Aid workers fighting Haiti’s cholera epidemic are not just facing a shortage of medical staff and a lack of sanitary facilities, they also have to deal with the fear of an unfamiliar disease.
Karline Kleijer, emergency aid coordinator for Médecins Sans Frontières, says: “Imagine a cholera outbreak in Amsterdam, with many people suddenly falling ill and some dying after just a few hours. The residents would be scared as well.”
Cholera strikes suddenly and strikes hard. The symptoms include vomiting and profuse watery diarrhoea accompanied by intense stomach cramps. Thirty to forty percent of those infected die from dehydration unless treatment is initiated within a few hours. Fear of the disease is the reason why some Haitians resist the construction of a treatment centre in their own neighbourhoods. According to Ms Kleijer:
“The population is very scared. They are also scared of the cholera centres, the treatment centres. You cannot treat the disease in normal hospitals. It is so contagious that you need to build separate centres. Our main problem is to find sufficient staff and to find space to build our cholera treatment centres.”
Despite the potential benefits, many Haitians don’t want a treatment centre in their neighbourhood, Ms Kleijer says:
“Many people think: I don’t want this in my neighbourhood. Before you know it, my family will fall ill as well. However, they would benefit from a neighbourhood treatment centre because help would be close at hand when they needed it. ”
Ms Kleijer says it often takes a lot of time and effort to convince local residents that a treatment centre is not a source of infection. “The chance of getting infected there is close to zero. Everybody has to walk through a chlorine bath to enter or leave the centre, which is also being sprayed with disinfectants.”
Once a neighbourhood has agreed to a treatment centre, local residents are often opposed to the centre providing treatment to residents of other districts, Ms Kleijer says. Obtaining their permission requires further negotiations.
Aid coordinator Goossen Hoenders from the organisation Save the Children confirms the Haitians’ distrust of treatment centres.
“People will have seen footage of the north of the country, where the cholera epidemic broke out three weeks ago. Footage of hospitals being flooded with patients, where people died in and around the hospital because they could not be treated in time. And of course people are afraid that is going to happen around here as well.”
Children are particularly vulnerable to cholera, just like pregnant women, the elderly and those who are already sick. The treatment is simple: a quick administration of a salt and sugar solution and lots of fluids. Patients suffering from serious dehydration must be put on a drip, and often need as much as ten litres of IV fluid.
Two days off
Nearly 15,000 Haitians have been infected with cholera and nearly 1,000 have died of the disease. Cholera spreads via human excrement, body fluids and contaminated food and water. The floods sparked by Hurricane Tomas earlier this month helped spread the disease from the north to the capital Port-au-Prince.
More than a million people have been living in unsanitary tent camps since the January earthquake. Contaminated faeces were spread around the camps when Hurricane Tomas flooded the latrines.
In addition to the flooding, there is another probable cause for the rapid spread of the disease: a two-day holiday, which saw massive numbers of Haitians travelling across the island to visit their relatives. According to Ms Kleijer: “The combination of the two factors has seen a rapid increase in the number of infections and, unfortunately, also in the number of deaths.”
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