December 02, 2016

Two months after Hurricane Matthew devastated southwest Haiti, thousands of people are still without adequate shelter, food and potable water. Certain remote communities have yet to receive assistance.

Médecins Sans Frontières (MSF) is concerned about the deterioration of living conditions, particularly in the departments of Grand’Anse, Sud and Nippes, all of which were affected by the hurricane.

In the Sud and Grand’Anse departments, MSF has set up mobile clinics to evaluate the general health conditions of children. Chiara Burzio, MSF medical coordinator explained that just in the last week, MSF’s mobile clinics “examined and treated 163 children under age five with respiratory complications, 60% of whom suffered from upper respiratory tract infections and 5% from pneumonia or bronchitis. These complications are mostly tied to a lack of adequate shelter, in addition to cold nights in the mountains. The other children had diarrhea and skin infections caused by poor access to clean water.”

Securing potable water supplies is already a chronic problem for most Haitian communities, one that only worsened in the wake of the hurricane. Pipe networks were destroyed, water reservoirs filled with sand. “Although our project has specialized in medical treatment for cholera since 2010, the lack of actors to improve water and sanitation in Baradères after the hurricane has forced us to take emergency action to repair the water supply network and distribute Aquatabs to 10,000 families living in the commune,” said Stuart Garman, MSF Project Coordinator.

Many families who lost their homes in the hurricane are still living in temporary shelter, leaving them vulnerable to extreme weather conditions. Displaced people who have taken shelter in government buildings, such as schools, face pressure from local communities demanding that authorities evacuate the structures. With nowhere to go, these people need a long-term housing solution.

 

Managing the risk of cholera

In November, the number of patients presumably suffering from cholera staying at MSF’s Cholera Treatment Centre (CTC) in Port-à-Piment rose from seven in the first three weeks of the month to twelve in the fourth. In just the last week, the Centre has admitted seven new patients per day, some of whom came from neighbouring communes. This shows a spike in new cases compared to the last three weeks of November. The patients arrive at the oral rehydration centres that MSF opened in the mountains and are then transferred to the CTC in one of two special ambulances.

On October 4, MSF and the health minister opened a CTC with 20 beds in Baradères, Nippes. Since then, MSF has treated more than 190 cholera patients in the Port-au-Prince metropolitan area, and one of its monitoring and rapid response teams is currently stationed on the Island of Gonave to respond to the increase in cholera cases and deaths in the community.

According to Garman, “our ability to combat cholera depends first and foremost on cohesion   between medical care (to keep patients from dying of cholera) and prevention measures, especially those to improve water supply networks and sanitation for communities living in precarious conditions.”

Two months after the start of its work in Nippes in response to Hurricane Matthew, MSF’s team began shutting down its emergency operations in the department. “The cholera epidemic we were anticipating in the area never came. For various reasons, great measures were taken to prevent an epidemic. In the rest of the country, emergency activities are still under way.”

 

 

Seven weeks after the hurricane, MSF’s teams have done the following:

Medical care

  • Seen more than 4,500 patients in the departments of Nippes, Grand’Anse and Sud 
  • Treated a large number of wounds (800 in total since October 8), respiratory infections, and diarrhea cases in Sud and Grand'Anse at mobile clinics
  • Transferred 30 patients by helicopter, 18 of whom were taken to MSF’s trauma centre in Tabarre, in Port-au-Prince
  • Provided support to the hospital in Port-à-Piment, where it has, among other services, assisted in 14 births since October 31

Anti-cholera treatment

  • Set up a Cholera Treatment Centre (CTC) in Port-à-Piment and treated 360 suspected cholera cases since October 9
  • Built a CTC with a 19-bed capacity in Baradères
  • Assisted the health minister at the Diquini CTC (Port-au-Prince) in caring for 190 cholera patients

Water, sanitation and hygiene

  • Provided hospital hygiene and sanitation support at the CTCs in the communes of Moron, Chambellan, Dame-Marie, Anse-d’Hainault, Les Irois and Abricots
  • Provided temporary shelter to 1,400 families in the Sud department and 4,500 hygiene kits in the Port-à-Piment valley
  • Distributed 3,459,000 litres of potable water at centralized reservoirs, for a total of  1,867,000 litres in Sud and 1,592,000 litres in Grand'Anse, and a capacity of 80,000 and 50,000 litres per day respectively
  • Repaired and restored functioning of 24 public fountains—17 in Baradères and 7 in Fond Tortue
  • Repaired two water catchment systems in the communes of Port-à-Piment  
  • Distributed 32,424,000 litres of potable water through centralized reservoirs, for 30,240,000 litres per system in Baradères (an average of 864,000 litres/day over 35 days) and 2,184,000 litres per system in Fond Tortue (312,000 litres/day over 7 days)
  • Distributed 4.5 million Aquatabs for home water treatment in the Sud and Grand'Anse departments and the communes of Baradères and Grand-Boucan in Nippes  

Supply distribution

  • Distributed reconstruction supplies, including pipes for rainwater collection, as well as sheet metal, cooking and hygiene kits, reservoirs and covers for 850 families in the Cayémites Islands. 

 

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