Health
 Haiti
Project #6629

Help PIH Respond to Cholera Outbreak in Haiti

by Partners In Health (PIH)
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Photo by Rebecca E. Rollins / Partners In Health
Photo by Rebecca E. Rollins / Partners In Health

Above: Patients are treated at the Cholera Treatment Center in Mirebalais, Haiti, on Nov. 8, 2012.

 

 

The World Health Organization recently announced that it will send 1 million doses of cholera vaccine to Haiti, where hundreds of cases of the deadly diarrheal disease have been reported after Hurricane Matthew tore through the country in October.

Partners In Health applauds the news for a simple reason.

“Cholera vaccines save lives,” says Dr. Louise Ivers, PIH’s senior health and policy advisor.

The WHO will coordinate the use of vaccines with Haiti’s Ministry of Public Health and Population, which leads the cholera response in Haiti, Ivers says. Any decision on the final destination of the vaccines will greatly depend on need and the logistical capacity to distribute them.

Zanmi Lasante, as PIH is known in Haiti, has seen firsthand the power of cholera vaccination. In 2012, staff conducted a successful vaccination campaign that reached 45,417 Haitians in the regions of Grand Saline and Bocozel. Nearly 90 percent of patients received the recommended two dosages.

The campaign dramatically reduced the risk of cholera for those who got the vaccine, and likely for those who didn’t. As Ivers explains, cholera vaccines have an effect called “herd protection.” The more people who are vaccinated, the less cholera circulates—meaning even those who didn’t receive the vaccine have less risk of getting the disease.

Hundreds of cholera cases have already been reported just one week after the hurricane in the hardest-hit South, including Jérémie, Port Salut, and Les Cayes. Flood waters have mixed with sewage contaminated with cholera bacteria. Because fewer than half of Haitians have access to clean water, they draw from these sources and suffer the consequences. The infectious disease causes vomiting and diarrhea, and patients can die within 24 hours if the illness is left untreated.

PIH staff are now organizing mobile teams to help support partners in the South, including at the hospital in Les Cayes.

Cholera was introduced to Haiti in 2010. Shortly after the devastating January earthquake, the United Nations flew in a group of peacekeepers from Nepal, whose capital had recently suffered an outbreak of the disease, and set them up in a camp with poor plumbing. Contaminated sewage leaked into a tributary of the longest river in the country, the 200-mile Artibonite, which is a water source for countless Haitians. A cholera epidemic was born. In the six years since, nearly 10,000 Haitians have died and 800,000 have been sickened by the disease.

Please sign our petition to fight cholera in Haiti
Please sign our petition to fight cholera in Haiti

Thank you so much for your continued support of Partners In Health and our efforts to eradicate cholera in Haiti.

Last week, the United Nations accepted responsibility for introducing cholera to Haiti in 2010, when U.N. peacekeepers contamined a crucial waterway. This is the world's worst ongoing outbreak -- nearly 10,000 people in Haiti have died from the disease, and just this year cholera has sickened 14,000 Haitians.

Partners In Health is collecting signatures for a petition to be delivered to Ambassador Samantha Power, the U.S. Permanent Representative to the United Nations, demanding that the U.N. fund a comprehensive plan to eliminate cholera in Haiti, including national vaccination campaigns, household water treatment, and clean water and santiation.

Please take a moment to sign the petition, and demand that the U.N. take action against this devastating illness: http://act.pih.org/page/s/tell-the-un-now

Your voice will help bring justice to Haiti, and your support of Partners In Health allows us to continue treating cholera, educating communities about the disease's spread, and saving lives. From all of us at PIH, thank you!

Links:

Thank you for supporting Partners In Health/Zanmi Lasante and our efforts to end the continuing cholera outbreak in Haiti.

