CHOLERA FACT SHEET #12

HAITI - CHOLERA FACT SHEET #12, FISCAL YEAR (FY) 2011
(ReliefWeb) - Source: United States Agency for International Development (USAID)

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KEY DEVELOPMENTS

The U.N. Office for the Coordination of Humanitarian Affairs (OCHA) notes that the overall decrease in recent weeks of the cholera case fatality rate (CFR) may be a result of the impact of the humanitarian response to the outbreak, but may also be due in part to underreporting of cases in rural areas.

The CFR is currently 2.1 percent countrywide and has declined by 0.2 percent since November 27. OCHA highlights that the CFR remains particularly high in Grand Anse Department.

USAID's Office of U.S. Foreign Disaster Assistance (USAID/OFDA) recently committed funding to grantee Catholic Relief Services (CRS) to provide health interventions in Grand Anse Department.

On December 29, USAID/OFDA also provided more than $400,000 to the Center for International Studies and Cooperation (CECI) to support WASH projects in Artibonite Department. USAID/OFDA funds will help reduce the vulnerability of approximately 250,000 people to cholera through the promotion of safe hygiene practices.

Map: Haiti: USAID Humanitarian Assistance for Cholera Outbreak (as of 29 Dec 2010)

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NUMBERS AT A GLANCE SOURCE:

Overall Cholera Caseload: 130,534 ................MSPP1 – December 18, 2010

Hospitalized Cases: 70,865 .................MSPP – December 18, 2010

Deaths Due to Cholera: 2,761...............MSPP – December 18, 2010

Overall Case Fatality Rate: 2.1 percent MSPP – December 18, 2010

HUMANITARIAN FUNDING PROVIDED TO DATE FOR CHOLERA

USAID/OFDA Assistance to Haiti for Cholera.......................................................................$39,212,495

USAID/OTI2 Assistance to Haiti for Cholera............................................................................$505,079

USAID/Haiti Assistance to Haiti for Cholera3 .....................................................................$2,015,000

Total USAID Humanitarian Assistance to Haiti for Cholera.......................................................................$41,732,574

CONTEXT

 On October 22, U.S. Ambassador Kenneth H. Merten issued a disaster declaration due to the cholera outbreak. On October 26, USAID deployed a Disaster Assistance Response Team (DART) to work closely with staff from USAID/Haiti, USAID/OTI, and the U.S. Centers for Disease Control and Prevention (CDC) to coordinate emergency response efforts, provide technical assistance to the MSPP, and support longer-term health systems. USAID also stood up a Response Management Team in Washington, D.C., to support the USAID/DART in Haiti and coordinate with the USAID Haiti Task Team (HTT) in Washington, D.C.

 USAID/OFDA’s response plan focuses on preventing cholera cases, reducing the number of cases requiring hospitalization, and reducing the CFR. The plan outlines four elements: provision of chlorine to increase availability of safe drinking water; expansion of national hygiene education outreach; provision of oral rehydration salts (ORS) and medical supplies; and an increase in the number of cholera treatment facilities, particularly in underserved and rural areas.

 USAID/Haiti continues to work with the MSPP and Pan American Health Organization (PAHO) to plan and respond to the cholera outbreak. USAID/Haiti grantees are distributing educational materials, conducting hygiene trainings, and broadcasting prevention messages. In addition, USAID/Haiti grantees have procured and consigned commodities—including ORS, water purification materials, intravenous sets, Ringer’s lactate (an intravenous solution), and bleach—to USAID-supported health sites and other sites treating cholera cases.

 In response to the outbreak, USAID/OTI is conducting direct cholera prevention activities; all ongoing and new USAID/OTI activities responding to the earthquake now also include cholera prevention and education elements. An initiative launched in late December aims to improve public health by increasing the supply of affordable, safe, and clean water for Cité Soleil residents by providing cost-effective water purification systems to six existing water kiosks.

 In addition to ongoing work to strengthen and rebuild Haiti’s basic public health infrastructure, CDC is contributing scientific leadership and technical guidance in response to the outbreak in four key areas: treating patients in health facilities; preventing illness and deaths in communities; monitoring the spread of disease; and improving laboratory and diagnostic capacity. CDC currently has a total of 183 staff providing support to the MSPP cholera response.

A total of twelve staff members remain deployed specifically for the cholera response, including eight staff members in Haiti, two staff members in the Dominican Republic, one staff member in Washington, D.C., and one staff member in Miami, Florida. Among those involved in the cholera response are medical officers, epidemiologists, laboratory scientists, environmental health specialists, public health advisors, communication specialists, planners, information
technology specialists, and support staff.

 The MSPP’s approach to the cholera outbreak has focused on community-level primary response to provide rehydration, disinfect affected sites, and promote good health practices; cholera treatment facilities (CTFs) at health service sites where patients can receive oral rehydration and basic intravenous therapy; and CTFs dedicated to treatment of severe cases.

 The attached CTF Distribution for Haiti Cholera Outbreak Map identifies the approximate locations of Cholera Treatment Units and Cholera Treatment Centers based upon data received from the U.N. Health Cluster. The information presented in the map is representative of data reported thus far to the Health Cluster and may not reflect the total number of CTFs operational in Haiti.

Health

 On December 27, the Health Cluster—the coordinating body for health activities—announced a simplified procedure for non-governmental organizations (NGOs) not currently registered with the MSPP to obtain medical supplies from the Program on Essential Medicine and Supplies (PROMESS) warehouse, the GoH-and PAHO-managed warehouse and distribution system for medical commodities. NGOs can provide required information—including documentation from the NGO’s country of origin, proof of NGO status, and a project work plan—to receive immediate temporary authorization to operate in Haiti and request medical supplies from PROMESS.

