Haiti’s first cholera outbreak in a century has killed at least 253 people and infected more than 3,000 with the acute diarrheal disease, overwhelming some clinics and causing the country’s worst public health crisis since January’s earthquake. The Haitian Ministry of Health said tests had confirmed the disease outbreak is cholera, while United Nations officials say the Artibonite River is the suspected source, as most of the cases have occurred in an area in the interior of Haiti along the river, north and northwest of Port-au-Prince. The town of St Marc has been severely affected. Cholera symptoms include a sudden onset of profuse extremely watery diarrhea and occasionally vomiting.
Some Haitians have died within three or four hours of exhibiting symptoms, and children seem to be especially vulnerable. Death from cholera is usually a result of acidosis, circulatory collapse, and renal failure, all brought about by rapid and severe dehydration. A person can lose as much as 9 liters of water per day via diarrhea. Just one victim of cholera can excrete enough pathogens to infect hundreds of others particularly if the excrement finds its way (directly or indirectly) into water supplies and/or food.
There are no effective antibiotics to treat this disease. It is imperative that a cholera victim berehydrated either orally or intravenously. Oral rehydration entails the ingestion of large quantities of water containing essential salts to replace those lost in the diarrhea. With proper rehydration cholera victims recover completely.
The Red Cross network has launched a rapid and coordinated response by putting personnel on the ground in the affected area, trucking in urgently needed medical supplies and water, and broadcasting emergency messages about cholera prevention via radio and text messaging.
Beginning last Wednesday, October 20, Red Cross officials sent a truck loaded with medical supplies including IV fluids, oral serum, antibiotics, first aid kits and water filters to a hospital in St. Marc that is handling many of the cholera cases. Two days later, two more trucks departed Port-au-Prince carrying 24,000 liters of clean water, drums of chlorine, cholera kits, surgical masks and gloves, as well as large tents and sleeping mats to increase the hospital’s capacity. Dozens of Red Cross health and water/sanitation experts are standing by to assist as needed, and about 340 Red Cross health promoters trained to educate the population about health and hygiene are being mobilized in and around the cholera-affected areas.
On Saturday, October 23, the Red Cross network sent several more trucks to the affected area with two water treatment units capable of treating enough water to supply 6,000 people per day, 8,000 water purification tablets, water bladders, 200 disinfectant sprayers, drums of chlorine, three large tents to support the hospital in St Marc, and hygiene promotion material including 3,000 hygiene kits.
The American Red Cross, which has been running the largest health promotion effort in the camps of Port-au-Prince for several months, has offered support by making health and water/sanitation experts available. The organization has provided large quantities of chlorine to support water treatment operations so clean water can be supplied to the affected areas for drinking as well as cleaning purposes. Chlorination is the most cost effective and reliable method of killing this pathogen in drinking water. In the coming days, health promotion teams will focus their efforts on tent-by-tent discussions with camp residents about cholera.
(Fred Reiff, P.E., is a former official of the Pan American Health Organization/World Health Organization and a member of the Water Quality & Health Council.)