October 07, 2011

Haiti 2011 © Yann Libessart/MSF

An MSF cholera treatment center in Port-au-Prince this past May.

Though the international community is paying far less attention now that it did last year, cholera is still rife in Haiti and far from under control. In June, it ravaged several outlying parts of the country. Now, the disease has returned to the Haitian capital with a vengeance. According to figures from the Ministry of Public Health and Population, cholera had infected more than 446,000 people and killed approximately 6,300 people through the end of August.

Since the first cases were confirmed in October 2010, MSF has treated almost 160,000 patients in nine out of the ten departments in Haiti. At present, MSF teams are fighting cholera in Port-au-Prince, as well as in the departments of Artibonite, Nord and Ouest.

In its four cholera treatment centers (CTCs) in Port-au-Prince, MSF has observed a significant increase in the number of patients admitted of late. “In the space of a month, we have gone from fewer than 300 admissions a week to more than 850, which unfortunately suggests that the situation will worsen in the weeks to come,” says Gaétan Drossart, Head of Mission in Haiti.

One MSF CTC is in Martissant, which is among the most deprived areas in the capital. Driving along the main road leading towards it, one sees piles of trash and other detritus. Water from the leaking sewers floods several streets. It’s the kind of environment in which infectious diseases can spread very easily. “The hygiene conditions in the area are atrocious,” explains Nicolas Charret, the on-site project coordinator. “It is extremely densely populated with very little in the way of functional sanitary infrastructure, which facilitates the spread of cholera, especially when people drink contaminated water and [eat contaminated] food.”

The center has 90 beds and at present is treating more than 250 patients a week (its maximum capacity). Mathias Kennes, a nurse at the CTC, explains that, with cholera cases, it is essential to quickly determine the degree of dehydration suffered by the people admitted, because this is the cause of most deaths. Treatment is then adapted according to the observed severity of the case. “If the person is severely dehydrated, they need to be treated straight away, either intravenously or through a nasogastric tube,” he says. “With the correct treatment and intensive monitoring, patients, even those [who are] severely ill, usually recover in three or four days.”

In the tent housing convalescent patients, 19-year-old Amonly Jaquette talks to MSF staff. He says that he initially felt bloating in his stomach, which was quickly followed by diarrhea: “I knew right away that I was ill because it was really intense. I’d heard on the radio that if this happened, you had to do something. I knew that MSF were in Martissant. So I turned up and they took care of me immediately.”

After three days of treatment, Amonly is hoping to go home soon. However, before he leaves, he explains, he is going to try and take more appropriate hygiene measures, including getting hold of chlorinated water. But he also says that it will not be easy to maintain these standards, given the area’s lack of sanitary facilities, which are shared by most of the residents.

In Haiti, almost a year after the cholera outbreak began, resources for adequately preventing the disease remain rudimentary and at the mercy of the uncertainties of life in the country.
 

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