 The Health Cluster reported 249 operational CTFs as of December 22. The updated figure represents a significant increase from December 13, when the Health Cluster reported a total of 183 CTFs. Several of the CTFs maintain operations 24 hours per day and can expand to accommodate additional patients, if necessary. USAID/OFDA is funding a total of 33 CTFs.

WASH

 According to OCHA, the number of cholera cases may be decreasing in urban areas, while the number of cases continues to increase in rural areas, where limited access to safe drinking water and more limited awareness of cholera and hygiene practices continue to present challenges.

 On December 22, the GoH National Direction for Potable Water and Sanitation (DINEPA) outlined its commune level procedure for distributing water purification tablets. The procedure involves two meetings per commune between GoH officials, local civil society groups, and relief agencies to determine areas of need, create a distribution plan, and train personnel on product use. DINEPA has distributed the equivalent of a one-month supply of water purification tablets to approximately 400,000 families.

 On December 23, USAID/OFDA grantee Action Contre la Faim (ACF) submitted results of a bacterial and chemical analysis of 31 wells in the Tabarre and Cité Soleil neighborhoods of Port-au-Prince. Results indicated that the majority contained potable water, with only two registering saline levels too high for drinking.

Logistics and Relief Commodities

 On December 28, USAID/OFDA transported 170,000 catheters to Haiti for use with the lactated Ringer’s intravenous solution that USAID/OFDA continues to deliver for treating severe dehydration associated with cholera.

 OCHA reports that health agencies continue planning for potential periods of unrest and that the Haitian population is also stocking supplies, including fuel, food, and water. PAHO staff recently met with the Joint Operations and Tasking Centre (JOTC)—a platform established by the U.N. Stabilization Mission in Haiti (MINUSTAH), OCHA, and others—to discuss arrangements for future security scenarios. Discussion topics included protection for warehouses and commodity transportation and distribution.

 From October 21 to December 20, the GoH-and PAHO-managed PROMESS warehouse distributed sufficient oral rehydration sachets and Ringer’s lactate intravenous solution to treat nearly 102,000 cholera cases. Additional stocks and supplies currently in Haiti or en route are sufficient to treat an additional 107,000 cases. USAID/OFDA recently consigned 100,000 liters of Ringer’s lactate solution to the warehouse, sufficient to treat 12,500 cases.

USAID HUMANITARIAN ASSISTANCE TO HAITI FOR CHOLERA - FY 2011
Grantee/ Activity/ Location/ Amount

USAID/OFDA ASSISTANCE1

ACF - WASH - Artibonite, Northwest Departments - $925,000

American Refugee Committee (ARC) - Health, WASH - West Department -$1,144,166

CRS - Health - Artibonite, Grand Anse, Nippes, North, Northwest, South, West Departments - $1,417,527

CDC - Health Affected Areas - $275,000

CECI - WASH - Artibonite - $400,096

Concern - WASH - Center, West Departments - $624,942

U.S. Department of Health and Human Services (HHS) - Logistics and Relief Commodities Affected Areas - $500,000

International Medical Corps (IMC) - Health, WASH - Artibonite, Center, North, Northeast, Northwest, South, Southeast, West Departments - $7,285,583

International Organization for Migration (IOM) - Health, Logistics and Relief Commodities - Artibonite, North, Northeast, Northwest, Southeast, West Departments - $4,600,000

IOM - Logistics and Relief Commodities - Affected Areas - $7,800,000

Management Sciences for Health (MSH) - Health - Affected Areas - $825,617

Mercy Corps - WASH - Center Department - $925,013

Partners in Health (PIH) - Health, WASH - Artibonite, Center, and West Departments -
$1,500,000

Samaritan's Purse - Health, Logistics and Relief Commodities, WASH - West Department -$2,869,431

Save the Children/U.S. (SC/US) - Health, WASH - West Department - $825,000

World Concern Development Organization (WCDO) - Health - West Department - 364,180

OCHA - Humanitarian Coordination and Information Management - Affected Areas -$1,000,000

U.N. World Health Organization (WHO)/PAHO - Health - Affected Areas - $635,580

Logistics and Relief Commodities - Affected Areas - $5,163,259

Administrative Costs - $132,101

TOTAL USAID/OFDA - $39,212,495

USAID/OTI ASSISTANCE
Implementing Partners - Health, Logistics and Relief Commodities, WASH - Affected Areas -$505,079

TOTAL USAID/OTI - $505,079

FY 2010
Program / Activity / Location / Amount

USAID/HAITI ASSISTANCE2

Community Health and AIDS Mitigation Project (CHAMP) - Community Health Services - Countrywide - $198,000

Leadership, Management, and Sustainability Program (LMS)- Logistics and Relief Commodities - Countrywide - $185,000

PROMARK - Health, Public Outreach - Countrywide - $232,000

Supply Chain Management System (SCMS) - Logistics and Relief Commodities -Countrywide - $600,000

Health for the Development and Stability of Haiti (SDSH)- Essential Health Services -Countrywide - $800,000

TOTAL USAID/HAITI - $2,015,000

TOTAL USAID HUMANITARIAN ASSISTANCE TO HAITI FOR CHOLERA $41,732,574

1 USAID/OFDA funding represents anticipated or actual obligated amounts as of December 29, 2010.

2 USAID/Haiti has pre-existing, long-term health programs that have been an integral part of the cholera response; these programs have also continued normal activities. The USAID/Haiti funding levels represent estimated amounts for one month of FY 2010 resources expended on the cholera response. The funding is based on an estimate of the program spending rate and percentage of resources expended on the cholera response.

Information on relief activities of the humanitarian community can be found at: http://www.reliefweb.int/

USAID/OFDA bulletins appear on the USAID web site at:
http://www.usaid.gov/our_work/humanitarian_assistance/disaster_assistance/