By Jason Usher
Cholera is one of the fastest-acting diarrheal diseases in the world and can result in death in 24-48 hours if left untreated. There are between 3-5 million cases each year, and about 100,00 deaths are attributed to this bacterial-borne illness1.
Before eight years ago, there was no history of cholera in Haiti. In the aftermath of the earthquake in 2010, an outbreak was traced to a United Nations Peacekeeper’s base, and began to quickly spread from the Artibonite region to the rest of the country. As a country that experiences a yearly hurricane season, Haiti has been vulnerable to resurgences of cholera and other water-born illnesses each year since the original outbreak.
Cholera is relatively simple to treat- severe cases require intravenous fluids and antibiotics. An oral vaccine has been developed but has not been widely distributed. A nation’s water and sanitation infrastructure, along with good hygiene practices, are a country’s most effective and preventive tool against cholera. As one of the poorest countries in the western-hemisphere, Haiti’s government has struggled to deal with issues in the WASH sectors.
Data from the Joint Monitoring Program (JMP), a partnership between the WHO and UNICEF to track progress towards Sustainable Development Goal targets and indicators related to WASH. This report shows that Haitians’ access to improved water sources and sanitation facilities has been steadily improving since 2000. It also demonstrates the inequality of access to these things between rural and urban populations.
Reported cases of cholera peaked in 2011, with nearly 350,000 cases during that year. Recently, beginning in 2014 we can see the reported cases begin to increase again for the first time since the earthquake. Yet the estimates of the Haitian population with access to improved water sources and sanitation facilities have been increasing.
Many efforts have been complicated to control cholera since 2010. In the wake of the earthquake, many NGOs came to Haiti, often in uncoordinated efforts, to alleviate the suffering following the natural disaster. In 2013, the Haitian government launched the National Plan for the Elimination of Cholera in Haiti, 2013-2022. This $2.2 billion intends to address the epidemiological, structural, and management problems in the health, water, and sanitation sectors in Haiti. Success has been limited in part due to the dynamic nature of cholera, which is also affected by things like weather, food insecurity, and the ecology of the disease itself4.
When dealing with a disease as relentless as cholera, success can be difficult to measure. Addressing the needs in WASH infrastructure in Haiti will be key to eliminating cholera in the country.