Haiti Cholera Update #15

As of writing, there are no updated figures from MSPP (Ministère de la Santé Publique et de la Population). The latest figures released on 16/11/10 showed 49,418 cases of cholera and 1186 deaths since the outbreak began. The hospital mortality rate is 3.9% Cholera promptly treated has a mortality rate of 1-2%.

James Wilson reports on conditons in the epicenter:

The rural camps, hardest hit by cholera are in the worst situation because there is NO relief aid presence and no UN presence.  During this last trip it would take almost 5 hours to drive from St. Marc back to Port au Prince to try and secure supplies.  We are purchasing ORS, water, and pedialyte (now absent from stores because we are buying so much of it).  [REDACTED] gave me 10 cases of pedialyte and some other supplies, which is all they could afford because they feared an outbreak in Port au Prince.  Finally, after running out of medications, fluids, etc. and being turned away from most all sources for medical supplies, including the UN, there was no way to help those suffering from cholera.  It was simply too difficult to watch another baby die of dehydration and I came home to recover from the worst week I’d experienced in Haiti since the earthquake.

I cannot begin to explain how much worse the situation is in Haiti and how there is very little coordination of any relief aid or the NGO’s.  The following is the mission statement of the UN for its mission in Haiti.  It is not being carried out now during this cholera outbreak and has not been carried out since the earthquake, which is more than a failure to the Haitian people.

“The mission of the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) is to mobilize and coordinate effective and principled humanitarian action in partnership with national and international actors.”

I have shared all my findings with the CDC in order to give them as much data as I can gather for their investigators.  I have also given our findings to the MOH and OCHA -mainly for informational purposes because I’ve given up the hope of obtaining necessary supplies.  I wish the news was better and sadly the deaths will continue because there is little to no support available for those providers in rural areas.  There is very little available in the way of supplies even in the larger cities now facing patients with cholera.  I am contacting organizations here at home to try and get the ORS, which comes in small packets, donated so I can take it back on my next trip.

The Columbia Journalism Review on Haiti as disaster porn:

CNN’s twenty-four-hour coverage of the aftermath of Haiti’s earthquake, which took an estimated 300,000 lives, doubled the network’s viewership. This coverage undoubtedly played a role in the America public’s response to the tragedy—one out of two Americans donated money to aid organizations. But little reporting has been done since then that asks how exactly that money is being spent, holds aid organizations accountable to their promises, or investigates the American government’s development and economic policies in the country. These policies, argues sociologist Alex Dupuy, have kept Haiti frozen in a destructive cycle of aid-dependence and exploitation for decades, stripping Haiti of its self-determination. “For the level of tragedy, no one’s really being very honest,” said Michael Fairbanks, a development expert, of the American and international community’s rhetoric about Haiti since the earthquake. “[Haitians] are constantly put into the position of adolescence and being infantilized so they can prey on the charity from the rest of the hemisphere.”

The longer American news outlets ignore these critical and complex issues, the easier it will become to view their occasional jaunts to Haiti with cynicism: it’s an convenient place to get B-roll of tragedy and disaster. Their coverage increases viewership, but without a moral component of responsibility towards Haitians themselves over the long-term, such coverage is basically exploitative. And over time, superficial reporting on Haiti’s problems—which plays a role in soliciting charitable donations from Americans-will arguably make the media culpable in the very system of aid-dependence and misguided development policies that help keep Haiti poor.

MSF criticizes the current response to the  epidemic:

Despite the huge presence of international organizations in Haiti, the cholera response has to date been inadequate in meeting the needs of the population.  According to national authorities, the epidemic has already caused more than 1,100 deaths and made sick at least 20,000 people nationwide.

“MSF is calling on all groups and agencies present in Haiti to step up the size and speed of their efforts to ensure an effective response to the needs of people at risk of cholera infection,” says Stefano Zannini, MSF head of mission in Haiti. “More actors are needed to treat the sick and implement preventative actions, especially as cases increase dramatically across the country. There is no time left for meetings and debate – the time for action is now.”

Crawford Killian at H1N1 has a couple of sharp posts, first on his own learning curve on Haiti and what he’s concluded, and second, an eye-opening read on the results of various charities’ fundraising after the earthquake — ones readers may well have donated to — compared to the actual money disbursed.

