More than three weeks after Hurricane Matthew swept over southwestern Haiti, thousands of people are still severely affected, with inadequate shelter, food, and drinking water, while some remote communities remain cut off and inaccessible.
Teams from Doctors Without Borders/Médecins Sans Frontières (MSF) are seeing deteriorating health conditions among people in the heavily hurricane-affected departments of Sud, Grand’Anse and Nippes.
"Women, men, and children are in a very vulnerable position," said Chiara Burzio, MSF emergency medical coordinator. "We are particularly concerned about the heightened risk of infectious diseases, cholera, and a deteriorating nutritional status of children under five in the isolated areas affected by the hurricane."
There are signs of food scarcity: most of the crops are destroyed or flooded and the vast majority of the livestock is missing or dead. In Sud and Grand'Anse, MSF has started to monitor the nutritional status of children under five years old in its mobile clinics in order to provide treatment with ready-to-use therapeutic food if necessary.
"During our medical consultations, our patients tell us they don't know how to feed their families," said Emmanuel Massart, MSF project coordinator in Grand'Anse. "Families have lost livestock, fruit trees, and their entire personal reserves during the storm, and what is left is decaying because of the insufficient protection from the rain."
The category four hurricane destroyed many roofs in the southwest of the country, and the heavy rains further damaged the few houses that were still standing.
"Entire families have lost their homes," said Renate Sinke, MSF project coordinator in Nippes. "Their houses were totally destroyed. They are now living in temporary shacks or are sharing overcrowded spaces with other families."
Wells, water networks, and reservoirs have been damaged by the hurricane and subsequent flooding. MSF assessed six wells on the coastline from Port-à-Piment to Les Coteaux, three of which were contaminated by saltwater. In the valleys and mountains, water sources are sometimes mixed with unsafe river water or debris from landslides.
Remote villages were already hard to reach before the hurricane but are now nearly inaccessible. For example, the two roads leading to the Baradères district in Nippes department are currently cut off.
"People can't come to or leave the district," Sinke said. "Supplies cannot get into the villages. Trade cannot happen anymore."
People in some remote villages have been cut off from medical care since the hurricane. When an MSF team traveled to the mountainous village of Pourcine by helicopter this week, they treated 14 people with serious injuries. Such medical needs can have more serious consequences if untreated.
"If open wounds are not treated properly, the patient may go into sepsis," Massart said. "If there is no access to care, the patient will likely die."
As the cholera epidemic is unpredictable under the current conditions, it is crucial to monitor new cases, provide sufficient access to treatment centers and provide safe drinking water. While the number of patients in MSF's cholera treatment center (CTC) in Port-à-Piment decreased to six on Oct. 25, the neighboring town of Chardonnières reported 40 suspected cases.
MSF Activities to Date
In their emergency response to the hurricane and its aftermath, MSF teams have so far:
- Conducted medical consultations with more than 2,500 patients in 27 villages and communities. In Nippes, the most common diseases treated are diarrhea, gastrointestinal infections, urinary infections, and upper respiratory infections. In Sud and Grand'Anse, medical teams continue to treat many wounds.
- Referred 10 patients by helicopter to Port-au-Prince: nine to the MSF's Tabarre trauma center and one to the MSF center for severe burns.
- Distributed temporary shelter supplies to 1,400 families in Sud, set up two cholera treatment centers in Port-à-Piment and Baradères, and treated 229 patients with suspected cholera.
- Provided training, water and sanitation support to six cholera treatment centers in Grand'Anse and one cholera treatment center in Nippes.
- Distributed medical supplies and non-food items to two health centers and two cholera treatment centers in Artibonite.
- Assessed medical and water and sanitation needs in preparation for a response on Île de la Gonâve and other affected areas.