ARTICLE - FIGHTING THE RISE IN CHOLERA CASES

FIGHTING THE RISE IN CHOLERA CASES IN HAITI
(AlerteNet) - Source WHO

There was a rise in the number of cholera cases reported in May and early June, particularly around Port-au-Prince and in the southern peninsula (Grand Anse, Nippes, Sud and Sud-Est) as well as in Artibonite and Nord. This increase may be due in part to the beginning of the rainy season and the flooding that hit the capital. Between 2 May and 12 June, 18 182 new cases were notified in Port-au-Prince, where 90% of the 2300 beds in cholera treatment facilities were occupied. As of 21 June, the occupancy rate had dropped to 72%.

On 12 June, the Ministry of Public Health (MoPH) reported 344 623 cases of cholera and 5397 related deaths (average case fatality rate 1.6%) since the beginning of the outbreak in October 2010.

Poor access to clean water and proper sanitation remains the main challenge in fighting the epidemic. Water-trucking is now down to 20% of what it was after the earthquake. According to the Water and Sanitation Cluster, about a third of the NGOs supporting camps in Port-au-Prince will be closing down their water-trucking and sewage removal activities over the next few months because funds are running out. Lack of sanitation facilities and the maintenance of existing latrines remain critical problems in the camps. WHO/PAHO supports all cholera treatment facilities to ensure safe water is available for patients and sanitation measures are respected.

According to Health Cluster partners, as of 14 June there were 38 cholera treatment centres and 216 cholera treatment units functioning in Haiti. Most of the facilities are financed by NGOs. While support continues in Port-au-Prince, many NGOs are scaling down operations in rural areas and transferring responsibilities to the MoPH, which does not have sufficient funds to cover health personnel.

WHO/PAHO is asking partners to consider keeping staff and facilities in place, and international donors to continue their support for these activities. WHO/PAHO supports the MoPH to keep some facilities operational.

Approximately 60 NGOs are working within the Health Cluster to respond to the cholera outbreak.

Transportation of patients is a challenge, especially severe cases from rural areas requiring rapid referral to a medical facility. WHO/PAHO, the French Red Cross, the MOPH, the Haitian Red Cross, and the NGO Alliance for International Medical Action (ALIMA) have established a network of 11 vehicles for referral and dedicated another two vehicles and trained teams for the management of dead bodies.

The central pharmacy warehouse run by the MoPH and WHO/PAHO has in-stock medication to treat over 350 000 cholera cases (37 000 severe cases and 313 000 mild cases).

The Dominican Republic has also experienced an increase in cholera cases over the past month. These cases coincide with the rainy season and rising temperatures. On 12 June, the Ministry of Public Health (MoPH) reported 1727 confirmed cases (191 in 2010 and 1536 in 2011) and 46 related deaths since the beginning of the outbreak at the end of 2010. The MoPH continues to work on improving water quality and sanitation services and educating the public on prevention.

The Health Cluster requested US$ 135.6 million from international donors to support the Consolidated Appeal (which includes cholera-related activities) in Haiti, of which US$ 40.1 million were requested by WHO. As of 1 June, it had received US$ 48 million or 35% of the money requested. WHO's activities have been funded at 49%.