The Canadian government, incidentally, has released an additional $4 million to fight cholera in Haiti. Much of this money is directed primarily for long-term projects for the provision of clean water and on education campaigns. Many aid agencies have suggested the need for funding has moved from mitigation and education to more basic needs, such as for supplies like intravenous solutions and antibiotics.

Pictures of the cholera protests.

HaitiLibre on the anti-Haitian protests in the Dominican Republic, ten cases of cholera have been reported.

I will post the next update Tuesday or (more likely) Wednesday, or sooner if events warrant. For more immediate updates, I highly recommend Crawford Killian at his blog H1N1.

More resources:

#Haiti Daily (Twitter newspaper)

Haiti Information Project.

Haiti: Operational Biosurveillance (Twitter)

H5N1

HaitiLibre (English) (français) (Twitter — English and French)

Mediahacker: Independent multimedia reporting from Haiti (Twitter)

Ministère de la Santé Publique et de la Population (Homepage) (Cholera Updates) (in French)

PAHO’s Haiti Cholera page. (PAHO Situation Reports and other documentation.) (Blog.)

Praecipio International (HEAS)

On the ground, good sources of information and of course needing donations:

Partners in Health (Twitter).

Médecins sans frontières

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  1. #1 by Connie Ghiglieri on Sunday 21 November 2010 - 1858

    I just spent two weeks at the cholera treatment center in Hinche. I am a RN from Arizona. Here is what I wrote to a friend to describe my experience:
    I am in Hinche…working at a cholera treatment center.. Cholera is a very dark hell, plain and simple. Not like anything I have ever seen or could have imagined….and thus far we have been able to keep things under control and have not lost many, which is a small victory but an unrelenting battle…there is not a moment to breathe…it is just work and sleep and sometimes eat. Never have been in a situation where the urgency to perform is so damn constant. Keeping people hydrated is the key, they come in often close to death and look like they are dead except that they are puking and shitting volumes. IVs are such a challenge to keep going and patent. Their clotting factors must be way off, have to constantly restart them. Then keeping them drinking when even tho they often end up vomiting what they have just taken in, and keeping them clean….oh the inhumanity…there is no dignity involved in this disease other than the compassion that we feel, and them saying an occasional quiet merci, or just making eye contact…but for the most part they are too sick to really care. Most of our patients are on cots that are soaked with liquid cholera (looks like rice water…sortof…that’s being generous )and bleach, with a bucket alongside to use if they can.. We try to keep a plastic barrier between them and the cot…yeah not entirely successful, the rest are on the wooden MSF cholera beds…wooden benches covered with plastic with holes cut in them with a bucket underneath. Pretty much everyone is naked and then covered with whatever we have, mostly plastic surgical gowns…and at night they are freezing. We used to diaper most patients when they first came in because they are too weak to use the buckets, yes adults …but we have run out of those, so you guessed it…naked…what I would give for a pamper….We too wear plastic surgical gowns as barriers… and gloves…at all times, I probably change my gloves at least 50-60 times in a shift…not kidding..I wear.rubber boots and I wash my hands several times a night with a clorox solution…and do not get my hands near my face…for any reason. Hard not to touch people skin to skin,but I just don’t do it. The best I can do is give the patients back rubs with lotion…but rarely have time for that. We try to clean people with baby wipes, but I’m not sure there are enough of those in the world for this disease….we run out every day. The smell is…well, it is distinct and now I am used to it and am sure I will recognize it anywhere…right now it is just what it is and I don’t think about it. I actually don’t think about much except checking IVs, keeping them going, keeping people drinking, keeping them clean, keeping the tents as clean as possible and then hydrate…checking IVs, drinking, clean,…..hydrate….IVs, drinking, clean….simple, simple, simple yet exhausting…BUT when you see someone go from death to life in a matter, sometimes, of hours…it is all good and for a moment you remember life really is beautiful….and then you take a breath and….hydrate…..IVs, drinking, clean……
    The news of it spreaking rapidly in Haiti is the worst possible. I don’t want to leave

    • #2 by torontoemerg on Sunday 21 November 2010 - 2126

      Connie, thanks so much for this. I’ve emailed you about it.

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