Cholera Deaths: The New Norm in Haiti?

The loss of funding means that in months, thousands of patients -- people we have the tools, skills, and expertise to save -- will become sick, and hundreds more may needlessly die. This wouldn't be accepted in a wealthy country. And we're not willing to accept it in Haiti.
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As Hurricane Sandy tormented the East Coast, bringing damage and distress to many, there's one thing she didn't bring -- cholera. With practically universal access to clean, chlorinated water and improved sanitation, cholera has been eliminated from the wealthy world for many years. But in Haiti, Sandy's torrential downpours have flooded rivers across the country and already contributed to an increase in cholera cases.

In reality, cholera has become a part of daily life here in Haiti. Despite being two years in and the caseload decreasing, it's still talked about at schools, in churches, at rural and urban market places, in government and business meetings as if it just arrived in the country. It's become the theme of numerous radio jingles and posters to encourage individuals to wash their hands, boil and treat their water, and properly clean and prepare their food. It's also instilled ongoing fear as young and old alike continue to be sickened by the highly infectious bacteria.

In total, cholera has sickened more than 600,000 people and killed more than 7,500. Last year, Haiti logged more cases than all the rest of the world combined, according to the World Health Organization. This year the epidemic is on track to be among the world's worst again, with nearly 77,000 cases and 550 deaths, according to the Haitian Ministry of Health. We're continuing to see cases rise and fall with seasonal rains. Despite the decrease in cases from 2011, every new case represents an unnecessary and preventable infection and an even further potential of completely preventable and unnecessary death in hardest-to-reach areas.

The initial signs of cholera first showed their tell-tale symptoms on that fateful day in mid-October 2010 in Mirebalais, where our organization, Partners In Health/Zanmi Lasante has been working for over 25 years. Since then, our team of more than 4,000 Haitian colleagues has been dedicated to bringing an end to cholera. Community health workers have provided household chlorination and cholera prevention messaging, doctors, nurses and infection control specialists have provided treatment for over 100,000 people, our water and sanitation team has built chlorinated water systems and latrines, and out experts piloted the oral cholera vaccine in hard hit areas earlier this year. This multi-pronged approach has contributed to a steep drop in cases.

We've both witnessed the deeply personal impact that cholera has had on individuals, families and communities here in central Haiti. In the initial days and weeks of cholera, we had families abandoning loved ones at treatment centers for fear that they would return home and make everyone else sick. We had patients treated and cured of cholera attempting suicide as their employers refused to take them back to work or school. We had children orphaned because their parents got sick and weren't able to get rehydrated quickly enough. As time has passed and more is known about the science of cholera transmission, much of this fear and social isolation has dissipated, but it took community-wide memorial services and psychosocial support groups to help patients and their family members come to terms with the fact that those with cholera did not deserve to be stigmatized.

We also witnessed incredible feats of solidarity: Community members helping to carry complete strangers for miles over mountains to treatment centers; signing up to help register and administer the oral cholera vaccine to every household in their neighborhood; leading education sessions in their churches, schools, and community centers.

We're also very aware that our work is far from over. The sad reality is that even though we know that cholera is not going away, emergency funding for cholera is. We at Partners In Health/Zanmi Lasante treated more than 900 patients with cholera just in September. If we continue treating cases at the rate we are now, our dedicated cholera funding will be gone in a few short months, and we have no new funds on the horizon. And we're one of a shrinking number of medical organizations partnering with the Haitian Ministry of Health to continue to provide prevention and treatment for cholera. Our friends at other organizations here in Haiti continue together with us in this struggle. They, too, are struggling to identify where ongoing funds for cholera prevention and treatment will come from as emergency cholera funding from incredible long-term partners such as the CDC and World Bank will no longer be available at the same rates in the new year.

We'll be blunt: The loss of funding means that in months, thousands of patients -- people we have the tools, skills, and expertise to save -- will become sick, and hundreds more may needlessly die. This wouldn't be accepted in a wealthy country. And we're not willing to accept it in Haiti.

Partners In Health/Zanmi Lasante doesn't come and go with the whims of media attention and the funds that come with it. We are, as always, committed to the people of Haiti, and that means working with our friends and colleagues in their communities as they battle cholera for the long haul. We need the ongoing support of the international community, now more than ever, to help us advocate for continued investments in water and sanitation infrastructure and for more accessible high quality health care options, especially for the rural poor. Will you join us in this ongoing fight to eliminate cholera in Haiti?

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