Combatting Cholera in a New Setting
By admin August 3, 2016

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(UN Photo/ Logan Abassi)

Since the introduction of cholera to Haiti in 2010, the UN has used more than $59 million out of the allocated $307 million to reduce the number of cholera case fatalities. The implemented 291 initiatives have led to more than a 90 percent reduction in cholera cases since peaking in 2011 – from 350,000 to 22,000 cases. A standard “sanitary cordon” set-up was set up as a rapid response mechanism to prevent cholera from spreading after neighbors are infected with disease, and has shown encouraging results. The working initiatives in Haiti have significant implications not only for cholera outbreaks, which are estimated at 3-5 million cases a year, but for infectious disease responses across the world.

Cholera is an infectious and often fatal bacterial disease that is characterized with symptoms of profuse watery diarrhea, vomiting, and leg cramps. The rapid loss of body fluids leads tos dehydration and shock, which can lead to death within hours. It is usually found in water or food sources contaminated by feces from an infected human. Places without water treatment or proper sewage system are likely to face epidemics. The lack of infrastructural development in sanitary facilities combined with local habits of open defecation and a rainy season result in community resources – such as rivers and unprotected wells – vulnerable to contamination.

Facing epidemics requires a two-pronged rapid response and long-term response approach. The short term response of setting up a sanitary cordon includes: interviewing the family and friends of a patient, identifying hygiene practices and water points and then identifying the cause of an outbreak. Disinfection of affected person’s surrounding and education of community about protective measures follows. The response team will provide a one-month supply of chlorine to purify water, supplies of soap and buckets for handwashing and anti-biotics to establish an immunity shield from bacteria. A few days after, a monitoring team will come to test for presence of chlorine in water. While most of funds are used to maintain the rapid response approach to control epidemic, long-term implementations must also be set to eliminate cholera in the region. These include measures that strengthen water, sanitation and hygiene infrastructure, ensuring access to health services and capacity development in preventative health through improved water supplies, non-shared toilets and elimination of open defecation.

Haiti, in particular, has faced enormous challenges in overcoming cholera. Because the disease was just introduced in 2010 from Nepal by a UN peacekeeper, Haitians did not have a built immunity to or basic understanding of the new disease. Moreover, Haiti had still been recovering from the earthquake earlier in the year. With recent devastation and an impoverished population and government, Haitians had already been living on a fertile ground for a disease spread by feces. While the UN set out to eradicate cholera in Haiti and the Dominican Republic in 2012, the initiatives have been considered inadequate and underfunded. Currently, the UN is facing pressure from the international community to claim responsibility for the epidemic. Regardless, the reduction in the number of fatal cases as a result of new protocol is promising for future emergency health initiatives.

Find out more:

Feature: Tackling cholera in Haiti by building sanitary cordons

CDC: cholera

In Haiti, Global Failures on a Cholera Epidemic

The Cholera Epidemic the UN Left Behind in Haiti

Kenya: Concerted effort to fight cholera shows significant success

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