Local and international organizations must step up distribution of chlorinated water in areas affected by epidemic

Since Oct. 22, 2010, Médecins Sans Frontières (MSF) has treated 62,000 people with cholera symptoms in Haiti. This week, MSF's 4,000 Haitian and 315 international staff treated close to 2,000 patients daily in the 47 cholera treatment units and centres across the country.

The number of patients admitted into MSF facilities in Port-au-Prince has stabilized, with a daily average of 385 patients this week. MSF has treated more than 15,000 people in the capital with cholera symptoms since the epidemic began. The situation is also stabilizing in Artibonite department or region, the area hardest hit by the epidemic, with more than 23,000 people treated. This week, more than 1,000 people were admitted into MSF facilities there.

However, the epidemic continues to spread in Haiti's northern cities and rural areas. In the last week, more than 4,000 patients were treated in the department of Nord, and 1,100 in the department of Nord Ouest. MSF teams are expanding the number of cholera units and treatment centres and are setting up rehydration points. This presents logistical challenges because the areas affected are extremely difficult to reach.

The epidemic increased sharply in the south, with a total of 475 people treated since the start, including 439 in the last seven days. In Jacmel, in the department of Sud Est, approximately 100 patients arrive at MSF's 50-bed cholera treatment unit every day.

"Our team had to handle an inflow of 260 in a single day," explains Dr. Loreto Barcelo, MSF's coordinator in Jacmel. "There were people everywhere … Patients, their families … There were several hundred people at the treatment site. We had to put up to four patients in a single bed and try to save as many as possible while waiting for extra help to arrive. We now have an additional 20 nurses helping us and opened a new 100-bed treatment centre, which is helping us manage the situation."

Haiti © Aurélie Baumel
MSF's cholera treatment centre in the Sarthe neighbourhood of Port-au-Prince.

This week, new cholera treatment facilities were set up in the following five cities, located in three different departments: Pignon, St. Raphaël and Ranquitte in Nord, Gaspard in Nord Ouest, and Jérémie in Grande Anse. However, as the epidemic continues to spread, the response by local and international organizations remains inadequate.

Some have raised the possibility of launching a vaccination campaign. Under the circumstances, MSF epidemiologist Kate Alberti wonders if this is appropriate.

"The epidemic affects the entire country today, including the most remote areas. This isn't the time to carry out a vaccination campaign. The priority is to treat patients, provide access to chlorinated water and improve hygiene measures to prevent others from becoming ill." However, Alberti adds, "in the future, we will consider vaccination as a viable option to immunize the population and limit the appearance of a new epidemic."

MSF treated victims of post-election violence

MSF treated 96 victims of the violence that erupted in Port-au-Prince and several other cities in Haiti between Dec. 7 and 12. Of those 96 people treated, 38 had gunshot wounds. Four people died of their wounds. MSF has surgical supplies and medical teams at six facilities in Port-au-Prince and two in other regions of the country. The organization remains prepared to treat any additional wounded patients. Despite the insecurity, MSF teams have managed to ensure continuity of medical care, including responding to the cholera epidemic and treating persons wounded in the violence.

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