By Cornelia Walther
Five years on, Haiti’s cholera epidemic remains an emergency, but as one village demonstrates, simple, cost-effective solutions are within reach.
ARTIBONITE, Haiti, 27 August 2015 – “In the past, many people here got very sick. My friend got cholera – she almost died,” says Maria, 12 years old. She lives in the commune of St. Michel d’Attalye, in Haiti’s Artibonite department.
Today Haiti continues to host the largest cholera epidemic in the Western Hemisphere, and despite a more than 90 per cent reduction in cases reported to the Ministry of Public Health and Population (MSPP) between 2014 (27,388 suspected cases) and 2011 (350,000 suspected cases), the risk remains acute.
But as clearly as any graph or report could do, Maria’s village offers an illustration of the link between water and health.
“Before the well, we had to walk two hours to fetch water,” she says. “But it was from the river, and sometimes it had a funny smell.”
The problem and the solution
Clean water and hygiene are at the heart of Haiti’s cholera crisis. The solutions are cost-effective and relatively simple, and they can have a big impact in improving the lives of Maria and thousands of families like hers.
“Last year they built a real water system, where everybody can come and get water,” Maria says. “I like to come here because the water has no taste.”
The persistence of cholera and other water-borne diseases is largely due to the fact that much of the Haitian population – 42 per cent – lacks access to both improved water sources and improved sanitation facilities.
While significant progress has been made in controlling cholera – thanks to quick response and improved surveillance – the overall level of vulnerability remains the same as observed in 2010, when the first outbreak occurred.
Water and hygiene are the problem and the solution at the same time. “Since we have a water point, nobody has gotten cholera in my village,” Maria says. Her big eyes take on a dreamy shine as she continues: “When I grow, up I want to become a doctor. That way I can help people in my country who have no water and get sick.”
National response
The four-pronged approach of the 10-year National Cholera Elimination Plan, led by the Haitian government and supported by partners including UNICEF, relies on speedy response as well as long-term investment.
The first axis comprises the strengthening of epidemiological surveillance, supported by rapid response and investigation of all cholera alerts. This emergency response is implemented with complementary investments in the underlying structural causes of the epidemic, in particular access to clean drinking water and adequate sanitation.
The third axis is the enhancement of health services at national and local levels to improve cholera case management. In parallel, individuals are sensitized on good hygiene practices and cholera prevention. Whenever possible, community-based interventions are prioritized.
Five years on, Haiti’s cholera epidemic remains an emergency. The current rainy season, which will last until November, is likely to increase cholera transmission. Ongoing vigilance and rapid response capacities must be ensured, particularly in the epicentres of cholera outbreaks and areas of persistence, which continue to be characterized by lack of water and sanitation infrastructure, insufficient social services and high mobility of populations.
It is possible to break the chain of transmission and get rid of cholera in Haiti. What happened in St. Michel d’Attalaye and many other villages across the country can be done in all high-risk locations.
To mobilize the funding necessary not only to maintain the response but to pick up speed during the rainy season, UNICEF is seeking US$4.1 million, via the appeal launched by the United Nations in August.