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Notes from the field: Cholera outbreak in Haiti


Saint Marc, Haiti – October 22, 2010

Twenty-month-old Clarena lies nestled in her uncle’s arms. Her mother, Rosedani, brought her to Saint Nicholas Hospital three days previous, leaving her seven other children in the care of relatives.

“I’m very worried,” Rosedini admits. “Very worried.”

Clarena is among hundreds of cholera-diseased patients who are overwhelming the already meagre resources of this local hospital, 70 kilometres north of the Haitian capital of Port-au-Prince.  Young and old lie dazed and distracted on makeshift beds spilling into the hospital courtyard. They rest immobile, tied to intravenous bottles filled with saline solution to combat dehydration. Tired relatives stand by holding the bottle a loft. Men, women, and children alike lie wrapped with diapers to stem the constant flow of bodily fluids.

The uninfected, mostly family members and local and international volunteers, mill about the hospital’s crowded courtyards, many with their noses filled with cotton believing this alone will protect them from infection.  The hospital gates open regularly to admit more of the infected, some arriving in the back of pickups, others on motorbike sandwiched between mother and father.

This is the heart of Haiti’s frontline response to this cholera outbreak.

“What we are seeing here is the start of a potentially bigger health crisis,” says Jean Claude Mubalama, Chief of the Health section in UNICEF Haiti. “Proper preparation and coordination now between humanitarian agencies and local health officials will determine just how wide-spread this disease will be and the kind of impact it will have on children, pregnant women, and older citizens who are the most vulnerable.”

What began as a severe outbreak of diarrhea has just now been confirmed for what was most feared – cholera; an intestinal bacterial disease that results in watery diarrhea and vomiting. It is spread through contact with contaminated drinking water and food. Proper treatment comes through rehydration and antibiotics. Unless properly treated, cholera can quickly expand into a full-scale outbreak.

Ministry of health officials estimate 115 people have died since Monday and an estimated 1,040 people have been hospitalized in Haiti. At least half of these patients were admitted in the last 24 hours having travelled to this small urban centre from outlying communities.

This latest emergency comes just over 10 months after the devastating January 12 earthquake that killed an estimated 300,000 and left 1.3 million homeless in this small Caribbean nation. It also comes on the heels of recent flooding in the Artibonite region north of Port-au-Prince, which can further aggravate efforts to contain the disease.

Areas immediately impacted are the jurisdictions of Grand Salines and L'Espere, and the community of Saint Marc itself.  Although Saint Nicholas Hospital is filled to overflowing, health officials report that there are enough supplies to treat the current level of disease for another three days.

The fact that most of those sick with acute diarrhea have come from outer lying areas indicates the nexus of the disease. Ministry of health officials believe the disease to be concentrated along the Artibonite River, running southeast to north west of Saint Marc.

UNICEF is working with partners on the ground to deliver antibiotics, saline liquids, chlorine tablets, tents, blankets, hygiene kits, and water treatment tablets, as well as response coordination assistance.

“We cannot overstate the importance of acting quickly now so that the impact on children can be lessened later on,” added Mubalama. 

“Children are the most vulnerable in disease outbreaks such as this. We will be working with our partners, including the Ministry of Health, to mobilize community responses. Simple actions such as hand washing with soap before coming into contact with food and after using latrines and also drinking only boiled or purified water are simple but effective ways of preventing the spread of this disease.”

This information might have helped six-year-old Emmanuela, who lies unmoving on her lap of her mother, Momma. Emmanuela waits quietly for additional medication, having already received antibiotics and some sterilized water from a hospital worker. Like so many here at Saint Nicholas Hospital, she and her mother came from outside the city seeking medical care.

To support UNICEF's emergency efforts, please donate to the
Haiti earthquake relief fund.

For further information:

Stefanie Carmichael, Communications Specialist, (416) 482-6552 ext. 8866; Cell: (647) 500-4230,
Tiffany Baggetta, Director, Communications and Brand, (416) 482-6552 ext. 8892; Cell: (647) 308-4806,