Kolera 2012: “It gets worse”

May 24, 2012

While most major U.S. media attention focuses elsewhere, NGO’s and UN agencies are sounding alarm bells about rising rates of cholera infection. A release today from the UN Office for the Coordination of Humanitarian Affairs (OCHA) states

Grave concerns were expressed by aid workers that this year’s epidemic, which has already affected 13,000 people, 132 of whom have died, may escalate. Detection and response capacity are significantly reduced this year due to cuts in aid budgets. The OCHA Director stressed the urgency for new and more sustainable approaches by aid agencies and local authorities, and more commitment by donors. “It is unacceptable that lives are being  lost to cholera because last year’s capacity building in the areas of prevention and response were lost due to a lack of funding,” [OCHA’s Director of Operations John] Ging said.

An Inter Press Service article last week, titled “Funding Dries Up Even as Rains Worsen Cholera Deaths” begins

As predicted, the beginning of the rainy season in Haiti brought exponential increases in the numbers of people sickened and killed by cholera.

While the number of new cases in December was about 300 per day nationwide, this week one centre in the capital alone reported receiving 95 cases per day. And the numbers are expected to increase.

“Between the first week of April and the last week of April, the number of new patients increased by three-fold” in the capital, Gaëtan Drossart, head of mission for Doctors Without Borders or Medecins san frontières (MSF), told IPS on May 16. “In April alone, we saw over 1,600 patients at the four cholera centres MSF supports in Port-au- Prince.”

The cholera death toll is up to 7,155, with 543,042 infections over 586 days (and no UN apology so far), according to a new “cholera counter” created by advocacy group Just Foreign Policy.

Inter Press’ Jane Regan also writes that on May 1, OCHA “put the national fatality rate at above three percent, the highest since the beginning of the outbreak. And the Pan American Health Organization (PAHO) announced that between 200,000 and 250,000 more people will likely contract the disease during the course of 2012” – a figure also cited in a recent New York Times editorial that said “the U.N. and the international community have a responsibility to meet the crisis head-on,” to the tune of “$800 million to $1.1 billion” to build water and sanitation infrastructure (thus echoing the demands of the Institute for Justice and Democracy in Haiti, Rep. John Conyers – who is currently circulating a letter in Congress, and so many others).

Regan goes on to note a key factor that this blog, a feature New York Times article, and the Times editorial have all warned about: the scaling back of cholera treatment and prevention, just as incidences rise with the rainy season – which is what happened last year.

Despite the fact that all actors knew this year’s rainy season would bring increased cases, the number of CTCs has dropped precipitously since the outbreak. In January 2011, there were 101 centres nationwide. Today there are only 30.

The number of actors has also dropped.

MSF is one of the handful of large non-governmental organisations (NGOs) still involved in the fight against cholera. The French organisation has fielded about one-third of all cases since the outbreak began, according to their figures.

Many of the NGOs who first heeded the call when the disease struck are today long gone.

Regan reports that the few NGO’s that are left – such as Partners in Health and MSF – work overtime to fill in the gaps.


CTCs run by the government, staff and community outreach workers have not been paid in months. For example, at the only CTC for Gonaives, one of Haiti’s largest cities, 12 of 15 employees haven’t been paid in for the past four months.

The budget for Haiti’s ministry of health is very small compared with its neighbours. In 2009, the World Health Organization determined that total spending on health in Haiti per capita was 71 dollars. For the Dominican Republic, the figure was 495 dollars. For Jamaica it is 383, and for Guatemala, 337 dollars.

As the Times editorial notes, the situation is even more dire, as there is a new danger this year:

It gets worse: the Centers for Disease Control and Prevention released a report this month that cholera in Haiti was evolving into two strains, suggesting the disease would become much harder to uproot and that people who had already gotten sick and recovered would be vulnerable again.

The CDC report states

Thus, if the Inaba strain becomes established in Haiti, persons who previously were infected with the Ogawa serotype of V. cholerae might be relatively more susceptible to reinfection with the Inaba serotype than with the Ogawa serotype because there tends to be stronger serotype-specific protective immunity.

But so far, even this new danger doesn’t seem to be enough to make fighting cholera in Haiti a cause célèbre. Maybe a viral “Kolera 2012” campaign would do the trick?

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