Three Emergencies in One
2010 was a busy year without doubt in Haiti. In addition to the earthquake, we were presented with two other emergencies. In October, Cholera struck the island nation followed almost immediately by Hurricane Thomas.
Not long after returning from my Florida training, the October 2010 Haitian outbreak was the largest cholera epidemic to strike a single country in recent history.
Haiti just endured the tragic earthquake ten months previously, leaving hundreds of thousands of people homeless, forced to live in temporary camps or with crowded host families. The government was severely crippled after years of weak governance and large-scale damage to infrastructure.
It was at least a hundred years since the last outbreak in Haiti. The population had no immunity and the health system had no previous experience of any similar large-scale epidemic. The outbreak commenced with the contamination of the Artibonite River by a Vibrio cholera o1 strain near Mirebalais, 60 km north of the capital Port-au-Prince.
The first confirmed cholera case resided in Meille, a village two miles south of Mirebalais, and developed symptoms on October 14, 2010.
By October 19th, cases with severe diarrhea were reported upstream in Mirebalais. October 20th marked an explosion of cases throughout the communes of the lower Artibonite River valley, where bacterial transmission afterwards was confirmed to have taken place via the Artibonite River.
Cholera was not present in Haiti before the time of the outbreak and the initial suspicion that the sudden spike in severe diarrheal disease actually was cholera came on October 21st. This was followed by rumors among relief agencies that large numbers of people were leaving the cholera outbreak area, moving North and North-West.
How it Spread
Cholera spreads primarily through two ways, either through infected water or by the movements of infectious people.
It is now well established that the early spread of the epidemic took place through the Artibonite River. The river is the source of drinking water and also where many people defecate. This provides ideal conditions for the spread of the bacteria.
At the time, Nepal was suffering a cholera outbreak, and the peacekeepers are suspected to have transmitted the disease through their waste. The river was a primary source of water for thousands of people, and lacking sanitation options, the water may have been consumed without proper treatment.
Haiti anti-UN protest spread
Not that Haitians really needed any excuse to riot against the UN. But by November 17, Anit-UN riots spread to several Haitian cities and towns, as protesters blamed a contingent of Nepalese peacekeepers for an outbreak of cholera that killed more than 1,000 people exchanged gunfire with UN soldiers.
Protesters barricaded some roads, mainly around the UN MINUSTAH base. These protests resulted in several deaths and injured, both protesters and UN peackeepers.
World Vision Response
We responded in various ways to the cholera outbreak. Our health and NFI teams were busy organizing soap delivery to our areas of operations. The Children in Emergencies developed a “Child-Friendly Cholera Message” Health and WASH messages. These messages were translated into both French and Creole.
My team, in coordination with the WASH team, looked at the water sources for our team houses/apartments. We also developed protocols and new “no-go” areas. Sadly, these included all of our beaches. The Dominican Republic also closed her borders to Haiti to prevent the spread across the island.
In mid-October, I noticed a system developing off the South American continent. I gave a pre-warning of a possible storm system that could impact Haiti. On October 29, the system was declared a tropical storm by the National Hurricane Center.
On November 5, 2010, heavy rain from Hurricane Tomas has battered western Haiti, causing floods which killed at least four people. The eye of the storm clipped the island with winds of 140km/h (85mph).
There was a danger of mudslides and further flooding, which could have worsened the current cholera epidemic affecting parts of the country. Fortunately, the storm spared the hundreds of thousands of people who rode it out in flimsy tent camps.
The Rains continued off and on for hours after the storm moved on to Cuba. This gave fear that the death toll could rise once isolated areas of the country were reached.
The southern town of Leogane was completely under water three meters (10 feet) deep in places. In the city of Port-au-Prince, Haitians were up to their ankles in water in some of the refugee camps that grew up around the city since the earthquake.
There were fears that the conditions could help incubate and facilitate the spread of cholera. Few refugees heeded the government warning to evacuate, although mothers and babies were evacuated from an exposed camp near the mountains.
During the hours leading up to the arrival of Thomas, we initiated our hibernation protocols. All international staff were locked down in their team homes. National staff were advised to remain home and monitor the conditions.
Each team house/apartment was fully equipped to survive up to seven days on Meals Ready to Eat (MRE’s) as well as pre-purchased items. Emergency survival gear was provided if required, including lights, candles, spare batteries, communication devices, etc. We were ready for this storm and ready to respond when it passed. Our shelter team, let by Tom pre-positioned items for immediate access following the storm. Our health team was ready to respond to any health requirements, including the above noted cholera.
Next – WV Haiti End of Mission