Case Study - Cholera in Haiti + NGO - Disease Dilemmas

Haiti Earthquake: Date, magnitude, death toll, aftershocks

• 12th January 2010

• 7.0

• 238,000

• 50+ aftershocks

Geographical area covered by the disaster

Epicentre approximately 25km west of the capital Port-au-Prince, with most hazards concentrated in or around the capital

Haiti’s socioeconomic situation prior to the eathquake

• 60% of the population survive on less than $2.50 a day

• 86% of inhabitants in the capital Port-au-Prince lived in slums

• 27,000 people per km² in Port-au-Prince

Environmental factors affecting the spread of the disease

• Insignificant in initial outbreak

• Hurricane Tomas on 5 November 2010 caused rapid flooding in many parts of the country

  • Overflowing toilets

  • Further spreading infected water

• Hurricane Sandy in December 2012 again caused a serious resurgence

• Rice farming and fishing increased contact with contaminated river water

Human factors affecting the spread of the disease:

• A Nepalese UN peacekeeping force brought it

• Sewage from the army base had then transmitted the bacteria to the Artibonite river, contaminating the whole of the valley downstream of Mirebalais

Response to the epidemic:

• Large-scale response from the UN, aid organisations, and medical relief groups

• Approximately 40 specialised cholera treatment centres set up across

  • From Jan-Oct 2012, over 12,000 cholera patients treated in the 5 Cholera Treatment Centres by Medecins Sans Frontiers

• Local hospitals recieved additional training in cholera treatment

• Health awareness campaign promoted personal hygiene, hand washing, and how to build secure latrines

• Campaigns also launched focused on the importance of boiling or chlorinating water

  • Supplied chlorine tabs to rural communities

Specifically British Red Cross response to the epidemic

• Delivered clean drinking water to 300,000 people living in camps in Port-au-Prince

• Built 1,300 latrines serving 250,000 people

• Provided medical supplies to the main hospital in Saint Marc

• Treated 18,700 cases of cholera in treatment units in La Piste camp and Piment camp in southwest Haiti

Relative success of the response:

• Can be viewed as a huge success

• Infection rates plummeted in 2011

• Mortality among cholera victims decreased from 10% in October 2010 to less than 1% from Jan 2011 onwards

• However, continues to reemerge every rainy season, related to the larger problem of providing adequate sanitation

• The only long-term solution is widespread access to clean water, but unlikely as is still one of the poorest countries in the world