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Potential rise in cholera cases as lack of funding reduces services in Haiti

Just over a year since the outbreak of cholera first struck Haiti, the leading response organisation tackling the disease is warning that reduced services risk a significant rise in cases.

This echoes an earlier expression of concern about the situation from the Secretary-General of the United Nations (UN). In his last report on the ‘Stabilization Mission in Haiti’, he noted that the number of non-governmental agencies pulling out of Haiti because of a drop in donor funding could have a detrimental impact on cholera prevention efforts. Already, more than 6,500 Haitians have died of the disease since the outbreak began and nearly 500,000 have fallen ill.

International Medical Corps provides treatment for cholera sufferers in Haiti. According to a recent statement from the organisation, the closure of many cholera treatment centres (CTCs) has left the remaining facilities overwhelmed with patients. (As at July 2011, the UN reported there were 34 cholera treatment centres, 189 treatment units and 858 oral rehydration points throughout the country). The reduced number of CTCs also means longer distances for patients to travel and sufferers therefore tend to be more dehydrated when they arrive. The timing of treatment is key, since dehydration caused by the disease can kill within a matter of hours.

Greater awareness among the population has at least meant people with diarrhoea and vomiting are seeking medical help earlier. And messages about hand-cleaning and using clean water continue to be distributed by all available means, including graffiti on walls. More than 2,600 community health and sanitation agents have been trained by the United Nations Children’s Agency (UNICEF) to give advice on cholera prevention. However, some areas of Haiti, such as City Soleil in the capital, remain at high risk because of the limited access to safe water and latrines. And further into the mountains of Port au Prince, the availability of clean water becomes scarcer still.

Before the outbreak, Haiti had been free of cholera for nearly a century and therefore Haitians have little natural resistance. Studies suggest that the water-borne disease was probably brought by United Nations peacekeepers, who allowed untreated waste from a UN base to be dumped into a main river. Recently, the Institute for Justice and Democracy in Haiti has filed a legal case against the UN, demanding compensation on behalf of around 5,000 victims. If this suit is successful, the UN could be liable for hundreds of millions of dollars in compensation payments. In response, the BBC reported a UN spokesman as saying that the demand for compensation was being looked at by the “relevant parts of the UN system”. But in the meanwhile, the UN was continuing “to do everything possible to bring the spread of cholera under control, to treat and support those affected by cholera and ultimately to eradicate cholera from Haiti”.

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