Monday, November 08, 2010

Tomas storm passes Haiti, but a cholera storm could follow

A little silver lining can be found in Haiti, as the the tropical storm did minimal damage to the nation's capital of Port-au-Prince. Only eight people died in the storm, but it is still uncertain if the storm's waters could spread the cholera epidemic.

From Time Magazine, writer Jessica Desvarieux gives us the latest and shares a story of heroism.

"With all the inundation and consequences of the hurricane, the [populace] can become more vulnerable. There are more and more people [ingesting] cholera [through contaminated water]. We must prepare ourselves for the worst," says Dr. Claude Surena, a consultant for the Ministry of Public Health and Population. Surena's ministry first confirmed an outbreak of cholera on Oct. 20 in the bucolic Artibonite region, just north of the capital. Since then, there have been more than 7,700 confirmed cases in the country and at least 500 deaths, according to figures released on Nov. 5. Confirmed cholera cases rose 60% just this past week, ahead of Tomas' feared arrival.
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As Tomas' rains swept through Haiti, anecdotal evidence mounted regarding conditions that could lead to cholera's spread. In the Port-au-Prince district of Delmas 33, canals came close to flooding the fraying blue tents of a camp for people made homeless by the earthquake. The only reason no flooding occurred was that a group of men stood in the canal's murky water, picking up piles of trash with their bare hands to keep the waterway from clogging and overflowing. "We as a community had to band together to clean out the canals ourselves," says Renauld Pollicard, a camp dweller. "A lot of people are scared of getting cholera, so we had to pay those men. Otherwise, no one would go down in that hole." This does not mean, however, that the men who worked the canals were not infected. Or that other areas were not deluged with infected water.(Comment on this story.)

While there have been no confirmed cases in Port-au-Prince, people suffering from cholera who have been through Artibonite have been hospitalized in the capital. It is feared that flooding in southern regions like Léogâne poses an increasing risk of the bacteria contaminating more water sources. About 80% of those infected with cholera do not show symptoms but can still pass on the bacteria and infect others.

"This certainly right now is an epidemic," says Dr. Jordan Tappero, an epidemiologist and Haiti team leader for the U.S. Centers for Disease Control and Prevention (CDC). "We have to keep a mind-set that cholera is likely to spread across the county due to poor sanitation and lack of potable water."

Read more: http://www.time.com/time/world/article/0,8599,2029982,00.html#ixzz14ipar4T8

Medecins Sans Frontieres has this update on their operations in Haiti to prevent the spread of cholera.

As the cholera epidemic continues in Haiti’s northern and central regions, a primary objective is to ensure treatment for affected communities dispersed throughout these areas. With Hurricane Tomas having moved past Haiti, MSF medical teams will be able to expand their support and activities.

As of now, MSF has treated more than 6,400 patients suffering from acute diarrhea, including a large proportion suffering from severe dehydration, symptoms typical of cholera.

MSF is supporting two Haitian Ministry of Health hospitals in the Artibonite Region, where the cholera outbreak originated. Medical teams are working in the main hospitals in St. Marc and Petite Riviere. Relevant medical supplies, such as intravenous fluids, catheters, and oral rehydration solution, as well as chlorine for disinfection, are also being provided. But it is outside more populated areas such as these where assistance is especially needed.

“Outside of the larger population centers, it is critical that smaller, dispersed communities are able to access treatment,” said Kate Alberti, an epidemiologist with Epicentre, MSF’s epidemiological research arm, who is currently in Haiti. "We are very concerned about the spread of the epidemic in rural areas, where transport to existing health structures is difficult. Treatment centers need to be established and existing ones further supported in order to ensure rapid access to treatment.”

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