By Stephen Kaufman
Washington — Although the number of Haitians infected with cholera continues to climb, the overall mortality rate from the disease is decreasing, thanks to efforts by the Haitian government and U.S. and other international partners to halt the spread of the disease, State Department Assistant Secretary of State for Public Affairs Philip J. Crowley says.
Speaking to reporters in Washington November 15, Crowley acknowledged a tragic death toll, with the Haitian Ministry of Public Health and Population reporting November 14 that the outbreak has claimed 917 lives and resulted in 14,642 hospitalizations.
“As we anticipated, you are seeing an increase in the number of cholera cases,” Crowley said. But “the mortality rate as a percentage of the number of cases identified continues to go down.”
“We think, through the work that we are doing with the international community, including the Pan American Health Organization, procuring and distributing medical and sanitation supplies, increasing the number of cholera treatment centers across the country, and a public health campaign that is going on in Haiti and includes active participation by Haitian leaders, including President [René] Préval, this is the way to best manage the cholera outbreak in Haiti,” he said.
The Obama administration will continue to work aggressively in cooperation with the Haitian government to stop the outbreak, he said.
“Once cholera has emerged, we understand that the disease will be in the country for a number of years and we will have to take a number of steps over a sustained period of time to contain and ultimately eliminate the outbreak,” Crowley said.
According to a November 11 fact sheet from the U.S. Embassy in Port-au-Prince, part of the rise in the number of reported cases and deaths can be attributed to improved reporting on the outbreak by Haitian officials, who have been working with technical support from the United States and other countries to “enhance their surveillance system for more timely, detailed, complete, and sustainable reporting of cholera.”
“This will contribute to a spike in reported numbers as outpatient figures are added to the total and better reporting from all 10 departments in Haiti occur[s],” the fact sheet said.
The United States is taking the updated facts and figures into account as it continues its support to the Haitian government’s efforts to combat the disease.
The fact sheet said experience in other countries has shown that cholera has the ability to spread and will persist “for several years,” and that the increased response to the disease will result in an increase in the number of reported cases.
“This is expected and reflects improved identification of those sickened by the disease, which can help to save lives,” the fact sheet said.
The United States has provided nearly $2.3 million and has mobilized medical supplies to help fight the epidemic. It is also helping to support seven cholera treatment centers in Port-au-Prince that can treat up to 1,000 people at a time. In addition, the U.S. Centers for Disease Control is training health care personnel in the country and will be conducting a survey among Port-au-Prince residents to “determine how they obtain and store water and if they know key information about cholera prevention, symptoms, and treatment.”
Julie Sell, a spokeswoman for the American Red Cross in Haiti, reported November 9 that her organization has been sending supplies such as chlorine for clean drinking water and cots for hospitals, and providing about 660,000 gallons of clean drinking water every day to camps in and around Port-au-Prince, where Haitians displaced by the January 12 earthquake have been living.
Speaking from Port-au-Prince to Washington-based WAMU radio, Sell said that during recent months the Red Cross has had teams of “health promoters” talking to Haitians in the camps about health and good hygiene.
The Red Cross network has also sent out SMS text messages to about 380,000 people through cellular phones, warning them about the disease and ways to prevent it.
“Cholera is easily prevented. It’s about washing your hands. It’s about boiling the water you drink,” Sell said.
“It seems like such a simple thing, but for people who don’t have access to electricity, who have very little access to water — you know, if the choice is do you have water to drink or are you going to wash your hands several times a day … most people are probably going to choose to drink that water. So it’s a tough situation and we can only hope that the prevention efforts will contain it as much as possible,” she said.
Dr. Carleene Dei, who is the U.S. Agency for International Development’s mission director in Haiti, told WAMU that it was difficult to diagnose the disease at the beginning of the outbreak.
“When the disease first hit, people didn’t know what it was. Haiti hadn’t seen cholera in 50 or 60 years. So there was some difficulty in diagnosing it. And a lot of people died because they didn’t know what they had, how sick they were. And that the disease can kill you in a couple of hours. So you need instant treatment,” Dei said.
“Once we figured that out, people keep getting sick, but by the time they get to the hospital for treatment, they’re not that sick because they know they need to get help immediately. And we have set up systems for handling it,” she said.
With people traveling to different parts of the country, the disease will inevitably spread, she said. But it “does not have to be fatal if you get it early and you treat it promptly and aggressively.”
