Monday, November 22, 2010

Waiting for Treatment

Women and their children wait in line for treatment at a Medecins Sans Frontieres(MSF - Doctors Without Borders) cholera treatment center in Port-au-Prince, Haiti.

Cholera is a scourge that has claimed millions of lives in just the last 200 years. It originated on the Indian subcontinent thousands of years ago and spread to Russia in the early 1800‘s. From Russia it spread to the European mainland and North America. Cholera is spread by contaminated water and inadequate sewage treatment. The last major cholera outbreak in the US was 1910-1911.

Cholera can kill a healthy person within hours. The disease causes uncontrolled vomiting and diarrhea, the sudden dehydration brings on shock and rapid electrolyte imbalance. Death follows. Despite the savage nature of the disease, cholera is almost ridiculously easy to prevent and treat.

Water treatment and sound sanitation practices prevent the disease. The cholera bacterium is killed by chlorine bleach and boiling. Treating cholera in a patient requires little more than a course of antibiotic treatments and rapid rehydration, frequently through IVs. 

A disease that kills so many is thoroughly understood and easy to stop.

Now cholera has come to Haiti. Many public health specialists have been predicting an epidemic of water borne diseases since the earthquake last January. For 10 months there were none. Then in October reports of a budding cholera epidemic started coming out of rural northern Haiti, near a Nepali United Nations Peacekeepers’ base. Disease detectives determined that the strain of cholera in Haiti more than likely originated in South Asia. Many Haitians immediately blamed the Nepali troops but the official source of the disease hasn’t been found.

The disease has spread across Haiti and into neighboring Dominican Republic. More than 1,300 Haitians have died from cholera in just six weeks. In Port-au-Prince, which has yet to recover from the earthquake, cholera victims have been left in the streets. The UN is reporting that a shortage of hydration supplies and body bags is slowing efforts to contain the epidemic. 

It would seem that a disease spread by contaminated water and poor sanitation would be right at home in Haiti, the poorest country in the western hemisphere. But that’s not the case. Up until last month, cholera hadn’t been seen in Haiti in at least 100 years. Now the fear is cholera will be in Haiti forever.

I was in Haiti working on a story about an earthquake survivor for the Arizona Republic. I worked on the cholera story in my downtime. There are more photos of the cholera epidemic in my archive