1.c. case study haiti cholera

location

located in the Caribbean sea sharing the island of Hispaniola with the dominncan republic. southeast of cuba and west of puerto rico. 12 mil population. cholera= infectious disease of small intestine caused by waterborne bacteria. transmission typically occurs through water contaminated by infected faeces, drinking this water or eating food that has had contact= extreme diarrhoea and vomiting= life threatenig dehydration

overview

prior to 2010 earthquake- not greatly developed being 145th out of 169 countries in UN human development index- lowest in western hemisphere. more than 70% of population were living on less than $2 per day amounts with 86% of people in Port au Prince living in slum conditions- tightly packed, poorly built and concrete buildings and only ½ had access to toilets, only 1/3 had access to tap water. education was poor quality private schools for 80% with the state system generally providing better education yet too little places

impacts of the 7.0 magnitude earthquake that struck near Port au Prince: 3.5 mil people affected, 220,000 died, 300,000+ injured. 300,000 houses damaged/destroyed= 1.5 mil homeless. 60% of gov and administrative buildings damaged/destroyed. at peak 1.5 mil living in camps, some at critical risk from storms and flooding. resulted in cholera outbreak oct 2010- aid worker was infected

response and recovery from jan 2010 to july 2012- improving water suppl for 350,000 people. supplying drugs to 5 cholera treatment facilities serving 20,000 people. 40,000 provided with free medical care. improved shelter for 35,000

cholera background

the peacekeepers sent by the UN were directly responsible for bringing cholera to haiti when they were transferred from nepal to assist with ermergency rescue work after the 2010 earthquake. this tarnished the UNs reputation of peacekeeping. cholera cases quickly appeared in sept 2010 with many people living in extremely poor conditions such as makeshift shanty towns or temporary camps= limiting access to clean drinking water for 1000s. 10th nov senior health officials called the outbreak more than than a mere health emergency was now a matter of national security.

resurgence of cholera in oct 2022 after 3 years of no reported cases along with ongoing humanitarian crisis- gang violence, socio-political conflicts, insecurity, fuel shortages and economic instability. 13,000 cases between sept dec 2022, most affected age group 1-4 children and overall 59% of cases are male

geographical area’s influence on the risk and outbreak of disease

vulnerable due to: tropical climate of haiti being warm and wet supported the survival of the cholera bacteria and with rivers (artibonite river) having multiple purposes- drinking, cooking and waste, it meant the spread of the waterborne disease= rapid. plus the land used for agriculture on the flood plains of the river got contaminated as well as being low lying and flat. means no physical barriers to prevent the transmission within the village communities. overall land of haiti is very mountainous resulting in difficulties of building secure infrastructure such as medical facilities (could treat people) and sewage systems

after effects of the earthquake affecting the spread of disease- environmental

for 2010- high levels of internal migration. migrants often lived in temporary accomodation or stayed with extended family= overcrowding in poor quality places with many having insufficient water supplies and inadequate toilets. water and sewage pipes destroyed

E: Hurricane Tomas arrived 5th nov 2010= rapid flooding= overflowing toilets and further spreading of infected water. hurricane sandy dec 2012= serious resurgence of infection. late 2010 to early 2012= continual correlation between daily rainfall and daily suspected cholera cases reported. heavy rainfall increases the runoff and therefore contaminates more water sources

after effects of the earthquake affecting the spread of disease- human

political instability: may 2011 micheal martelly= president. couldnt form a gov and couldnt address massive challenges being faced by country. many medical and public health teams lack the necessary tools to be effective, including oral rehydration salts, IV fluids, antibiotics, vaccines, soap and ambulances. relimace on the artibonite river- rice growing, fishing and transportation. before earthquake: 17% had access to proper toilets- rivers used but also used for drinking, cooking and washing. lack of general awareness and ill equipped medical facilities. political crisis- parliament has ceased functioning= a void in governance. rise of armed hangs to power- take control of large parts of the capital and essential infrastructure. instability and major 2021 earthquake worsened poverty, food insecurity and conditions. without a stable strong gov= no consistent fair elections and no rule of law with few trials occurring and police struggling to control violence. estimated total value of recovery and reconstruction= $11.5 bil. high population density

impacts of the disease on resident populations- health

impacted vulnerable groups like under 5. 10,000+ deaths since 2010 mainly due to dehydration from the diarrhoea and vomiting. it placed pressure on the weak healthcare system with it becoming overwhelmed. many essential medical supplies such as oral rehydration salts, IV fluids and antibiotics shortages and with instability and gangs controlling urban areas this continued for 2022

impacts of the disease on resident populations- social

fear and disruption caused with schools and public spaces avoided. communities living in temporary camps and slum settlements= overcrowding and poor sanitation so disease easily spread. trust decreased in the UN after it was revealed that the peacekeeper introduced cholera in 2010. lack of attendance in already poor school affected children= lower literacy rates etc

impacts of the disease on resident populations- economic

reduced productivity and incomes by affecting employment. those infected couldnt work and vital industries like agriculture and fishing were contaminated by water sources/rivers. this increased poverty levels and therefore food security. those with healthcare available faced the costs economically and mentally for caring for sick family. nationally- repeated outbreaks slowed the economic recovery from the 2010 earthquakes, with focus moving from potential long term development to immediate emergency responses.

strategies used to minimise impacts- national and international scales- UN

try to redress some damge they ere trying to create $400m of resources over 3 years to invest in combatting the epidemic and the impact by introducing new sanitation and health treatment to reduce the incidence of disease. however there was a lack of finance leading to insufficient funding

strategies used to minimise impacts- national and international scales- USA

pledged $1.2 bil for the first 18 months of reconstruction. jan 2010 Obama assembled agencies to work on a coordinated response- Office of Foreign Disaster Assisstance= lead agency. money primarily for new activities, focused on urgent infrastructure repairs, especially in the energy and agricultural sectors, critical healthcare, governance and security

strategies used to minimise impacts- national and international scales- oxfam

provision of clean water, shelter and basic sanitation. provided paid employment in camps= clean, toilets built and clearing destroyed neighbourhoods. 300,000 people reached with aid in first 3 months for earthquake. provided clean drinking water and mobilised emergency specialists to double cholera response= more water, sanitation and hygiene programs- over 700,000 reached in Port au Prince, artibonite and cap haitien. creating initiatives to influence gov policies on agriculture, housing and climate change. supporting employment creation through small enterprise development

strategies used to minimise impacts- national and international scales- red cross

emergency response in 2022, providing water, sanitation, hygiene kits, ambulance support and community outreach. focused on setting up cholera treatment centres

strategies used to minimise impacts- national and international scales- haiti gov

‘international groups or personal efforts’, no support from own country’s gov. in the streets the govs efforts are barely visible. gov given the people nothing, no medical services or water with many sleeping on the ground for days. gov did nothing despite knowing the country sits on a fault in the earth. poorly effective compared to those of international efforts and charities