17 May 2011 - Cholera, like most news in Haiti, made headlines and then was placed on the sidelines as other more "newsworthy" events were brought to the forefront. Since the fall of last year, Haiti has been battling this ugly epidemic and it has been particularly devastating in the countryside due a lack of water infrastructure and nearly unnavigable dirt roads.
Haitians still in the midst of dealing with the tragedy of the earthquake began losing thousands to a once forgotten illness. For many this is an unimaginable new wave of heartbreak and loss. As of March 2011, over 240,000 individuals have been infected and 4,600 people have died from cholera.
The troubling part is that the worst is yet to come. A new study conducted at the University of California, San Francisco (UCSF) and Harvard Medical School predicts that the cholera epidemic could be far worse than initial projections, which had estimated 400,000 cases of the disease throughout the epidemic. The study is predicting that there could be nearly twice that number — perhaps 779,000 cases of cholera between March and November of this year alone.
Why? How can it be that cases of cholera had not been seen on the island for more than 100 years and now the disease has reemerged as a full blown epidemic? Simply put, cholera is bacteria spread from person-toperson through contaminated food and water. It causes diarrhea and can be deadly if left untreated (ScienceDaily, March 2011). Cholera is completely preventable in places where modern sanitation and clean water are readily available.
This is not the case in Haiti. Only 1 in 5 Haitians have access to a sanitary toilet or latrines. Of the rural population in Haiti, just 12% have access to sanitation and 51% have access to improved drinking water sources. These dire circumstances create a perfect storm for cholera to grow, spread and continue to contaminate individuals. The devastating truth is that 2010 brought the earthquake which was over and done with in mere minutes. Cholera which arrived just nine months later is not quick. It is persistent and will linger for years given the proper conditions.
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| Girls Carrying clean water |
And linger it has. Cholera continues to claim lives in rural communities throughout Haiti. A lack of proper water infrastructure and sanitation continue infections, while poor roads and a complete shortage of timely transportation (like ambulances) greatly reduce timely access to immediate care and increase the severity of the illness.
Several longtime partners of Lambi Fund have lost their lives to cholera and every partner has been affected by this deadly infection. Farmers from the Bige district recount story after story of carrying sick friends and family members on wooden doors across rivers. Four people carry one sick individual as they trudge through mud, fields, water and over hills in pursuit of the nearest Cholera Treatment Center (CTC). Others cart loved ones in wheel barrels, which as you can imagine is a jarring and unwieldy journey for someone who is ill and in desperate need of a hospital bed. Treatment at a CTC in a timely manner is proven to be critical, yet for the majority living in the most remote parts of Haiti, they simply are not close enough to be effective. Even more upsetting, many of these centers have been closed down as officials declare the need is subsiding.
What is being done in efforts to contain and control the rate of infections? The Haitian Ministry of Health has done a good job of launching a prompt and comprehensive awareness campaign. They have launched radio and television ads throughout Haiti that educate citizens on the contamination, spread, and symptoms of cholera, along with techniques for prevention and care. Educational materials and brochures have been widely distributed to health centers, schools and other public gathering places throughout the country. This campaign has been particularly effective in cities and towns and countless lives have been saved, yet for the rural parts of Haiti much of this information has yet to be received and cholera, not surprisingly rages on, intensifying in new spots of infections.
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| These community members living in rural Haiti have received clean water training |
Disseminating information in the rural parts of Haiti has been particularly difficult. Following the immediate outbreak, hysteria reigned. Due to a complete lack of knowlege of what cholera is or how it spread, community members abstained from organizing or meeting in local spaces. This immense fear made holding meetings to inform locals on the prevention of cholera very difficult.
Getting communities to once again organize and trust one another was the first step. From there, Lambi Fund has been fervently working to share the published information and reinforce the messages and strategies proven safe.
This has been a two pronged approach: first staff are meeting with organizations and providing information and visuals that explain how to prevent the spread of cholera. This includes water purification methods and hand washing.
From there, Lambi Fund field staff are planning training sessions for 2-3 people in each partner organization. These trainees have the role of circulating information regarding cholera prevention to all organization members and their families.
This is a critical component as these water ambassadors will work to keep the information alive. In order to prevent the return of old habits, they will work with community members to remind them to continue washing their hands and purifying their water long after the scare of cholera has subsided.
In the South, cholera numbers have been steadily increasing. Cholera broke out in the Artibonite region of Haiti, thus most treatment efforts have been focused in this region.
Given this reality, Lambi Fund project monitors are visiting all partner organizations in the southern provinces. During these visits, they are sharing with members how to prevent and protect their families from contracting the cholera bacteria. If symptoms are shown, Lambi Fund recommends keeping individuals hydrated through a serum of water and sugar. This is incredibly important, because these are measures to take before seeking a CTC, which are few and far between in the South.
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| Women using clean cooking methods to prevent the transmission of cholera |
This health crisis was certainly not one that was foreseen, but Lambi Fund has been doing its very best to mobilize and utilize its resources in an effort to educate the greatest number of individuals in rural communities. Maricelle, an organization member and recipient of Lambi Fund's cholera awareness program said, "We went through the earthquake, Lambi Fund is with us. We went through hurricanes, Lambi Fund is there and now we face the cholera epidemic and Lambi Fund is with us distributing goods and resources. Lambi Fund is with us hand in hand through the tough times."
To be certain, cholera will not disappear overnight. Josette Perard, Lambi Fund's Program Director emphasized the importance of these education programs stating that, "It is essential that we reinforce the prevention of cholera through education across Lambi Fund's various projects as a means to controlling and eliminating the disease." It is hoped that through this comprehensive grassroots campaign to educate and improve access to clean water, entire communities will benefit from improved health and cleaner environments as a direct result.
Read more updates in Lambi Fund's Spring 2011 Newsletter.
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