Cholera Outbreak

SECTION 1

Executive Summary

In October 2010, just nine months after the Haitian people were met with the catastrophic earthquake, they were now being stricken by another human tragedy; the outbreak of a cholera epidemic. The initial outbreak began in the rural Center Department of Haiti about 100 kilometers (62 miles) north of the capital, Port-au-Prince. “Now the largest in the world, which has killed over 8,000 people and sickened more than 600,000, and promises new infections for a decade or more”. (2013, Transnational Development Clinic) Unfortunately, the cholera outbreak was caused by the United Nations peacekeeping troops who inadvertently carried the disease from Nepal to the Haitian town of Meye. Should the United Nations be held liable for the major role they played in the outbreak of cholera in Haiti? Where their policies and procedures in place to make sure that the sanitation process were maintained to avoid any type of outbreak?

The cholera outbreak in Haiti has had a devastating impact on the Haitian nation and the surrounding nations around the country. Due to the negligence of two Nepalese soldiers from the United Nations peacekeepers that were originally stationed in Nepal where cholera was in the endemic stages became contaminated. When they arrived in the town of Meye, they set up camp and utilized the Artibonite River, which is the Haitian main source of water drinking, cooking and bathing to dump waste.

As a result of the United Nations peacekeepers dumping waste in the Artibonite river is what attributed to the cholera outbreak spreading in such a quick manner. By March 2011, after the initial flare up, there were some 4,672 Haitians that died because of the infection. It is believed that the numbers could be even higher since the Haitian government does not track deaths in rural areas that do not make it to get medical attention.  Another impacting problem is that every rainy season or hurricane has caused temporary spikes in the spread of cholera.

Given the current situation in dealing with the Cholera epidemic with poor sanitation and water quality, which is in combination with poor hygiene practices, is the main equation for the persistence of Cholera in Haiti. Unfortunately, until the Haitians begin to practice better hygiene practices they will not be able to control the outbreak. One of the most important factors is the Haitian government contributing to assist their nation with the ability to have clean water and better sanitation practices. “The task of the Government and its international partners is therefore enormous as the sources of contamination are vast and the risk of recontamination will remain constant as long as the problem of water, sanitation and poor hygiene practices is not addressed. This will require time and significant resources”(United Nations in Haiti, 2014).

The Haitian Government along with the United Nations have come up with a national action plan to put into effective for the next ten years to assist in eliminating Cholera from Haiti with an estimated budget of $2.2 billion needed; furthermore, a two year operational component to the plan as well. “The ten year plan focuses on the long-term elimination of the disease through the large scale development of public health and sanitation infrastructure.” (United Nations in Haiti, 2014).  Furthermore, the United Nations system has developed a two-year support plan that will help facilitate the national two-year plan for the elimination of cholera.  This is a plan that has been placed into action to assist and make sure that the ten-year plan is put through in motion to eliminate cholera in Haiti. “The plan highlights the key objectives and activities the UN intends to carry out to support the Government. The 2014 emergency activities of this plan will be reflected in the 2014 Haiti Humanitarian Action Plan. UN efforts in support to cholera elimination aim at attaining three key objectives. The short-term objective is to reduce infection rates by limiting and cutting the transmission of the epidemic (i.e. reducing the annual incidence rate of cholera from 3% to less than 0.5%) and meeting the lifesaving needs of affected populations. The midterm objective is to reduce the annual incidence of cholera to less than 0.1% by 2017. The long-term objective is to reduce cholera incidence to less than 0.01% by 2022 and ensure Haiti is less vulnerable to the disease by improving water and sanitation services and hygiene practices. These objectives are fully in line with the national objectives. The UN plan is structured around the four pillars of the national cholera elimination plan, namely: 1) epidemiological surveillance; 2) health promotion; 3) medical treatment; and 4) water, hygiene and sanitation. The UN will support national authorities to lead and coordinate these efforts” (United Nations in Haiti, 2014).

SECTION 2

Policy and Alternatives

The cholera outbreak in Haiti is and remains one of the worst health epidemic ever experienced by that country. Nevertheless, the cholera outbreak was further worsened by increase of the rainy season and Hurricane Sandy and now in 2016 Hurricane Matthew. Due to the lack of institutional and health infrastructure beforehand deeply prevented local and international organizations from assisting in the combating of the outbreak from the onset.

Cholera is a continuing health crisis in Haiti. But in order to properly treat and eradicate the cholera presence in Haiti altogether, adequate prevention, preparedness and timely control measures must be in place to mitigate the impact of cholera on the Haitian population. Although the number of deaths has considerably declined since the outbreak six years ago, the local infrastructure remains just as weak and inefficient as it as before. Preventing the spread of the disease and treating those currently infected is a constant and urgent need that must be addressed not only now but to prevent future outbreaks as well; furthermore, due to the recent passing of Hurricane Matthew the current situation in Haiti has worsen due to the recent floods with at least 3,500 new suspected cholera cases has bolstered.

As we know there is currently a few plans underway being implemented by both the United Nations and the Haitian government to eradicate the cholera outbreak within the next years to come.  The first set of plans in which the United Nations and the Haitian government implemented was the Haitian Ten Year plan and this was put into effect between 2010-2022. The plan aims to limit the transmission of cholera by improving access to water, sanitation, hygiene and health care facilities for 80-90% of the population.