You are here: HomeCommunityStories blogAs Haiti Combats Cholera, Health Facilities Central to Long- and Short-term Solutions

Blue dots - Cholera Treatment Facilities throughout Haiti (as of May 2012).  Red shading – cumulative Cholera cases, darker red indicates greater intensity (as of Nov. 24, 2012). Blue dots - Cholera Treatment Facilities throughout Haiti (as of May 2012). Red shading – cumulative Cholera cases, darker red indicates greater intensity (as of Nov. 24, 2012). Pan American Health Organization

As Haiti Combats Cholera, Health Facilities Central to Long- and Short-term Solutions

Last week the UN announced a new campaign to combat Cholera in Haiti and the Dominican Republic, committing $23.5 million in UN support as well as $215 million in existing donor funding.  A $2.2 billion call for additional donor support over the next ten years was also made.  This new push by the UN comes on top of the Initiative for the Elimination of Cholera in the Island of Hispaniola, launched by the presidents of Haiti and the Dominican Republic last year.

Cholera was introduced to the island of Hispaniola in 2010, in the wake of the earthquake which devastated much of Haiti.  According to the latest figures from Haiti’s Ministry of Health (MSPP), 625,899 cases of the disease have been reported since its appearance in October of that year, leading to 7,787 deaths – a further 420 deaths have occurred in the Dominican Republic. Cases have risen since Hurricane Sandy swepth through the region, underscoring the island's continuing vulnerability.

The global health community has a long track record of responding to cholera outbreaks, with successful eradication campaigns having taken place over the past 50 years in Latin America, Asia, and Africa.  Cholera, which is spread primarily through contaminated water, is most effectively curtailed through the provision of clean water, sanitation services and proper hygiene practices.  Even a rapid response to the outbreak on Hispaniola must focus on these long-term issues, but matters of funding, institutional coordination, education and infrastructure buildup will be critical to ending the epidemic.

Health facilities play a central role in these efforts.  While the need for clean water and sanitation extend far beyond the health facility, clinics and hospitals are on the front lines of reporting, treating and preventing the disease.  In responding to Cholera, health facilities have a number of crucial tasks, including:

•    Diagnosing and reporting cases
•    Treating patients
•    Supplying clean water
•    Safe disposal of contaminated waste
•    Preventative vaccination
•    Health and hygiene education

To meet these needs in the short-term, Cholera Treatment Clinics (CTCs), high-capacity clinics specific to cholera treatment, and Cholera Treatment Units (CTUs), low-capacity cholera treatment areas in existing health facilities, have been set up around the country to identify and treat cases of the illness.  These facilities must be prepared to tackle many of the challenges listed above, especially with regard to reporting, treatment and waste disposal.

In addition to the broad deployment of Cholera treatment facilities, education and vaccination initiatives have been launched as rapid, cost-effective response measures.  The CDC, for instance, has produced a suite of materials to train health workers to diagnose, treat and prevent infection, addressing subjects such as: rehydration, hand washing, water treatment, food preparation and community mobilization.

Vaccinations are increasingly viewed as an appropriate option for Cholera prevention in Haiti.  Small scale campaigns to vaccinate nearly 100,000 people were piloted by MSPP, Centre GHESKIO and Partners in Health’s Zanmi Lasante hospital in the spring of 2012.  In assessing the potential for a nation-wide vaccination effort, the organizations cited a need for greater cold-chain capacity and logistical planning in the country.  Were such a campaign successful, it could mean relief from the epidemic in the short-term, while water and sanitation improvements are ramped up.

Those long-term investments in water treatment and sanitation infrastructure, as well as health facility infrastructure for cold-chain capacity and power supply, will be essential to eliminating Cholera on the island.  They will also make Haiti more resilient to any future outbreak of the disease.  Achieving those goals, however, will take many years, and large sums of money to accomplish.  The UN’s latest Cholera initiative, the call for $2.2 billion over 10 years, is designed to that very purpose.

Through the Improving Health Facility Infrastructure (IHFI) project, USAID Haiti is supporting MSPP’s cholera efforts by contributing to the strengthening of the energy infrastructure of hospitals and health centers throughout Haiti. This includes backup power for laboratories and electronic data and communications systems, improved electrical wiring and installations to extend health facilities’ capabilities, and training of MSPP technical staff in proper operation and maintenance of backup power systems, including inverters, batteries and diesel generators.

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