What's Working: Public Health Progress Since the Haiti 2010 Earthquake

As a country, Haiti has faced and continues to face enormous difficulties, but it has also proven remarkably resilient.
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The hardest moment of my 6 years as CDC director was telling the family of Diane Caves, a young professional staff member at CDC, that she had died in the Haiti earthquake.

Diane was one of many who lost their lives in this devastating earthquake. The 7.0 magnitude earthquake that hit Haiti in January 2010 killed more than a hundred thousand people and displaced another 1.5 million. It also decimated the country's already fragile health care system, and was followed by a devastating cholera outbreak that affected more than 725,000 people.

As a country, Haiti has faced and continues to face enormous difficulties, but it has also proven remarkably resilient. Addressing the public health needs of Haiti and helping them recover has been a daunting task, but it's one that CDC, along with the government of Haiti and other partners, has taken seriously.

2015-02-23-TEPACtestingchlorineresidual.jpgIn Haiti, a trained technician checks a water source for chlorine levels. Photo credit: David Snyder/CDC Foundation

And it's working. Over the past five years since the earthquake the country has made real progress. Four particular areas of progress are clean water, HIV prevention and treatment, immunization, and core public health capacity.

One of the most important areas of progress has been safer water systems to reduce the spread of cholera and other diseases. Water chlorination programs have been implemented in more than 100 communities, and more than 250 water and sanitation technicians have been trained. This investment in clean water and improved sanitation will have long-lasting effects for child growth and development, economic productivity, and community health.

Before the earthquake, the President's Emergency Plan for AIDS Relief (PEPFAR) was working in Haiti to ensure HIV-positive pregnant women were receiving antiretroviral therapy, so their babies could be borne HIV-free. Thanks to efforts to restore the program, the number of women treated not only rebounded by 2011, it almost doubled compared to pre-earthquake levels. Haiti is now close to its goal of eliminating mother-to-child spread of HIV.

Immunization programs are one of the best long-term investments a country can make in health. Since the earthquake, Haiti has nearly doubled vaccination rates for children and added new vaccines to protect children against two deadly killers: Haemophilus (Hib) and rotavirus. These vaccines now save more than one child's life every hour of the day -- more than 10,000 a year. The country has also doubled its cold-storage capacity, ensuring vaccines can be stored and used safely and effectively now and in the future.

2015-02-23-img4.jpgA vaccination team member gives cholera vaccine in Haiti. Photo credit: Nandini Sreenivasan/CDC

CDC and our partners are doing more than helping Haiti with these programs. We are also ensuring the country has skilled public health experts who will carry out these programs into the future. Since 2010, Haiti's Field Epidemiology Training Program (FETP), a program modeled after CDC's Epidemic Intelligence Service, has graduated more than 200 disease detectives whose skills will serve Haiti long into the future as the country continues to rebuild and strengthen.

Since the earthquake, I have visited Haiti three times, and with each trip I see progress being made. From the revitalization of HIV treatment services, to the establishment of new diagnostic tests, to the expansion of treatment for tuberculosis, Haiti is doing and achieving more. The health care workers and leaders I have met with are among the most passionate and dedicated in the world, and are deeply committed to building on the gains they've made.

While this is real progress, it is fragile. Although immunization rates are improving, they are still not yet where they need to be. And while chlorinated water systems greatly improve the prospects of the 107 communities that have them in place, the risk for cholera remains for the four out of every five communities that still need safer water systems.

At CDC, we know our work in global health must not only help countries heal in the aftermath of a crisis, but must lead to sustained improvements in public health. Each year, we present the Diane Caves Public Health Service Early Career Award to a young CDC professional who honors Diane's enduring traits of caring and service. CDC will continue to invest in Haiti's public health systems through partnership and training, ensuring Haiti will be able to continue saving lives into the future.