Overall numbers declining, but staff remain alert. As Haiti remembers those killed by the earthquake one year ago, the pace of the spread of cholera seems to have slowed in the north and in Port-au-Prince, though the outbreak remains unpredictable and Médecins Sans Frontières (MSF) teams are still on high alert. The number of new admissions is declining in most of MSF’s cholera treatment centres in Port-au-Prince and in the Nord and Nord-Ouest departments. Numbers are stable in the Artibonite area, where the outbreak began. In the south, MSF is dealing with a small number of patients at this time, but the number has recently slightly increased. In several of MSF’s treatment centres, tents that were earlier filled with patients now stand empty. Cholera treatment takes effect rapidly and patients can usually go home within a few days. So if the number of new patients declines, overall activity declines quickly as well.

Haiti © Ricardo Garcia
A patient with cholera symptoms in the hospital in Saint-Marc in the Artibonite area of Haiti. There is no room for complacency, however. “The decreasing number of cases does not mean we have won the battle,” warns Kate Alberti, an MSF epidemiologist in Haiti. “Cholera can be unpredictable, especially in a country that has no history of the disease. The rains to come could be a factor, and social unrest can also have a negative impact.” Demonstrations and sporadic violence late in 2010 coincided with a spike in cholera cases in the capital, Port-au-Prince, as people were unable to access treatment. Over the past week, MSF treated 5,000 patients in its 50 cholera facilities throughout the country, bringing the total number people who have received care in MSF or MSF-supported facilities since the beginning of the outbreak to 97,000. This represents more than half of the 181,829 total cases reported by health authorities since the outbreak began. Also according to official figures, 3,759 people have died of cholera since Oct. 22. MSF is also providing supplies for oral rehydration points in areas where the epidemic has yet to take a deep hold and in remote regions or villages underserved by health posts. Through it all, MSF has continued to provide essential medical services at its seven free-of-charge secondary care hospitals and at two government hospitals it supports in Port-au-Prince. MSF has been providing obstetric services for women with high-risk pregnancies as well as emergency care, trauma care, and burn treatment for people in the city. Outside the capital, MSF runs a hospital in Léogâne and supports another public hospital in Jacmel. MSF has approximately 7,500 Haitian and 430 international staff maintaining these existing programs and responding to the cholera emergency.

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