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The urgent need to stop the spread of cholera in Haiti

By Guest
October 25, 2010 at 11:29 am

Guest post from Alyson Lewis, head of the British Red Cross health advisory team .

After every major natural disaster that robs communities of their homes and forces people into conditions without clean water or toilets, fears of further deaths through disease are immediate.

Whatever the cause, be it storm, flood, or as in Haiti’s case an earthquake, the combination of having no access to clean water coupled with unsanitary conditions – where human waste can mix with water people have no choice but to drink – creates a fearsome breeding ground for disease.

While there is a vast array of possible health threats, top billing for potential outbreaks amongst those hit by a disaster is almost exclusively reserved for cholera.

But just why is this disease so feared?

A tiny bacteria, cholera causes extreme diarrhoea and vomiting.

Initial symptoms are stomach pains, quickly evolving into diarrhoea that becomes rapidly worse, eventually producing what is colloquially known as ‘rice water’ – pale, watery faeces which literary pours out of the body.

Patients can lose up to 10 litres of fluid in a single day and, untreated, the dehydration brought on by cholera can kill within 24 hours.

It is an unimaginably horrible way to die, and anybody who has witnessed the disease at first hand is unlikely to ever forget it.

On top of this, in places where conditions are ripe, cholera’s transmission can be terrifyingly prolific.

In the last year, an outbreak in Zimbabwe resulted in almost 100,000 cases in a little over six months and more than 4,000 deaths.

Passed on through dirty water, when bacteria from the faeces of a sufferer finds its way into drinking water, or through food, if people don’t thoroughly wash their hands after going to the toilet, the potential for the disease to breakout and claim lives in the wake of a disaster is huge.

But paradoxically, for such a formidable disease, treatment is simple.

Rehydration with clean water, salt and sugar should be enough to save someone’s life.

IV fluids can help in more advanced cases, and antibiotics can shorten the length of the disease, but straightforward rehydration is the major tool.

Treatment alone, however, is unsustainable without tackling the root cause of an outbreak.

In virtually every case, this is a lack of access to clean water and clean toilets, and a lack of hygiene.

Since the earthquake in Haiti, agencies have been working continuously to minimize the threat of cholera and other waterborne diseases.

Every day, the Red Cross trucks 2.4 million litres of clean water to more than 300,000 people living in camps in Port-au-Prince, and has built more than 2,500 latrines, serving almost a quarter of a million people.

There have also been mass hygiene promotion programmes reaching tens of thousands of people living in camps.

That cholera has not raised its head before is in no small part to the massive international aid effort.

In response to the current situation, the Red Cross has already sent vital medical supplies to the main hospital in Saint Marc, in the affected area, and is trucking tens-of-thousands of litres of clean water, along with chlorine, to help stop further transmission of the disease.

Red Cross teams have also been reaching people with hygiene information, including through mass SMS messaging.

All of these are effective, common sense emergency steps, just as the nine months of water distributions and latrine construction and servicing, have been sensible, effective measures to prevent an outbreak.

Longer term, are the issues of development and reconstruction.

Pre-earthquake, sanitation in Haiti was already some of the worst in the world – last year, the UN reported that less than half of people in Port-au-Prince had access to clean water and only around a third had access to adequate sanitation. The earthquake has only made things worse.

To prevent cholera and other diseases being a constant threat, permanent infrastructure needs to be put in place, but this is long-term recovery which will take years.

Right now, the Red Cross will continue its work, delivering lifesaving help to those in need and desperately working to protect communities from outbreaks of disease.

Read more: Red Cross responds as health concerns grow

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Tags: cholera, Haiti, water and sanitation

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This entry was posted on Monday, October 25th, 2010 at 11:29 am and is filed under Emergencies, Health and social care, International. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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