer? None that I could see. Do women use these in the middle of the night? I question whether they would feel safe. Is feces tossed into the gutter into the morning? Yes.
Hours after the government’s news conference, which addressed again the need for hand washing and careful attention to sanitation, I walked about the Champs de Mars and saw no evidence of outreach. What I did see was the same lineup of guys who, for 15 gourdes (about 30 cents), will peel back the pieces of carpet and bedding that protect the huge blocks of ice they’ve brought in from God knows where and chip off a chunk with their ice picks.
The kids will suck on a break-off piece as they carry the ice home to mom to melt for cooking.
Earlier in the day, on the other side of the road, Gabriel Thimothe, director of Haiti’s health ministry, and Claude Surena, president of the Haitian Medical Association, presented themselves before the local and international media and spoke of statistics (the vast majority of confirmed cases lie to the north of Port-au-Prince with, as we’ve said before, Grande Saline fingered as the epidemic’s birthplace).
“Stay calm,” said Thimothe. “It may stay for a time . . . The ministry has control of the situation.”
The ministry has control? Why does that not ring terribly true?
Perhaps because once again there’s that feeling of jack rabbit involvement by myriad health organizations and NGOs and, yet again, a lack of overarching co-ordination.
The Red Cross is organizing a cholera centre. UNICEF is involved in water treatment. The Haitian government, Surena said in an interview after the news conference, is “ready to install cholera facilities outside of Port-au-Prince.” As many as five are in the works.
The talk of the cholera cases in Port-au-Prince proper was verboten, as if a plague had been cast on ministry officials, who, at a guess, are terrified.
By Wednesday, Thursday at the latest, there should be a cholera isolation centre in Saint-Marc in the Artibonite region, where St. Nicolas Hospital has attempted to absorb the majority of sufferers who have sought help.
On Sunday officials stated that of the 3,015 cases confirmed, 2,774 came from Artibonite, north of the capital. St. Nicolas crashed under the weight of newly arrived patients. For a week, the ill and the healthy have intermingled with the hospital’s existing patients.
Late Sunday, UN deputy special representative Nigel Fisher said there were unconfirmed reports of cases in the city of Cap-Haïtien, on the island’s north coast.
“We must assume it will spread,” says Fisher. “We must be prepared for that.”
For all that, he raised a note of optimism. “It does seem the initial response has worked well,” he said in an interview Sunday evening, noting a decline in the death rate in percentage terms.
All eyes are on Port-au-Prince, where reports of five more unconfirmed cases bubbled — or tweeted — to the surface Sunday night.
Where this takes the country is into the great unknown.
David Sack, an eminent Johns Hopkins University cholera expert, probes the base science aspects of the outbreak. Has the source of the outbreak been traced to an estuary where a freshwater river meets a saltwater host, he wants to know.
“Cholera enjoys a little bit of salt,” says Sack on the phone from Baltimore.
Yes, as it happens, the waters where the Artibonite River meet the ocean at Grande Saline is the spot where many of the cholera patients interviewed by the Star said they had commenced their journey to seek medical help. More than 25,000 villagers have no access to latrines. “It likes to grow in brackish waters,” says Sack.
At Sunday’s news conference, reporters were told that the bodies of dead cholera victims had been dumped into the Artibonite in the Grande Saline area.
Still, the outcome is unknown and unpredictable. “There’s a lot we don’t understand about cholera,” Sack says. “In the past we’ve said the outbreaks will typically be over in a few weeks or a couple of months.”
Sack’s research has focused on Bangladesh, where the Ganges River (fresh water) meets the Bay of Bengal (salt).
“I have been in other camp situations in Bangladesh during the rainy season,” he says. “Basically you were walking in feces. Strangely enough, and I don’t know why, it didn’t develop into an epidemic.”
“But then there was Zimbabwe,” Sack continues. “It went on for a year. It was a horrible situation.”
What lies in store for Haiti?
“The big concern for Haiti,” says Sack, “is that once cholera is established it can persist in the environment basically forever.”
The shorter term outcome for Haiti is being measured case by case.
(The Toronto Star) - By Jennifer Wells
PORT-AU-PRINCE—The contradictions are inescapable.
Just as Haiti’s health officials prepared to present their update on the status of the country’s cholera epidemic Sunday – 253 dead, 3,015 hospitalized — a Jedco Services truck pulled up across the street to ream out the stinking port-a-potties that line the Champs de Mars displacement camp.
