By Binta Diallo, Global Health Issue Analyst

Eleven months after the earthquake hit Haiti, the country is now faced with its worst health challenge; cholera.  As of November first, the cholera outbreak in central Haiti had killed more than 250 people and infected more than 3,000 people.  Until the current outbreak, cholera has not been documented to be found in Haiti since the 1960s.  Due to the lack of familiarity with the disease, many people are said to be frightened by the news of the outbreak and unsure of what steps to take to avoid the disease.

For those of you unfamiliar with cholera here are some key details about the disease.  Cholera is an acute infection of the small intestine that causes a large amount of watery diarrhea and vomit.  It is caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae.  The diarrhea and vomiting leads to severe dehydration, and can become deadly within 24 hours if left untreated.  It is easily treated through rehydration and antibiotics however may be difficult in Haiti’s current poor sanitary conditions.

Although, it is very tempting to link the outbreak to the January earthquake, it is very uncertain as to where the outbreak came from.  Many experts including Dr. Brigitte Vasset from the international organization Medecins Sans Frontieres (MSF) in Paris are reluctant in linking the outbreak directly with the quake.  Sanitary conditions were poor in many parts of Haiti even before earthquake.  In addition, the Centers for Disease Control and Prevention (CDC) said that after the earthquake while cholera testing should have been carried out, the disease was “extremely unlikely to occur.”  Many health experts agree that for cholera to occur, bad sanitation and hygiene have to coincide with people carrying the Vibrio cholerae bacterium.

There are many other hypotheses of how the disease appeared in Haiti.  Adam Kamradt-Scott from the London School of Hygiene and Tropical Medicine believes that with more people and aid coming to Haiti since the earthquake, there is a possibility that the bacterium was brought to the country from the outside.  There was also some speculation that the epidemic came from bilge water and algae that was dumped by an Asian cargo ship, contaminating local shellfish.  It has also been suspected that the disease spread from Artibonite River while people used it for washing and drinking.

Although the spread of cholera appears to be contained, poor sanitary conditions make the camps and slums very vulnerable.  Currently the United Nations (UN) and other aid organizations are working to keeping the disease contained.  Imogen Wall, UN spokeswoman, said most of the efforts are being directed into setting up dedicated treatment centers and making sure people across Haiti were kept informed of the best ways to prevent the spread of the disease.  The UN’s Office of the Co-ordination of Humanitarian Affairs is managing the mass distribution of soap and other basic hygiene items, including bucket with lids to prevent clean water becoming contaminated, she said.

Informing civilians of this disease and providing preventative care is best first step that can be taken.  Although the UN has been working to inform and teach the general public, they remain concerned that areas outside of its post-earthquake emergency remit, including the slums of Port-au-Prince, are still vulnerable to infection.  Essentially, there is only so much that the UN can do on their own.

What can we, as informed students, do to help?  According to the World Health Organization, cholera is widespread and on the rise, with three to five million cases worldwide.  Each year more than 100,000 people die from the disease every year with the majority of cases in Sub-Saharan Africa.  Clearly, the problem resides in countries where poverty is the highest.  With global disease such as cholera, they are very difficult to measure due to the withholding of information that some countries do.  Some countries are reluctant to report cholera for fear of travel sanctions, says Mr. Kamradt-Scott.  How do we help offset a disease that is easily treated?  How do we help improve sanitary and water conditions?  These are very complex and difficult questions to answer; however, there are solutions to these problems.  Improving sanitation and water conditions is not something that occurs overnight.  It takes a lot of time, energy and contribution.  Will you develop informational pamphlets that may be given to civilians?  Will you donate water filters to families who are in dire need of clean water?  Will you join an organization that is working closely with sanitation and water improvement?  How will you contribute?

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