More than 12,000 treated for the disease in five centres this year Two years after the cholera epidemic began in Haiti, the continued treatment of patients is still not certain, even at a time when people are still largely exposed to the risks of contamination. In Port-au-Prince, more than 350,000 survivors of the 2010 earthquake are still living in camps, and many thousands are living in shantytowns, where sanitary conditions remain deplorable and risk exposure to cholera. Wilsème has been living in a camp now for almost three years: “We’re living under difficult conditions, with no access to clean water and soap. We know that we are at risk of being infected with cholera, but we don’t have any of the means we need to protect ourselves from the disease.”
Since the start of the year, more than 12,000 cholera patients have been treated in the five cholera treatment centres (CTC) run by Médecins Sans Frontières (MSF) in Port-au-Prince and Léogâne, a town some 30 kilometres west of the capital. “This is a drop in the numbers, compared with the approximately 35,000 cases that we admitted during the same period in 2011 in Port-au-Prince,” says Oliver Schulz, MSF’s head of mission in Haiti. “We continue to see an average of 250 new cases each week in our facilities, but this is still a high number,” he says. Reduced international funding is limiting the response of the humanitarian organizations providing medical care and access to clean water and sanitation. “This year, MSF had planned to respond only to the peaks of the epidemic, but we have had to keep most of our CTCs open throughout the year because the cholera epidemic is far from being controlled. The measures to prevent and treat cholera are still not enough,” says Schulz. In fact, the response capabilities of the health ministry remain extremely low two years after the onset of the epidemic. As a result, during the most recent peak last May, MSF treated more than 70 per cent of the total number of patients registered in Port-au-Prince. Wilsème is one of these cases. “I went to the public hospital, but they told me that they couldn’t treat me and I was sent to an MSF treatment centre, where I received care.” Only lasting achievements in the areas of water and sanitation will make it possible to conquer the epidemic. “This will take time, and this is why medical care for cholera patients remains a key challenge that the Haitian authorities need to address right now,” Schulz says.
Cholera is a disease that is easily treated, but it is crucial that specialized treatment centres be accessible and that patients be brought to them as soon as possible after the first symptoms appear. Without adequate treatment, the disease can take a person’s life within just a few hours. Simple measures to include the treatment of cholera as part of the services offered through Haiti’s healthcare facilities would bring about a reduction and facilitate patient access to treatment in the future. MSF remains ready to support Haitian health authorities during the peak periods of the epidemic and to provide technical and logistical support to healthcare facilities with a view to facilitating integration and the treatment of cholera. Since the cholera epidemic began in October 2010, the disease has claimed more than 7,500 lives out of a total of approximately 600,000 known cases (approximately six per cent of the population). As soon as the first cases were confirmed, MSF began an operation that is without precedent in the country. Between October 2010 and November 2011, MSF had more than 75 cholera treatment centres scattered throughout Haiti. During this period, 4,000 Haitians and 400 international staff worked to treat a total of more than 160,000 people.