Champs de Mars remains a petri dish of seething, seeping unsanitary conditions. Are there wash stations by the toilets? No. How about dispensers of hand sanitizer? None that I could see. Do women use these in the middle of the night? I question whether they would feel safe. Is feces tossed into the gutter into the morning? Yes.
Hours after the government’s news conference, which addressed again the need for hand washing and careful attention to sanitation, I walked about the Champs de Mars and saw no evidence of outreach. What I did see was the same lineup of guys who, for 15 gourdes (about 30 cents), will peel back the pieces of carpet and bedding that protect the huge blocks of ice they’ve brought in from God knows where and chip off a chunk with their ice picks.
The kids will suck on a break-off piece as they carry the ice home to mom to melt for cooking.
Earlier in the day, on the other side of the road, Gabriel Thimothe, director of Haiti’s health ministry, and Claude Surena, president of the Haitian Medical Association, presented themselves before the local and international media and spoke of statistics (the vast majority of confirmed cases lie to the north of Port-au-Prince with, as we’ve said before, Grande Saline fingered as the epidemic’s birthplace).
“Stay calm,” said Thimothe. “It may stay for a time . . . The ministry has control of the situation.”
The ministry has control? Why does that not ring terribly true?
Perhaps because once again there’s that feeling of jack rabbit involvement by myriad health organizations and NGOs and, yet again, a lack of overarching co-ordination.
The Red Cross is organizing a cholera centre. UNICEF is involved in water treatment. The Haitian government, Surena said in an interview after the news conference, is “ready to install cholera facilities outside of Port-au-Prince.” As many as five are in the works.
The talk of the cholera cases in Port-au-Prince proper was verboten, as if a plague had been cast on ministry officials, who, at a guess, are terrified.
By Wednesday, Thursday at the latest, there should be a cholera isolation centre in Saint-Marc in the Artibonite region, where St. Nicolas Hospital has attempted to absorb the majority of sufferers who have sought help.
On Sunday officials stated that of the 3,015 cases confirmed, 2,774 came from Artibonite, north of the capital. St. Nicolas crashed under the weight of newly arrived patients. For a week, the ill and the healthy have intermingled with the hospital’s existing patients.
Late Sunday, UN deputy special representative Nigel Fisher said there were unconfirmed reports of cases in the city of Cap-Haïtien, on the island’s north coast.
“We must assume it will spread,” says Fisher. “We must be prepared for that.”
For all that, he raised a note of optimism. “It does seem the initial response has worked well,” he said in an interview Sunday evening, noting a decline in the death rate in percentage terms.
All eyes are on Port-au-Prince, where reports of five more unconfirmed cases bubbled — or tweeted — to the surface Sunday night.
Where this takes the country is into the great unknown.
David Sack, an eminent Johns Hopkins University cholera expert, probes the base science aspects of the outbreak. Has the source of the outbreak been traced to an estuary where a freshwater river meets a saltwater host, he wants to know.
“Cholera enjoys a little bit of salt,” says Sack on the phone from Baltimore.
Yes, as it happens, the waters where the Artibonite River meet the ocean at Grande Saline is the spot where many of the cholera patients interviewed by the Star said they had commenced their journey to seek medical help. More than 25,000 villagers have no access to latrines. “It likes to grow in brackish waters,” says Sack.
At Sunday’s news conference, reporters were told that the bodies of dead cholera victims had been dumped into the Artibonite in the Grande Saline area.
Still, the outcome is unknown and unpredictable. “There’s a lot we don’t understand about cholera,” Sack says. “In the past we’ve said the outbreaks will typically be over in a few weeks or a couple of months.”
Sack’s research has focused on Bangladesh, where the Ganges River (fresh water) meets the Bay of Bengal (salt).
“I have been in other camp situations in Bangladesh during the rainy season,” he says. “Basically you were walking in feces. Strangely enough, and I don’t know why, it didn’t develop into an epidemic.”
“But then there was Zimbabwe,” Sack continues. “It went on for a year. It was a horrible situation.”
What lies in store for Haiti?
“The big concern for Haiti,” says Sack, “is that once cholera is established it can persist in the environment basically forever.”
The shorter term outcome for Haiti is being measured case by case.
