Clean water and sanitation needed to halt spread One year since the start of the ongoing cholera epidemic in Haiti, people all over the country are still threatened by the deadly disease. Healthcare services and measures to prevent the spread of cholera are still inadequate, Médecins Sans Frontières (MSF) warned today. “Haitian authorities and international aid actors need to do much more to treat and prevent cholera,” said Romain Gitenet, MSF head of mission in Haiti. “There is an urgent need to improve healthcare, provide access to clean water, and ensure proper sanitation. Clean water and sanitation are essential to halting the spread of cholera.”

Haiti © Frederik Matte/MSF
Patients with cholera receive treatment in one of the MSF cholera treatment centres located in the capital, Port-au-Prince. “Even though the international community has pledged huge sums of money to assist Haiti, thousands of Haitians are still getting sick from cholera every week, and some are still dying.” Since the first cases of cholera were identified in October 2010, more than 465,000 Haitians have fallen ill and more than 6,500 people have died, according to Haiti’s Ministry of Health. The ongoing rainy season is facilitating the spread of the disease. At the same time, MSF is seeing international organizations involved in healthcare, water and sanitation withdrawing from the fight against cholera in Haiti. Yet the needs remain significant and urgent. There continue to be dangerous and unpredictable fluctuations in the number of cholera cases. For example, in the fourth week of August of this year MSF treated 281 patients for cholera in Port-au-Prince; by the end of September, cases jumped to 840 per week.

Haiti © Frederik Matte/MSF
MSF teams leading mules with medical material destined for a cholera treatment centre in Cheno village in the Artibonite region. The village is located more than five hours by foot in the mountains and a two-hour drive from Gonaives.

It is likely that cholera will continue to be present in Haiti for years to come. Haitian authorities will ultimately have to take responsibility for responding to the disease. But they have not yet been able to mount an effective response countrywide. While ensuring that Haitians’ urgent needs for cholera care are adequately met, international aid actors should do more to assist the Haitian government in rapidly integrating proper cholera treatment into healthcare facilities, and in implementing prevention plans. MSF has been working to transfer management of the healthcare facilities it has been supporting back to the Ministry of Health. Meanwhile, the focus must be on saving Haitians’ lives. According to Gitenet: "Cholera patients continue to die from dehydration in remote areas of the country simply because there are no oral rehydration points or treatment facilities nearby, or because of a lack of trained healthcare personnel or community outreach workers. This is unacceptable."

Haiti © Frederik Matte/MSF
Two patients with cholera receive treatment in an MSF cholera treatment centre.   About cholera and MSF’s response to the epidemic Cholera is a bacterial infection that spreads primarily through contaminated water and food, and through interpersonal contact. It can kill quickly, but is easy to treat if appropriate healthcare services are available. It is also easy to prevent, through access to clean water, regular hand washing and hygienic food handling. But a majority of Haitians living in rural areas and urban slums can’t access potable water or proper hygiene and sanitation facilities. Since the beginning of the cholera epidemic in October 2010, MSF has treated more than 160,000 patients for cholera, about 35 per cent of total cases reported nationwide. MSF teams are currently responding to cholera in the Martissant, Carrefour, Delmas, Choscal, and Drouillard neighbourhoods of Port-au-Prince; and in the Ouest, Nord, and Artibonite departments.