Nearly six years after arriving in Haiti, cholera is still sickening and killing thousands of Haitians. According to recent government figures, over 770,000 Haitians - 7% of the country's population - have suffered from cholera. 9,200 have died. So far in 2016, more than 6,000 have fallen ill, and on average 37 people are dying per month.

Cholera occurs so regularly in Haiti that World Health Organization officials now consider it endemic to the country. Many researchers point out that the cholera bacterium has likely become established in the country's rivers, estuaries and coastal waters, making the illness that much harder to eradicate. Not to mention the fact that only 24% of the population has access to toilets, meaning that adequate sanitation and safe water - keys to beating cholera - are unavailable to the vast majority of Haitians.

Dwindling international support for cholera eradication compounds these issues. In 2010, when cholera first hit Haiti, over 200 international organizations were offering financial and policy assistance. Fewer than 12 of these organizations are still providing these resources, which has slowed relief efforts and helped allow cholera to rage on.

PIH's senior health and policy advisor, Dr. Louise Ivers, commented, "We need to raise our expectations of what's possible to do in Haiti and other countries in terms of these diseases that we've completely eliminated from our own societies."

PIH/ZL continues to fight cholera through treatment and prevention. Our staff of local community health workers accompany cholera patients to treatment at PIH clinics; open rehydtration posts in remote locations; educate communities about santitation; and work to establish adquate sanitation and water systems.

Your support makes this lifesaving work possible, and along the way helps redefine what's possible in global health. From all of us at PIH, thank you!

Links:

Photo by Calixte Wilsonn/Partners In Health
Photo by Calixte Wilsonn/Partners In Health

Thank you so much for your generous support of Partners In Health and Zanmi Lasante’s efforts to treat and prevent cholera in Haiti.

Cholera continues to plague Haiti, particularly at the border shared with the Dominican Republic. Political tensions and a consequent migrant crisis have resulted in makeshift camps throughout the region, populated by thousands of Haitian migrants who fled the Dominican Republic among threats of violence and deportation. These camps are overcrowded and lack adequate sanitation – two conditions that have allowed cholera to spread and, according to a December 2015 New York Times report, infect more than 100 people.

PIH and ZL are working to treat cholera within the borderland. In the below excerpt from an article on PIH’s website, Dr. Alexandre Widner (pictured above, left), PIH’s border health activities coordinator in Haiti, comments on this political and medical crisis.

"Despite many signs of brotherhood between Haiti and the Dominican Republic, which share the island of Hispaniola, the binational relationship is worsening each day due to a high peak of migratory tension. According to various sources, more than 500,000 Haitians live in the Dominican Republic, more than 75 percent of whom lack identifying documents (a passport or identity card), which leads to constant marginalization, stigmatization, and discrimination—including torture by some authorities along the border. To make matters worse, on September 23, 2013, the Dominican Republic’s Constitutional Tribunal published Law TC 168-13 with a retroactive clause that eliminates the citizenship of thousands of Dominicans of Haitian descent who have lived in the country since 1929.

Despite the fact that mass deportation would expand the humanitarian crisis in Haiti on top of the impact of the major 2010 earthquake, the Dominican migration office started in August the expulsion of thousands of Haitian migrants and Dominicans of Haitian descent (who are now stateless) out of profound xenophobia. Since then it’s estimated that more than 65,000 people were deported or forced to leave the country, causing an alarming situation at several unofficial and official border points, including Ouanaminthe, Belladère, Malpasse, and Anse a Pitres. In Anse a Pitres, the repatriated and stateless live in open-air camps at high risk of extreme poverty, child malnutrition, juvenile delinquency, and an increase in death due to cholera, malnutrition, and malaria—among other diseases.

Clinicians are providing care to patients primarily for infectious diseases like HIV, tuberculosis, and cholera and for children under 5 suffering from moderate or severe malnutrition. The number of hospital births has increased considerably thanks to a dynamic collaboration between Zanmi Lasante and the Ministry of Health in these remote communities.