ARTICLE - HAITI ON PRECIPICE
HAITI ON PRECIPICE OF CHOLERA DISASTER
(The Toronto Star) - By Jennifer Wells
Saint Marc, Haiti - “Yes, I have confirmed that today,” says Claude Surena, conveying the grimmest possible news. “There are five cases confirmed in Port-au-Prince.”
Over the course of a very long day Saturday Surena, president of the Haitian Medical Association, had repeatedly asked for more time in answering the question everyone wanted answered: has the cholera epidemic breached the Artibonite region, moving south of Saint-Marc and into Haiti’s overcrowded, often fetid and tent-cluttered capital?
By Saturday night there was no other answer.
“Be careful, be careful,” has become a watch phrase. Drink only bottled water. SMS messages are being sent by the Red Cross through cellphone providers Voila and Digicel on how to identify “kolera” (grey diarrhea, vomiting) and how to prevent against its spread (bottled water, hand washing). Do not panic is the main message. Followed by get yourself to a clinic within four hours should you experience the signature symptoms.
The Red Cross has started training volunteers to go into Port-au-Prince’s displacement camps, where, reminds Red Cross communications adviser Sophie Chavanel, the people are most vulnerable. Prevention protocols will be conveyed. Soap disbursement is being considered. The volunteers should be at work in the camps as early as Monday.
At St. Nicolas Hospital, 45 kilometres north of the capital in Saint-Marc, volunteers and medical workers — a documentary team from CBS just landed — step past an incongruous scene of hot dog vendors and sugar cane sellers and men shaving ice into cups for the much-loved fruit-flavoured frescoes, seemingly oblivious to the fact that any water not in a bottle named Evian or similar is being looked upon with horror in Port-au-Prince.
At the threshold of the hospital chunks of foam have been soaked with bleach, and it is into this that one must walk to enter the hospital courtyard.
It takes only seconds to lay eyes again on 14-year-old Magdela Felix. I saw her lying more or less in the same spot on Friday. On Saturday she lies supine on a canvas cot, no longer on the unforgiving brick of the hospital grounds where she first arrived.
Magdela’s father, Marius, had to return to the tending of his fields in the Artibonite in order to feed his family. So Magdela has been left in the care of Meyciu Alcius. Meyciu arrived at the hospital last night with her 6-year-old son, Bien-Aimé.
News of the outbreak travelled quickly and Meyciu moved with haste from her village of Gobèg. What is heartbreaking, in observing the little boy tied to an IV, is that he lies in such a clean, starched pressed shirt and you know that Meyciu was thinking, “We’re going to town. We must dress appropriately.”
Meyciu has never known a cholera outbreak in her lifetime.
“Most Haitians have no familiarity with prevention or treatment,” says the Red Cross’s Chavanel.
The Red Cross has trucked in 31,000 litres of good water to Saint-Marc over 48 hours. They are at the ready. Emergency responders are poised in Canada for more bad news.
Chavanel leads to way to a depot of sorts where the Red Cross has trucked in the water. As she walks she knocks back a soccer ball that has come her way, kicked by a barefoot player on a rocky road. Saint-Marc on its surface seems all but oblivious to the disaster.
By late Saturday afternoon the death toll in Haiti’s cholera epidemic had reached 208. The number of reported cases had surpassed 2,600. The doctor with the CBS crew surveyed the grounds of St. Nicolas and remarked that, given the odds, the march of this is unstoppable.
For now, the medical authorities are offering comforting assurances that the cases in Port-au-Prince were villagers arrived from the Artibonite. There are no source cases in Port-au-Prince — or none yet reported.
In a Saint-Marc news conference Saturday, Dieula Louissaint, the director of health for the Artibonite region, itemized contributions from the international community (UNICEF is helping in the treatment of water), and media dissemination of information (Partners in Health, a longtime co-partner of St. Nicolas Hospital, is supporting financially the radio and television information onslaught to wash fruit and wash hands).
Dispose of trash responsibly was one message. Do not wait too long to see a doctor was another.
The origin of the epidemic has been pinpointed at Grande Saline, the coastal city north of Saint-Marc where the Artibonite River meets the coast. The Artibonite River is contaminated, Louissaint informed the press, perhaps not realizing that this was apparent 24 hours before.
Most Grand Saline residents drink from the Artibonite River. And as they grow sick, they travel south to the capital, where the displaced of Jan. 12, when the earthquake shook Haiti and the world, lie in wait.
