The AP’s Trenton Daniel reported over the weekend on the rise in cholera cases that have been seen since heavy rains hit Haiti early in June. Daniel reports:

The number of new cases each day spiked to 1,700 day in mid-June, three times as many as sought treatment in March, according to the Health Ministry. The daily average dropped back down to about 1,000 a day by the end of June but could surge again as the rainy season develops.

According to data from the Health Ministry, over 5600 people have now died from cholera, while over 380,000 have been sickened. In addition, throughout June, on average 8 people were dying each day, up from an average of 3.5 in May. As Daniel points out, however, “[t]he precise total is unknowable since many Haitians live in remote areas with no access to health care.”

Yet despite the renewed strength of the epidemic, there are signs that the health sector is being stretched thin:

The disease faded in winter and spring, when rain is less frequent, and many aid workers moved on. U.N. troops in Haiti turned their attention to the country's many other pressing problems.

Now there is a fear among aid workers who remain that there won't be enough resources if the latest surge gets much worse.

"If the cases continue on the same path we could see a lot of health-worker fatigue," said Cate Oswald, a Partners in Health co-ordinator. "The health care force is already stretched thin."

After heavy rains hit Haiti last month, the Red Cross and Doctors Without Borders (MSF), among others,  issued statements saying they would be reopening cholera treatment centers (CTCs) in the capital to respond to the renewed outbreak. Updated lists released in late June by the Health Cluster, however, reveal that the decline in the number of CTCs has continued throughout the beginning of the rainy season. Table 1 shows the evolution of CTCs in each department over the last four months.  The only department that saw an increase in the number of CTCs was the Ouest department, and even there it was only by one. While more than one CTC was reopened in the Ouest, nearly the entire gain was offset by the closing of other centers. Although the number of CTCs has fallen, the total capacity of cholera facilities (including CTUs) seems to be holding steady, according to partial numbers from the Health Cluster. This may be further evidence that those health providers that have continued to operate have been forced to stretch resources to make up for the exit of other organizations.

Last Thursday, in the Dominican Republic, every westbound bus traveling on the transportation artery Autopista Las Américas (The Americas highway) was stopped upon its arrival in the capital city of Santo Domingo between 7 a.m. to 10 a.m., according to Listín Diario. A joint operation between immigration officials, the National Police and the Dominican Army set up checkpoints, which led to the detainment of “dozens” of “illegal Haitians.”

The sugar-producing East, from which the buses came, is a hub for thousands of Haitian migrants working under brutal conditions cutting cane. As was reported by Dominican Today, “When inspectors entered the buses and asked the Haitians for their ID, if they were in order, they weren’t bothered, but dozens of them that didn’t [have appropriate documentation] were escorted onto buses to clearing centers.”

This description gives a good idea as to how Dominican authorities ascertain whether or not one is in the country illegally—by targeting those who appear to be Haitian. Summary detentions and mass deportations of Haitians amount to a longstanding and ubiquitous dynamic in Dominican law enforcement. The seemingly straightforward protocol of asking for proper identification quickly becomes an exercise in discrimination, as many Dominican nationals also have difficulty obtaining valid documentation. A 2006 survey by the Dominican government’s National Office of Statistics found that 22% of children born during the previous five years did not have birth certificates, “and thus,” Unicef noted, “legally, did not exist.” The crackdown against illegal immigration is closely linked to efforts to remove those of Haitian descent from the country.

The human rights community has strongly opposed mass repatriations to Haiti. Earlier this year, Amnesty International demanded that the D.R. “immediately halt the mass deportation of Haitian migrants.” Last month, the UN Office of the High Commissioner of Human Rights appealed to all governments to “refrain from conducting returns to Haiti” [PDF]. Given the “current situation prevailing in Haiti,” the High Commissioners also asked governments to “renew, on humanitarian grounds, residence permits and other mechanisms that have allowed Haitians to remain outside the country.” Similarly, the ACLU, along with more than 50 other groups, has called on the U.S. to stop deportations to Haiti.