Recent weeks have seen a sharp increase in the cases of cholera seen in the capital Port-au-Prince and outbreaks have been reported elsewhere in the country.
In mid-May, case numbers tripled in a week. Médecins Sans Frontières MSF (Doctors Without Borders) quickly reopened cholera treatment centres (CTCs) to care for those infected.
In the second week of June, MSF treated 2891 cases, more than six times the number of cases treated in the last week of April. For now, the surge may be starting to subside. In the week ended 19 June, MSF treated 1470 cases, a reduction of almost 50 percent over the previous week.
“Last week’s decrease in cases is good news, but we can’t get complacent. The cholera epidemic in Haiti is far from over,” said Sylvain Groulx, head of MSF's cholera response in the Carrefour area.
Much more still needs to be done. The authorities and other aid partners need to stop the spread of the disease by strengthening the national disease surveillance system and treatment facilities. Immediate improvements in hygiene, sanitation and drinking water supply should be a national priority.
Pictures by Yann Libessart and quotes from Romain Gitenet, MSF head of mission.
"The figures are alarming. In the first week of June we had more than 1,800 cases in three days. Cholera has affected the whole city. We have also been asked to intervene in other areas in the interior of the country," said MSF Head of Mission Romain Gitenet. "Too many public facilities are still inadequate." Yann Libessart/MSF
Gitenet added: "We had to reopen emergency CTCs to prevent existing treatment centres in Carrefour, Delmas, Martissant, Cité Soleil and Drouillard from being overwhelmed. We are in a city with land disputes, so we set up where we can. We have no choice." Yann Libessart/MSF
"We have put together an entire system of ambulance transfer- five MSF ambulances transfer patients between treatment centres." Yann Libessart/MSF
But for Gitenet, "vigilance is still the best protection. People must be strict about their hygiene and drink treated water. As soon as cholera symptoms like vomiting and diarrhoea appear, it is vital to go as quickly as possible to a treatment centre. Cholera is treatable but without medical care it kills quickly." Yann Libessart/MSF
He explained: "During the first peak, the camps were hardly affected because there was help with latrines and distribution of chlorinated water. Since late March, the national organisation which used to distribute free chlorinated water in IDP camps began recovering costs: water is now paid for. We sounded the alarm at the time, saying that we were still in an outbreak phase. This could be in part why the camps are now infected when before they had not been." Yann Libessart/MSF
"We spend a lot of our time readapting structures and moving staff around. When you have 300 employees, it is like a hospital, and it must be managed. The most acute problem however is not the national staff. When we don't receive the expatriates to oversee these structures, it becomes a serious problem." Yann Libessart/MSF
"In the first four months, MSF treated 50% of all reported cases in the country while the Cuban medical brigades treated about 30%. Other teams were also here, but some were slow to start. Now, we are no longer alone," Gitenet confirmed. Yann Libessart/MSF
"Not many other organisations have big facilities - we are still the one of the few able to provide CTCs with 300 beds; most of the others have 40 or 50 beds, but put together, that's something. If the outbreak spreads to the countryside, we will quickly see who is able to react and who is not." Yann Libessart/MSF