(The Toronto Star) - By Jennifer Wells
Saint Marc, Haiti - “Yes, I have confirmed that today,” says Claude Surena, conveying the grimmest possible news. “There are five cases confirmed in Port-au-Prince.”
Over the course of a very long day Saturday Surena, president of the Haitian Medical Association, had repeatedly asked for more time in answering the question everyone wanted answered: has the cholera epidemic breached the Artibonite region, moving south of Saint-Marc and into Haiti’s overcrowded, often fetid and tent-cluttered capital?
By Saturday night there was no other answer.
“Be careful, be careful,” has become a watch phrase. Drink only bottled water. SMS messages are being sent by the Red Cross through cellphone providers Voila and Digicel on how to identify “kolera” (grey diarrhea, vomiting) and how to prevent against its spread (bottled water, hand washing). Do not panic is the main message. Followed by get yourself to a clinic within four hours should you experience the signature symptoms.
The Red Cross has started training volunteers to go into Port-au-Prince’s displacement camps, where, reminds Red Cross communications adviser Sophie Chavanel, the people are most vulnerable. Prevention protocols will be conveyed. Soap disbursement is being considered. The volunteers should be at work in the camps as early as Monday.
At St. Nicolas Hospital, 45 kilometres north of the capital in Saint-Marc, volunteers and medical workers — a documentary team from CBS just landed — step past an incongruous scene of hot dog vendors and sugar cane sellers and men shaving ice into cups for the much-loved fruit-flavoured frescoes, seemingly oblivious to the fact that any water not in a bottle named Evian or similar is being looked upon with horror in Port-au-Prince.
At the threshold of the hospital chunks of foam have been soaked with bleach, and it is into this that one must walk to enter the hospital courtyard.
It takes only seconds to lay eyes again on 14-year-old Magdela Felix. I saw her lying more or less in the same spot on Friday. On Saturday she lies supine on a canvas cot, no longer on the unforgiving brick of the hospital grounds where she first arrived.
Magdela’s father, Marius, had to return to the tending of his fields in the Artibonite in order to feed his family. So Magdela has been left in the care of Meyciu Alcius. Meyciu arrived at the hospital last night with her 6-year-old son, Bien-Aimé.
News of the outbreak travelled quickly and Meyciu moved with haste from her village of Gobèg. What is heartbreaking, in observing the little boy tied to an IV, is that he lies in such a clean, starched pressed shirt and you know that Meyciu was thinking, “We’re going to town. We must dress appropriately.”
Meyciu has never known a cholera outbreak in her lifetime.
“Most Haitians have no familiarity with prevention or treatment,” says the Red Cross’s Chavanel.
The Red Cross has trucked in 31,000 litres of good water to Saint-Marc over 48 hours. They are at the ready. Emergency responders are poised in Canada for more bad news.
Chavanel leads to way to a depot of sorts where the Red Cross has trucked in the water. As she walks she knocks back a soccer ball that has come her way, kicked by a barefoot player on a rocky road. Saint-Marc on its surface seems all but oblivious to the disaster.
By late Saturday afternoon the death toll in Haiti’s cholera epidemic had reached 208. The number of reported cases had surpassed 2,600. The doctor with the CBS crew surveyed the grounds of St. Nicolas and remarked that, given the odds, the march of this is unstoppable.
For now, the medical authorities are offering comforting assurances that the cases in Port-au-Prince were villagers arrived from the Artibonite. There are no source cases in Port-au-Prince — or none yet reported.
In a Saint-Marc news conference Saturday, Dieula Louissaint, the director of health for the Artibonite region, itemized contributions from the international community (UNICEF is helping in the treatment of water), and media dissemination of information (Partners in Health, a longtime co-partner of St. Nicolas Hospital, is supporting financially the radio and television information onslaught to wash fruit and wash hands).
Dispose of trash responsibly was one message. Do not wait too long to see a doctor was another.
The origin of the epidemic has been pinpointed at Grande Saline, the coastal city north of Saint-Marc where the Artibonite River meets the coast. The Artibonite River is contaminated, Louissaint informed the press, perhaps not realizing that this was apparent 24 hours before.
Most Grand Saline residents drink from the Artibonite River. And as they grow sick, they travel south to the capital, where the displaced of Jan. 12, when the earthquake shook Haiti and the world, lie in wait.
