CHOLERA FACT SHEET #13

CHOLERA FACT SHEET #13, FISCAL YEAR (FY) 2011
(ReliefWeb) - Source: United States Agency for International Development (USAID)

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Note: The last fact sheet was dated December 29, 2010.

KEY DEVELOPMENTS

Between December 29 and 31, USAID/OFDA delivered 310,000 sachets of oral rehydration salts (ORS) and 10 metric tons (MT) of calcium hypochlorite (chlorine), bringing the USAID/OFDA-provided total to 2.3 million ORS sachets and 20 MT of chlorine, respectively.

USAID/OFDA also transported additional shipments of decontamination supplies and personal protective equipment, including sprayers, scrub brushes, aprons, gloves, and goggles, more than doubling the amount of USAID/OFDA-funded decontamination supplies in-country.

On December 29 and 30, USAID Disaster Assistance Team (USAID/DART) staff visited grantees International Medical Corps (IMC) and the Center for International Studies and Cooperation (CECI), which conduct cholera response and prevention activities in heavily-affected Artibonite Department. USAID/DART staff observed wellorganized treatment facilities following proper safety protocols.

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NUMBERS AT A GLANCE SOURCE
Overall Cholera Caseload - 157,321 MSPP1 – December 29, 2010
Hospitalized Cases - 87,639 MSPP – December 29, 2010
Deaths Due to Cholera - 3,481 MSPP – December 29, 2010
Overall Case Fatality Rate - 2 2.2 percent MSPP – December 29, 2010

HUMANITARIAN FUNDING PROVIDED TO DATE FOR CHOLERA
USAID/OFDA Assistance to Haiti for Cholera........................................................................................$39,453,463

USAID/OTI3 Assistance to Haiti for Cholera.............................$505,079

USAID/Haiti Assistance to Haiti for Cholera4 ........................................................................................$2,015,000

Total USAID Humanitarian Assistance to Haiti for Cholera...........................................................................$41,973,542

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 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 sachets of 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 30, the Health Cluster—the coordinating body for health activities—reported an increase in cholera cases in North Department and the MSPP reported high CFRs in Grand-Anse and Nippes departments, although CFRs remain stable or have decreased in recent days.

The USAID/DART is in contact with grantees Catholic Relief Services (CRS) and the International Organization for Migration (IOM), which are working in the departments, and
neither organization reported supply or treatment gaps to date in these areas.

 In Artibonite Department, IMC operates four USAID/OFDA-supported CTFs and will open three additional facilities in the coming days. On December 30, USAID/DART staff visited two IMC-operated CTFs in the department and observed adherence to standard cholera treatment protocols, including proper hygiene practices, disinfection of beds, and frequent cleaning. IMC provides patients with ORS sachets upon discharge, as well as instructions for handwashing.

IMC reported no security problems or commodity disruptions to date.

Water, Sanitation, and Hygiene (WASH)

 According to the Health Cluster, the GoH recently approved additional health promotion materials developed by the MSPP and PAHO. The materials include guides for community leaders regarding cholera prevention messages; posters on the importance and practice of hand-washing, as well as the need to use ORS quickly and seek help at health facilities rapidly; and a series of educational posters for distribution to patients upon leaving treatment facilities.

USAID/OFDA grantees are incorporating the newly-approved materials into ongoing messaging campaigns.

 During the assessment trip to Artibonite Department, USAID/DART staff noted that USAID/OFDA grantee CECI is providing hygiene training to approximately 550 women from 11 communes in La Chapelle municipality near Saint-Marc, Artibonite Department. CECI is coordinating the distribution of soap, water purification tablets, and ORS with a local women’s organization. Women who spoke with USAID/DART staff reported that as a result of training, they treat water not only for drinking, but also for cooking and hand-washing.