Dominican Republic: Cholera Outbreak Emergency Plan of Action (EPoA) DREF n° MDRDO011

A. Situation analysis

Description of the disaster

During Epidemiological Week (EW) 28, the Ministry of Public Health and Epidemiology reported that the Los Pinos Health Center (La Descubierta, municipality) saw an increase in the number of patients with acute diarrhoeal diseases from surrounding communities, which were suspected to be cases of cholera.

In EW 32, the Ministry of Health reported that Vibrio cholerae had been identified in samples collected from residents of La Descubierta municipality in the National Public Health Laboratory. The same report also stated that three confirmed cases of cholera in the municipality had been identified.

Since the outbreak began in EW 28 and up to EW 34, 4 confirmed cases of cholera and 91 suspected cases have been identified in the municipality (please see Figure 1 below), in residents of Los Pinos del Edén, Ángel Feliz, urban area of La Descubierta and Los Bolos.

In comparison, the province of Independencia, which accounts for only 0.77 per cent of the Dominican Republic’s total population, has seen twice as many suspicious cases (91 versus 46) of cholera as the rest of the country in the last two months. Moreover, the presence of suspected cases in this province is 300 times higher than in the same period of 2017, and this is the only province where the suspected cases of cholera have increased in relation to 2017. These data are even more concerning when considered against the fact that the 90 per cent of the suspected cases are concentrated in the municipality of Descubierta, which has a population of only 6,939 inhabitants.

The Municipality of La Descubierta is one of the six municipalities that make up the province of Independencia. The municipality is in the south-western part of the country, and it is bordered by the Neyba Mountain Range to the north, Enriquillo Lake to the south, the municipality of Poster Río to the east and the Republic of Haiti to the west.

It is among the 10 municipalities with the highest overall poverty rate in the Dominican Republic. In total, 78.77 per cent of households are considered poor, and 45.96 per cent of households are living in extreme poverty .

Because the province of Independencia had not suffered a major outbreak of this disease since 2011, the high incidence of cases has caused the municipal healthcare system to collapse. The sharp increase in suspected cases of cholera and the resulting collapse of the healthcare system has led health authorities in the province of Independencia to request support from the Dominican Republic’s Ministry of National Health and national humanitarian organizations, including the DRC.