ARTICLE - HELP FROM CANADA
HAITI GETS CANADIAN HELP AFTER CHOLERA OUTBREAK
(The Vancouver Sun) - By Peter O'Neil
MONTREUX, Switzerland - Canada and the French-speaking nations of the world will never abandon their responsibility to help Haiti rebuild after its devastating earthquake, Prime Minister Stephen Harper said Saturday in his opening speech at the Francophonie summit in Switzerland.
He also announced as much as $1 million in additional aid to combat the outbreak of cholera in rural Haiti that has caused 140 deaths and sent more than 1,500 to hospital.
``The reconstruction will take time,'' Harper told leaders and representatives of the 56 members and 14 observer nations of the alliance of primarily French-speaking countries.
``But by sticking together we can help our Haitian friends rediscover hope, to help them reconstruct their villages and rebuild their lives.
``And I believe I speak for our organization (in saying) `Your friends in the Francophonie will never let you down.' ''
The new assistance will go to the rural Artibonite region, where the cholera outbreak began this week.
``Canada is concerned by the loss of life and the risk of this serious medical crisis spreading into further communities,'' Harper said in a statement.
``Canada will continue to respond to the needs of the people of Haiti, who are experiencing tremendous hardships in the aftermath of the earthquake that took place earlier this year.''
The release said the Canadian government has already committed more than $1 billion over the 2006-12 period to Haiti. The Canadian International Development Agency website says $770 million has been pledged since the earthquake in January, which killed nearly 300,000 people.
The new emergency aid will ``respond to this outbreak and prevent further water-borne disease,'' according to a news release.
Quebec Premier Jean Charest also spoke on the subject of solidarity with Haiti, but focused his speech on the need to promote and protect the French language.
``We Quebecers are the first line in the defence of the French language,'' he said, adding that the Francophonie is the only global institution that can protect the language.
He didn't mention his proposal to host a gathering of French-speaking nations in 2012 to focus solely language issues. It will be considered at the summit Sunday.
French President Nicolas Sarkozy barely touched the Haiti issue, instead focusing forcefully on his proposals to reform the global financial system and reform the United Nations Security Council to include permanent members from regions such as Africa and South America.
Amnesty International, meanwhile, issued a statement saying La Francophonie has failed to follow up on commitments made a decade ago by French-speaking African countries to end armed conflicts.
(The Vancouver Sun) - By Peter O'Neil
MONTREUX, Switzerland - Canada and the French-speaking nations of the world will never abandon their responsibility to help Haiti rebuild after its devastating earthquake, Prime Minister Stephen Harper said Saturday in his opening speech at the Francophonie summit in Switzerland.
He also announced as much as $1 million in additional aid to combat the outbreak of cholera in rural Haiti that has caused 140 deaths and sent more than 1,500 to hospital.
``The reconstruction will take time,'' Harper told leaders and representatives of the 56 members and 14 observer nations of the alliance of primarily French-speaking countries.
``But by sticking together we can help our Haitian friends rediscover hope, to help them reconstruct their villages and rebuild their lives.
``And I believe I speak for our organization (in saying) `Your friends in the Francophonie will never let you down.' ''
The new assistance will go to the rural Artibonite region, where the cholera outbreak began this week.
``Canada is concerned by the loss of life and the risk of this serious medical crisis spreading into further communities,'' Harper said in a statement.
``Canada will continue to respond to the needs of the people of Haiti, who are experiencing tremendous hardships in the aftermath of the earthquake that took place earlier this year.''
The release said the Canadian government has already committed more than $1 billion over the 2006-12 period to Haiti. The Canadian International Development Agency website says $770 million has been pledged since the earthquake in January, which killed nearly 300,000 people.
The new emergency aid will ``respond to this outbreak and prevent further water-borne disease,'' according to a news release.
Quebec Premier Jean Charest also spoke on the subject of solidarity with Haiti, but focused his speech on the need to promote and protect the French language.
``We Quebecers are the first line in the defence of the French language,'' he said, adding that the Francophonie is the only global institution that can protect the language.
He didn't mention his proposal to host a gathering of French-speaking nations in 2012 to focus solely language issues. It will be considered at the summit Sunday.
French President Nicolas Sarkozy barely touched the Haiti issue, instead focusing forcefully on his proposals to reform the global financial system and reform the United Nations Security Council to include permanent members from regions such as Africa and South America.
Amnesty International, meanwhile, issued a statement saying La Francophonie has failed to follow up on commitments made a decade ago by French-speaking African countries to end armed conflicts.
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