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Cholera

The Challenge

On October 21, 2010, in the aftermath of the devastating January 2010 earthquake, the Haitian Ministry of Health and Population confirmed cases of cholera for the first time in at least a century. The U.S. Government was already on the ground, helping Haiti build sustainable health systems to detect and combat the spread of communicable diseases and therefore was in position to quickly respond to the Government of Haiti’s urgent need for support. At the request of the Government of Haiti, the U.S. Government immediately began working with the Haitian Ministry of Health, the National Directorate for Potable Water and Sanitation (DINEPA), and the Pan American Health Organization (PAHO) to lessen the severity of the outbreak. 
 
As of January 4, 2014, Haiti has reported 696,922 cumulative cases, and 8,531 deaths. There was a 29 percent decrease in the number of deaths from 2010 to 2011, and a 71 percent decrease from 2011 to 2012. There has also been a 42 percent decrease in cases seen between January and October 2013 compared to the same period in 2012. 

Accomplishments

The U.S. Government, through the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Development (USAID), provided expertise and more than $95 million during the emergency phase of the cholera response by:
  • Supporting cholera prevention and treatment efforts through social marketing and distribution of drinking water purification products, oral rehydration salts (which prevents dehydration in patients with acute, watery diarrhea), and soap for washing hands and household items.  
  • Working side-by-side with the Ministry of Health and other partners to establish a national system for tracking cases of cholera, responding to cholera outbreaks, and routinely testing suspected cases of cholera at the National Public Health Laboratory.
  • Supporting treatment for cholera and other diarrheal diseases at public and non-governmental organization health facilities nationwide at the height of the epidemic.
  • Providing technical assistance and support to DINEPA to improve its capacity to provide clean water, sanitation, and improved hygiene (WASH). 
  • Providing training for 264 Communal Potable Water Technicians (TEPACs) who are deployed to all 133 rural communes outside of Port-au-Prince, where they promote community water system operations and disinfection. 
  • Developing cholera education materials to train more than 6,000 community health workers to conduct outreach activities on cholera prevention and treatment throughout Haiti.
  • Improving access to clean water in communities by providing support to drill new wells, repair others, and promote safe household water practices.
  • Working with Ministry of the Health to evaluate various aspects of the recent oral cholera vaccine campaign.

Challenges Ahead

Access to clean water and availability of sanitation systems are limited in Haiti, and cholera is likely to persist until access to adequate water and sanitation improves. The U.S. Government is committed to strengthening the Haitian healthcare system to prevent and contain future outbreaks and treat those who become ill.  In line with the Ministry of Health’s desire to integrate cholera prevention and treatment into overall health programming, the U.S. Government is working more broadly on the prevention and treatment of all causes of diarrheal diseases. To reduce vulnerability to cholera and other diarrheal diseases, the U.S. Government is providing the Government of Haiti and other partners with support to improve access to treated drinking water at the community and household levels in urban and rural communities. In addition, the U.S. Government, in collaboration with PAHO, UNICEF, and the Governments of Haiti and the Dominican Republic, helped launch the Coalition for the Elimination of Cholera on the island of Hispaniola, which aims to coordinate and leverage WASH efforts that contribute to the elimination of cholera on the island. Additionally, the U.S. Government is participating in the coalition's donor mapping exercise that aims to track the commitments, geographic sites, and lines of action supported by donors and determine their alignment with the Government of Haiti’s two-year action plan on cholera.  

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Last updated: February 10, 2014

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