Too much water. Too little water. Cholera-bearing water. For the last several weeks, life's most essential liquid has taken a special prominence in our thoughts and activities. Since our previous post, Haiti's cholera epidemic has expanded, sickening over 8,000 people and killing over 500 in total. Given that cholera only produces severe symptoms in about 10% of infected people, the actual number of infections is substantially higher. We have been carrying out the cholera prevention campaign outlined in our last entry to equip people with the knowledge and supplies to avoid and treat the illness (at right, Fidel helps a student practice proper hand washing at a local high school). Though there have been cholera cases in Hinche and other nearby towns, Thomassique seems to have dodged the cholera bullet as of now. We are continuing prevention efforts with soap distribution and education, and are promoting the use of SODIS and other water treatment techniques as we wait on a new shipment of Klorfasil (we sold our entire stock in 3 days, while it would have normally lasted a couple of months!).
The other prominent water-related news item has been Hurricane Tomas. At the clinic, Tomas manifested as a very large 3-day rain storm. Though Tomas proved less destructive than it could have been, a hurricane could not have come at a worse time. Not only were the tent cities in Port Au Prince terribly exposed to the elements, but the spread of cholera (and any of Haiti's many endemic water-borne illnesses) could be vastly expedited by such a large influx of water. At least 20 Haitians were killed by the storm itself, and 6,000 families were left homeless. Though it is too early to tell exactly how the hurricane impacted the cholera epidemic, the country is bracing itself for a potential swell of cases.
In one way, however, Tomas actually had a silver lining, as it provided a solution to our next water-related issue: a break in the pipe that provides Thomassique with water. For the last 5 days, the clinic, the staff house, and all of Thomassique have been without water. During the hurricane, we were able to collect rainwater (Brian and Fidel brave the elements at left) and treat it with Klorfasil, but since the rain stopped we have had to purchase bottled water downtown. Unfortunately, the vast majority of Thomassique's residents do not have the luxury of being able to afford this. Therefore, many people resort to getting their water from the local river. The same river is used for bathing and washing motorcycles, and often has many animals in and around it. The water pipe should be fixed by tomorrow, but from experience we know that things often take much longer to repair than expected.
This unrelenting series of problems facing Haiti is unbelievable at times, but what seems like 'bad luck' actually has much more complicated roots. Cholera is a disease of poverty, which would never spread in a nation with proper water and sanitation infrastructures. The earthquake and hurricane, though unavoidable, would have had far less destructive impacts if Haiti had maintained more stringent building codes, and had strong medical and emergency response capacities. If you're interested in learning more about the history of Haiti's water problems, we highly recommend that you read this report, which is the result of a collaboration between several groups including Partners in Health. As the report describes, the Inter-American Development Bank (IDB) approved several loans to improve Haitian water infrastructures in 1998. However, over a decade later, no progress has been made on any of the projects, due primarily to the interference of American politicians who blocked the loans to push an unrelated political agenda (a practice which is explicitly prohibited by the IDB).
As the report argues, the human right to water has been severely neglected in Haiti. As we have experienced first hand over the last few weeks, fulfilling this right means having water that is:
- Available (the pipe bringing water to Thomassique must be repaired)
- Accessible (everyone should be able to access water, not just people like us who are lucky enough to be able to afford the bottled water downtown)
- Of high quality (free of cholera and other water-borne diseases)
Though recent events highlight the importance of the right to water, these are problems that Haitians face every day. It is a shame and injustice that it has taken such extreme conditions to draw attention to these issues.
