As of this morning, an outbreak of cholera in the Artibonite region of Haiti has killed approximately 200 and hospitalized over 2600. Though we are thankfully not seeing signs of an outbreak in Thomassique as of now, we are implementing several preventive measures to buffer against a potential emergency here.
The key messages we want to convey are the importance of:
- Using purified water. For this, we are encouraging people to purchase and use our Klorfasil systems, which we have been selling for the last several months at the highly discounted price of $2.50/system (actual value is $8.50/system). Klorfasil works by using a small quantity of granulated chlorine to treat water within 30 minutes. For people who cannot afford the Klorfasil systems, we are encouraging the use of SODIS, a free purification technique where water is placed in clear water bottles and treated by sunlight. We have a large collection of clear plastic bottles available for distribution. Going along with this message is the importance of properly preparing food.
- Practicing proper sanitation. The emphasis here is on hand washing, especially after using the bathroom and before cooking. We have a large supply of hygiene packs which we are distributing widely. Each pack contains soap and a washcloth, and many also contain items such as toothbrushes, toothpaste, and combs.
- Responding to illness: People showing signs of cholera should seek immediate medical care to be re-hydrated with Oral Rehydration Solution (ORS) and possibly IV fluids. They should also take measures to avoid spreading it to others.
We are disseminating these key messages through a variety of avenues:
- Radio: Clinic Director Dr. Casseus will be appearing on the radio at 5pm to discuss the cholera outbreak. He will also appear on another station tomorrow.
- Community Health Workers (CHW): We are having an emergency meeting with our CHWs at 3pm this afternoon. They will be instructed to conduct hygiene information sessions in their communities, as well as look out for and begin treating potential cholera cases using ORS. They will continue to promote the use of Klorfasil systems or other treated water.
- Education in the clinic: With the help of our midwife, Mis Ketna, we are creating signs conveying hygiene and sanitation messages to post around the clinic. We will also hold education sessions about prevention each day for patients waiting to be seen.
- Schools and Churches: We are collaborating with pastors and school directors to provide educational information about cholera prevention to church goers and school children. Several of the schools were already part of our hygiene program, in which teachers were trained in hygiene techniques to teach their students. The churches and schools are also involved in the hygiene pack distribution.
In addition, we are preparing for the possibility of a cholera outbreak here by preparing our supply of IV fluids and ORS. The department medical director is sending us 16,000 bags of ORS. In the case that pre-made ORS runs out, it can also be made using a simple mixture of purified water, salt and sugar.
This cholera outbreak highlights major ongoing challenges facing Haiti: access to clean drinking water and effective sanitation systems. According to a 2008 report by Partners in Health, approximately 70% of Haitians 'lack direct access to potable water at all times.' Addressing these types of problems in the long term and preventing future outbreaks will require major changes to the water and sanitation infrastructures.
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