Homeland Security Watch

News and analysis of critical issues in homeland security

November 13, 2010

Haiti update

Filed under: Catastrophes,International HLS — by Philip J. Palin on November 13, 2010

On Friday the Haitian Ministry of Public Health reported 796 deaths and 12,303 hospitalized cases of cholera.  A complete report can be downloaded from the Pan American Health Organization (PAHO).

According to PAHO:

While the impact of Hurricane Tomas was not as immediate or severe as many had feared, Dr. Jon K. Andrus, Deputy Director of the Pan American Health Organization said, “We have every reason to expect that the widespread flooding has increased the risk of cholera spreading.” The effects of this could become apparent through a spike in cases in the coming days.

Also of concern—though not unexpected—are cases being reported in the country’s capital, Port-au-Prince, which is home to some 3 million people.

Even before the earthquake last January, the city had inadequate water and sanitation infrastructure and crowded living conditions in many areas. Now, conditions in the city are “very ripe for rapid spread of cholera.”

“We have to prepare for a large upsurge in cases,” Andrus said. “We have to be prepared with all the resources that are needed for a rapid response.”

Based on previous cholera outbreaks the PAHO projects upwards of 270,000 cases in Haiti before the epidemic is contained.

The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) has released a new response strategy for cholera response through the end of December.  To implement the plan the United Nations is requesting the urgent contribution of $164 million.

Given the professional background of many HLSWatch readers, following are the planning assumptions for the new UN response plan:

In order to guide the planning process, the following assumptions were made to estimate the potential evolution of the outbreak.

  • Assuming all of the population (estimated at about 10 million for the purpose of this plan) is at risk of contracting cholera, and estimating a cholera attack rate of 2% (not a conservative estimate, given the prevalence of risk factors for cholera transmission including lack of safe water supply, poor sanitation conditions and the rainy season), the estimated number of cases would be 200,000 (10,000,000 pop x 2%). Of course, the effectiveness of the control measures put in place will influence this estimated figure.
  • In most cholera outbreaks, approximately 10-20% of symptomatic cases of cholera develop a severe form of the disease which requires vigorous rehydration. Therefore, approximately 20,000 cases at least would require admission for intensive rehydration treatment, and potentially antibiotics. Other symptomatic cases will have to be treated in out-patient capacities and at community level.
  • A capacity of 1,000 beds has been already set up throughout the country and will be expanded rapidly to 2,000 beds. Accordingly, the agreed holding capacity of a CTC for the purpose of this plan is 50 beds. The human resources and material and logistical requirements have been estimated based on this operational figure
  • For each CTC to be established, a cholera kit for 100 people may be used to initiate the response. Additional materials shall be made available as per the request of the responsible CTC coordinator, but kits should no longer be used to run operating CTCs and CTUs.
  • Capacity of primary health facilities for triage, outpatient management of cholera cases, and safe referral of severe cases to CTC, in agreement with the MSPP plan, must be assessed and strengthened. Hospital readiness for surge capacity and infection control and contingency plan to be able to cope with sudden influx of cholera patients must be in place to ensure safe management of patients along with prioritization of other health activities to continuity of care to other patients suffering life-threatening conditions.
  • From the WASH perspective the above scenario implies a caseload of 10 million people, i.e. those at risk of contracting cholera who need to be targeted for preventive measures. Therefore, WASH actions will need to be prioritized and strongly informed by health data, and will focus primarily on camps, high-density urban and sub-urban populations where the attack rate is difficult to slow down once the disease establishes itself.
  • Particular attention should be paid to cross-border areas and to the displaced, mobile and vulnerable populations as high-risk groups for disease outbreak and the spread of cholera.
  • All humanitarian organisations involved in cholera response are expected to contribute to the emergency stock and subscribe to this inter-cluster operational plan.
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3 Comments »

Comment by William R. Cumming

November 13, 2010 @ 10:31 am

Thanks Phil and great post reminding US of this “domestic” disaster.

Comment by The Rebuild of Haiti

November 14, 2010 @ 6:35 am

Phil,

The good people of Haiti sincerely – thank you – as well for this post and update on Haiti and what Haitians have had to endure since 12th January and must confront even as the affects of this substantial calamity continue to evolve and cause much concern.

With a team of “experts” in addressing prerequisite infrastructure development in Haiti – waste water and water purification development projects.

Danshin is also involved in a collaborative effort of Canadian and US companies led by Pure Water Corporation’s very capable, William Danshin in Vancouver (www.deferum.com and http://www.watercorp.com) in offering the locals the opportunity to manufacture and erect practical, permanent, eco-friendly and earthquake resistant housing as well as multi-level buiding earthquake resistant design with rainwater rettention and solar package included is the entrepreneurial and compassionate interest necessary by Mr. William Danshin and others like him who are optimists and insightful into the requirements which will assure a revitalized Haiti in the future, replacing hopelessness and despair shared by many in Haiti as days and weeks turn into a year and many years unless we all offer much needed assistance.

Phil, for those of us involved from day one for the long commitment, we must extend sincere appreciation to the numerous relief organizations and medical health staffs who have contributed their time in Haiti saving Life and in deed offering expertise and even a smile in the midst of such deprivation. So many children have had to endure such unimagineable hardship.

Utilizing the present and growing mounds of garbage strewn from neighborhood to city in Danshin’s effort to recycle in optimizing energy production, his assembled team of “experts” see an opportunity for the people of Haiti to become employed and productive in recycling all this material. Indeed interesting and hopefully the funding Danshin is seeking will be granted and Haitians will begin to work and recycle much of what they tread on today.

From my perspective, far too little has taken place in global aid and responsible distribution thereof and much needed coordination of relief as we approach the one year anniversary.

Furthermore, as an avid emergency management advocate, quite honestly, while I am encouraged by this article referencing the fact that UN (OCHA) officials seem to understand the consequences, I am soutterly disappointed, disgusted by the corruption so rampant even with local government officials as well as a world which frowns and turns its cheek to these wonderful people who yes, portray much resilience, yet like any other confronted by such substantial challenges, need in a Haiti rebuild which prepares itself for any such reoccurance….

Let us hope the United Nations as well as all others will engage Haiti as its should for too much tiem has passed and far too little has been accomplished in this first year.

We extend our clasp in hand of support to Haiti and our constant prayers that further compassion and much needed infrastructure global support will be extended to you.

We must applaud the Southern Military Command – Miami for a job well done especially in the first hours of this unfortunate event and to the US State Department which is quite busy these days globally for their continued commitment to the people of Haiti nand to all who have chosen to becoming participants in the planning and rebuild of Haiti offering dignity to everyone and the opportunity to be productive and revive Haiti as an example of what “humanitarian” effort can realize.

(Chris)topher Tingus
CEO & Managing Director
GlobalH2OSolutions, Inc.
PO Box 1612
Harwich, MA 02645
chris.tingus@gmail.com
#617-291-1940

Comment by William R. Cumming

November 15, 2010 @ 10:45 am

Cholera deaths about to hit 1000 milestone by next week.

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