Haiti one year after: Cholera emergency response

Anticipate the spread of the disease

In the middle of October, word came from the Artibonite region in central Haiti north of the capital that patients were presenting with cholera-like symptoms.

Consensus was that cholera was very likely to spread widely in a country where most people lacked access to clean drinking water or sanitation, where the population was unfamiliar with the necessary prevention measures, and where national health staff, too, had no experience with the disease upon which to draw. But the transmission dynamics were difficult to predict, because the only precedents were several decades old.

Warn for further action by other aid actors
Despite the huge presence of international organisations in Haiti, the cholera response had been inadequate in meeting the needs of the population. MSF issued repeated public statements pointing out that critical shortfalls in the deployment of well-established measures to contain cholera epidemics are undermining efforts to stem the ongoing outbreak in Haiti. On November 18, MSF issued a press release calling on other aid actors to do more, to scale up their responses and to do it quickly.

Current situation
At present, MSF is still scaling up activities, focusing on making more beds available and on case management, while making sure that non-cholera activities continue normally. By late December, the cases in the North, Northwest, and the Southeast departments, the Artibonite region, and the area just west of Port-au-Prince were all seeing cases decrease. However, there seems to be a widespread belief that the cholera response in the capital will have to last several more months, through early 2011, at the very least.

MSF has now mobilised a cholera emergency response across every administrative department of Haiti. By December 26, the Ministry of Health had reported 150,000 cases and more than 3,300 deaths across the country. At the same time, more than 84,500 cholera cases had been treated by MSF medical teams in 47 cholera treatment centres throughout the country. This accounts for approximately 60 percent of all cases treated in the entire country. MSF has established over 4,000 beds of hospitalisation capacity for the cholera outbreak and has been able to maintain the case fatality rate of less than 2 percent in these facilities.

Cholera activities in figures
More than 1,000 tons of medical and logistical supplies have been brought into the country, and MSF has more than 5,500 Haitian and international staff dedicated to cholera treatment.

MSF estimates it will spend approximately €10.8 million ($14.2 million) on cholera emergency programs in 2010. Another  €7.5 million ($9.9 million) is projected to be required to continue cholera-related activities in Haiti in 2011.