Cholera Outbreak Spreads in Haiti

As the cholera outbreak in Haiti worsens, Catholic Relief Services is responding with aggressive measures to help prevent the spread of the disease and treat the sick. The cholera outbreak has infected more than 15,000 Haitians and killed more than 900.

CRS is providing Haitians with soap, water purification tablets and related guidance to prevent the outbreak from continuing to spread. In Port-au-Prince, more than 10,000 families have received soap from CRS. CRS is also increasing water and sanitation activities in several camps, including latrine and water station repairs and extra disinfection, extra water treatment, and additional solid waste removal.

CRS’ health team, with colleagues from the University of Maryland, has also been working to help 7 CRS supported hospitals around the country and four health centers managed by our partner Caritas, to respond to an influx of cholera patients. CRS is also focusing on people living with HIV, who are at increased risk of cholera. Hygiene kits are being assembled for 7,000 people living with HIV supported through CRS’ AIDSRelief program to help them prevent infection.

The disease has reached Port-au-Prince, where more than one million displaced people still live. Poor sanitation and hygiene in the settlements make people particularly vulnerable to the disease, which causes diarrhea and vomiting so severe that it can kill a person within hours if rehydration measures are not taken.
Each of Haiti’s 10 regions, and neighboring Dominican Republic, have reported suspected cases of cholera.

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3 Responses to “Cholera Outbreak Spreads in Haiti”

  1. Paul Says:

    Please tell me how I can contribue via CRS to help this tragedy


  2. David M. Campbell Says:

    What is the best way to assure that Ringer’s lactate can be effectively distributed to the most critically needy Haitian refugees? Is there any way for CRS to avoid the stockpiling and government red tape that is preventing these drugs from getting into the right hands to provide relief for cholera patients?

  3. John Lindner Says:

    David Campbell,
    Here’s a response to your question:

    The internally displaced people within Port-au-Prince have relatively better access to health services and supplies, including Ringer’s lactate, than in the rest of Haiti. There are many organizations working in this urban environment, people live in relative proximity to health care services, transportation is relatively accessible, and the logistics of delivering supplies from the government warehouse in Port-au-Prince are among the most straightforward. The greater challenge in the case of Haiti’s cholera epidemic is reaching the rural poor. However, the challenge you raise with getting essential supplies (Oral rehydration supplies, aquatabs, intravenous fluids, antibiotics) to the people that need them is a critical one for all organizations working in Haiti.

    The United Nations system, through the Pan American Health Organization (PAHO) has been spearheading the supply chain management response. Understandably they face a massive challenge and things are not always seamless. Supplies are coming in to the country from a variety of sources (both ordered and donated) and it can be difficult to know arrival dates – this is turn makes it difficult to dispatch supplies. It is standard practice to maintain small “buffer stocks” that can be dispatched to sites with a pressing urgent need if the next shipment does not come in as scheduled. In times of crisis, such as this, many requests for supplies come in and must be prioritized so that the supplies go first to those with the most urgent needs, and then if supplies remain to sites that are trying to prepare. Human resources are needed throughout the process: managing warehouse stocks, reviewing requests for shipment, loading the trucks (you need trucks!), driving the trucks, unloading, and maintaining and monitoring stocks at the recipient site. Unfortunately, Haiti’s supply chain system was not well developed even before this emergency, and civil unrest has posed an additional challenge as some sites have been inaccessible for days as the result of blocked roads. That said, dispatching hospital supplies like Ringer’s lactate can actually be easier than other important household-focused goods like Oral rehydration salts or water purification tablets.

    Improving access to life-saving cholera treatment (and prevention) in Haiti requires a multi-pronged approach. First, get the right quantity of supplies to the right place at the right time. CRS has helped supported sites forecast their needs and transmit requests to the PAHO-managed warehouse. CRS is also helping sites manage their stocks so they know when to reorder. The better information on needs the warehouse can get, the more rationally they can dispatch supplies. As supply levels in country stabilize and needs are more easily forecasted, CRS will work with sites to create their own buffer stocks to avoid any stock-outs associated with disruption in the supply chain.

    Secondly, the supplies need to be available and accessible to the people most in need. This requires overcoming barriers such as long distances to hospitals and medical personnel who may not know how to appropriately use the supplies. CRS is working with the Centers for Disease Control and Prevention to help train the nation’s health care providers in proper management of cholera. The international community as a whole is trying to set up community-based rehydration centers which use oral rehydration solutions (which can be made from locally available supplies) to improve access.

    Of course, the best way to reduce the strain on the supply chain system is to reduce the number of cases of cholera (and people needing supplies). CRS and its partners are working to provide cholera-prevention materials such as key messaging and basic supplies (like soap).

    -Mereith Stakem, CRS

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