While we recognize the right of the Dominican Republic as a sovereign nation to pass laws or create fair and inclusive immigration policies within its territory, we demand justice for the flagrant violation of human rights executed by a brother country towards thousands of stateless Dominican brothers and sisters. Together we shout: “No to violence, no to racism!”

Long live solidarity between the people!"

Links:

Rebecca E. Rollins / Partners In Health
Rebecca E. Rollins / Partners In Health

 (Above: Dr. Thelisma Heber cares for a patient at the Cholera Treatment Center in Mirebalais, Haiti.)

Thank you for your support of Partners In Health, Zanmi Lasante (our sister organization in Haiti), and the thousands of people who you've helped to receive treatment for cholera, as well as education and resources to prevent it. Below please find an excerpt from a piece posted on our website this past summer. While we've made great progress in the places where we work in Haiti, cholera rages on.  

Haiti never knew cholera until 2010. That’s when the United Nations flew in a group of peacekeepers from Nepal, whose capital had recently suffered an outbreak of the disease, and set them up in a camp with poor plumbing. Contaminated sewage leaked into a tributary of the longest river in the country, the 200-mile Artibonite. Since the first person was diagnosed in October 2010, there have been more than 739,000 cases of cholera and 8,900 deaths, according to Haiti’s Ministry of Public Health and Population.

So why does cholera continue to plague Haiti, and PIH/ZL sites, five years after the initial outbreak?

“We haven’t gotten rid of the reasons for the transmission of the bacteria, and that’s because there’s such poor water and sanitation,” says Dr. Louise Ivers, PIH’s senior health and policy advisor. Since the outbreak began, “there have been no transformative water and sanitation activities, and so the underlying problem is still there. I think that’s why the number of cases has started to go up again.”

Ivers also says numbers may be higher where PIH/ZL operates because the Centre region is one of the poorest in the country and, therefore, has limited water and sanitation infrastructure. Plus, staff actively record cholera cases, something that is not true everywhere in the country because human resources are lacking. A full count of the disease could be much higher nationwide.

In response to the epidemic, the governments of Haiti and the Dominican Republic proposed a 10-year, $2.2 billion plan to eliminate cholera, including investments in new water and sanitation systems. But that plan, announced in 2012 and supported by an international community of donors, is only 13 percent funded.

Some advocates believe the U.N. should shoulder more of the burden for cholera in Haiti. Brian Concannon and the non-profit he co-founded, the Institute of Justice and Democracy in Haiti (IJDH), has requested the U.N. accept responsibility for the initial outbreak. The IJDH filed a lawsuit against the U.N. in U.S. federal court in 2013, but a judge dismissed the case in January 2015. The organization is now appealing that ruling.

Meanwhile, Partners In Health/Zanmi Lasante (ZL) staff do what they can to halt the most recent spike in cases, as they’ve done with others in the past. They mobilize a network of community health workers to find patients, open rehydration posts in remote locations, educate people about proper hygiene and sanitation, and diligently work to bring reliable water and sanitation systems to the region.

More comprehensive work needs to be done. In a 2010 article published in The Lancet, Ivers and Dr. Paul Farmer, a PIH co-founder and chief strategist, laid out a detailed roadmap to break the cycle of cholera. They wrote that health care professionals have to aggressively find and treat cholera cases and administer vaccines such as Shanchol, which Ivers and her colleagues found reduced the number of cholera cases by 63 percent among those vaccinated in villages north of St. Marc. Water and sanitation systems need to be improved. Public health care systems have to be strengthened. And global health policy must be crafted to give cholera the level of attention it deserves.

 

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Organization Information

Partners In Health (PIH)

Location: Boston, MA - USA
Website: http:/​/​www.pih.org
Project Leader:
Laura Soucy
Annual Giving Coordinator
Boston, MA United States
2016 Year End Campaign
Time left to give
$10,291 raised of $50,000 goal
 
137 donations
$39,709 to go
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