GHESKIO responds to Cholera outbreak in Haiti

As of October 7th, there have been 170 cases of cholera reported with 19 laboratory confirmed cases in Port au Prince. Both the Ministry of Health’s and GHESKIO’s lab have confirmed cholera cases. The cases have been reported in multiple neighborhoods in greater Port au Prince and so the suspicion is that the disease may have been spreading undetected for a few weeks and is now widespread in the city. It is not yet known whether this is a resurgence of the old strain from 2010 or the introduction of a new strain. Children are severely affected. The Haitian Ministry of Health provides informative updates here: https://www.mspp.gouv.ht/.

The GHESKIO team has opened two emergency cholera treatment centers (50 beds each). There are cases in the neighborhood (City of God) in downtown Port au Prince adjacent to GHESKIO’s campus. On Monday October 10th, the downtown GHESKIO cholera treatment center was nearing full capacity. GHESKIO has also started to provide education, chlorinated water, and outreach to the community. The Haitian Ministry of Health notes that poor neighborhoods are most severely affected by cholera.

The political situation, gang violence, and a blockade of the main port in Port au Prince has led to a severe fuel shortage in the country. It is impossible to purchase diesel fuel in the country though most organizations rely upon diesel generated electricity. Medical supplies are also blocked.  WCM faculty member and Director of GHESKIO Dr. Jean Pape provided the following statement:

“The fuel crisis may have initiated the resurgence of cholera and will definitely propagate it like wild fire.

Because of the lack of fuel in the country:

1. DINEPA (National Water Utility) could not pump water from its water reservoirs to provide for the most at-risk populations living in the slums of PAP. Bottled water companies have also shut off their production. This has led to a severe shortage of clean water for drinking, especially in the poorest neighborhoods.

2. The city’s garbage  trucks could not pick up the huge amount of trash. Recent heavy rain fall has flooded down town areas and washed even more garbage down into the low-lying neighborhoods. It is common to see large amount of garbage in public markets where food for consumption is sold. 

3. The heavy rain will cause flooding and bring the cholera bacteria in rivers. Water from such rivers are used by people for drinking, especially at a time of potable water shortage, leading to further spread of cholera in the same manner as the first epidemic.

3. Public transportation is inexistent making it impossible for sick patients with suspected cholera to reach hospitals and clinics for diagnosis and care. 

4. The fuel shortage and insecurity makes it difficult for Ministry of Health teams to go into the field to investigate suspected cases and to seek the potential sources of infection. Often, the source of infection is a water source in close proximity to a latrine.

5. This situation caused a delay in diagnosing the first cases, explaining why there are simultaneously many places (at least 5) where the emergence of cholera was documented. This will make the epidemic much harder to control.

In summary we have the perfect storm for a major cholera  epidemic which could cause thousands of deaths."