Cholera: 580,947 cases, 7,442 deaths since the epidemic began in Haiti, the CCO calls for the mobilization of international and national stakeholders

Report
from CCO Haïti
Published on 27 Jul 2012

The Comite de Coordination des ONGs Internationales en Haiti (CCO HAITI) calls on the national authorities, the international community and donors to engage in saving the lives of the thousands of Haitians threaten by the cholera epidemic that is affecting the country.

The cholera epidemic that struck Haiti in October 2010 has killed more than 7,400 and affected more than 580,000 people. Responding to the epidemic continues to be an urgent priority in 2012 and will require improved services in the areas of health, water, sanitation, and hygiene promotion.

The Comite de Coordination des ONGs Internationales (CCO Haiti) is calling on national authorities and international actors to protect the lives of thousands of Haitians at risk, especially those with limited access to water and sanitation and little or no access to health services. The epidemic has struck all Departments, but the over 390,2763 Haitians displaced by the earthquake and still living in camps are extremely vulnerable, especially as the hurricane season gets underway.

According to the World Health Organization (WHO) more than 42 000 new cases and nearly 400 deaths have been reported since the beginning of 2012 and numbers are increasing. WHO estimates that approximately 200,000 persons will be affected during the 12 month period ending in December.

However, the limited capacity of the Government of Haiti (GoH) to effectively address the prevention and treatment of the disease and a significant reduction in funding are jeopardizing the effectiveness of the ongoing cholera response.

The cholera outbreak that has already claimed thousands of lives all over the country remains a major threat to public health. Cholera prevention and response should be a key priority for the Haitian Government.

Further efforts need to be made to improve the quality and reliability of data collection systems. Thorough evaluations are needed to identify and address the problems in the epidemiological surveillance system. According to MSPP, only 57.8 % of the 341 daily cholera reports were submitted by departments during the period from March 27 to April 26, 20125. This lack of accurate reporting seriously impacts the capacity to effectively respond.

Furthermore, many public health workers in the Cholera Treatment Center (CTCs) have not received salaries for several months and there are reports of strikes by front line medical staff to redress this situation. This is a serious issue negatively affecting the effectiveness of the cholera response and it needs to be urgently addressed. In addition, there is evidence that the MSPP struggles to carry out its work efficiently due to poor logistics and inefficient fleet maintenance. This seriously hinders the material distribution within the CTCs, Cholera Treatment Units (CTUs) and Acute Diarrhea Treatment Centers (ADTCs), and affects the appropriate collection of cadavers. Necessary arrangement should be made to correct the situation. Overall, the MSPP must once again reinforce its leadership and coordination roles at both central and departmental levels.

Donors must provide sustained and adequate funding to support a comprehensive and integrated approach to cholera prevention and care.

Although less severe than the cholera outbreak last year, the current situation on the ground is much worse than statistics portray. And yet, a shortage of funding has translated into fewer health partners and created serious gaps in coverage. From August, 2011 to May, 2012, the number of Cholera Treatment Centers (CTCs) has declined from 38 to 20, and the number of Cholera Treatment Units from 205 to 746.

In 2012, additional donor support is needed to help the MSPP and humanitarian actors address all phases of cholera response including surveillance, medical treatment and technical assistance, new community and primary health programs, and capacity-building for national medical personnel and institutions.

In a country like Haiti identified by WHO as one of the most water insecure in the world, an effective response to cholera requires a comprehensive approach which integrates cholera prevention and case management into already existing health programs and facilities. Funding mechanisms should thus be more flexible to allow the re-allocation of funds in cases of emergency. Given the expected duration of the cholera epidemics in the country, it is crucial that humanitarian and development donors’ strategies and funding mechanisms are harmonized to ensure appropriate responses to current and future needs in cholera prevention and treatment, and avoid gaps in service provision.