NEW YORK – Fortune has not been kind to Haiti. The pain and suffering arising from last year’s earthquake was already enormous, and has since been compounded by Hurricane Tomas and an outbreak of cholera. Now there is growing tension surrounding the just completed election.
That epidemic has spread to all ten departments of the country, as well as to the capital, Port au Prince. The Haitian Ministry of Public Health reports that the number of deaths is approaching 2,000, with the number of infections exceeding 80,000. Because many people do not have easy access to hospitals and clinics, these figures are rough estimates at best. United Nations teams fear that the actual number of deaths and current infections may in fact be up to twice as high.
Clearly, the epidemic will continue to spread. This is a function of a particularly virulent strain of cholera and underlying issues: a weak national health system, poor sanitary conditions, and a lack of clean water and other basic services. The World Health Organization and the Pan-American Health Organization (PAHO) estimate that the outbreak could affect some 400,000 people.
As the international community mobilizes to respond, we have two priorities: first, bringing down the fatality rate through effective treatment, and, second, informing the population about how to care for themselves, their families, and their communities.
There is some positive news, however grim the overall picture. While the epidemiological statistics are alarming, the death rate has declined in recent weeks, from 7.6% to 3.6%. The Haitian government, UN agencies, and the humanitarian community are moving quickly to put treatment and preventive measures in place. They are providing water-purification materials, carrying out large-scale public-information campaigns, and helping to build treatment centers.
Yet one thing is clear. Admirable as these collective efforts may be, they are simply not sufficient. Without a massive and immediate international response, the lives of hundreds of thousands of people will be at risk. It is up to us to act, with maximum speed and full deployment of resources.
Most immediately, there is an urgent need for more cholera treatment centers. More trained medical and non-medical personnel are needed to run these facilities. PAHO and WHO estimate that an additional 350 doctors, 2,000 nurses, and 2,200 support staff will be required over the next three months.
Approximately 30,000 community health workers and volunteers are also needed to help staff an estimated 15,000 oral re-hydration points. Still others are required to educate and promote better hygiene in camps and communities. It is vital that the Haitian people in all communities are fully informed about how to deal with this disease, and that they understand that cholera is quickly cured when diagnosed and treated quickly.
Essential medicines and materials are in short supply: water purification tablets, chlorine disinfectant, antibiotics, jerry cans, soap, water cisterns, and construction material for latrines. Stocks of oral re-hydration salts must be constantly replenished.
Not surprisingly, the incidence of cholera is highest in Haiti’s slums and rural areas, where people are farthest from assistance. In the camps where an estimated 1.3 million took refuge after this year’s earthquake, ironically, incidence is relatively low. The reason: we are there with what is required – medical aid, sanitation, and clean water.
To help Haiti help itself, we must extend our reach. That is why the UN and its partners issued the Cholera Inter-Sector Response Strategy for Haiti, a $164 million funding appeal to support the international community’s efforts to contain the outbreak. So far, it is only 20% funded.
This will not be a short-term crisis, so we cannot think only in the short term in formulating our response. Millions of people look to the international community for immediate survival. At the same time, our response must be viewed within the broader context of recovery and long-term development. Investment in basic infrastructure is critical – clean water, sanitation, healthcare, education, and durable shelter.
Along the way, we must help strengthen Haitian institutions. Haiti needs a strong and legitimate government to overcome the challenges ahead. The recent elections were a milestone in the country’s long and very hard road. But irregularities now seem more serious than initially thought. Tensions are on the rise. Political leaders must put the national interest ahead of personal and partisan ambitions.
The UN and its many international partners will help Haiti to get back on its feet. But, at the end of the day, Haitians can stand only on their own. As a people, they are singularly resilient and brave. They need, and deserve, our support. But they need, and deserve, strong national leadership as well. This is Haiti’s moment.