Cholera, the dreaded disease, which has killed about 7,000 people in Haiti alone is now considered so entrenched there and next door in the Dominican Republic that their governments believe it would take at least a decade to eliminate it.
That’s why officials from both countries on the island of Hispaniola met the other day in Santo Domingo, the DR capital, to plan a joint 10 years health campaign designed to make the Caribbean nations cholera-free.
Rafael Schiffino, the Dominican Republic’s Deputy Minister of Health, has explained that they were working on a project to wipe out the disease on Hispaniola by 2022. He said a key component of the strategy was substantial investment in clean water facilities and a sanitation system.
International experts believe cholera was introduced into Haiti by United Nations troops in 2010, shortly after the Creole-speaking nation was struck by a devastating earthquake that left 250,000 dead; tens of thousands injured; 1.5 million homeless; and much of the infrastructure in Port-au-Prince, the capital in ruins. The disease has sickened at least 400,000 people there and has spread into the Spanish-speaking DR. The water-borne disease entered the rivers and streams in Haiti which serve as the only sources of water for people who live in many of remote villages, town and other rural communities there. The disease caused about 350 deaths and 22,000 other cases in the Dominican Republic.
“It’s a big headache,” said Romain Gitenet, head of Doctors Without Border, the French humanitarian aid group working in Haiti. “Cholera has not limits.”
It was that dire warning, the suffering of rural villagers and residents of often inaccessible parts of Haiti and a feeling of frustration that have propelled the government in Port au Prince to try to stem the cholera tide. Although the epidemic has lost much of its steam in the past year, it remains a potent force since the initial outbreak. Despite the efforts of foreign and domestic national groups to reach people, the treatable disease remains a hard fact of life and death because of the difficulty in reaching people with the medicines they badly need. The hilly terrain, the lack of paved roads and the fact that millions of people reside in communities that can only be reached by foot or mules are combining to obstruct anti-cholera campaigns. One such village, Boise Carre, is located in the Lower Artibonite Valley whose main water supply is the 199-mile Artibonite River, which is the lone source of drinking water for hundreds of thousands of people. It was the River where the epidemic began and quickly spread to such towns as Osse’, Chenoit and Perodin.
It is estimated that at least half of Haiti’s 10 million people live in rural communities and 40 per cent of them have little or no access to doctors nurses and other health care professionals, not to mention sanitation or potable water.
“Everything is so far away here, and that makes it hard to anticipate” the next area to fall victim to the disease, said Fabienne Lorcerie, a nurse who heads a cholera response team. She was speaking from Boise Carre. “All other medical missions I have been on, I could plan a little bit better.
“The hardest part is knowing there is an emergency and not being able to do anything today, and you have to come back another day,” she added.
The situation in Boise Carre underscores the challenges health officials are encountering as they work to treat victims. One such hurdle is the fact that the village is located hundreds of feet in the mountain. Another is that heavy rains make crossing the river impossible. Thirdly, the nearest hospital and cholera treatment center are five hours away by foot.
As a villager explained it to a news organization, “the situation is very difficult for us. There are times the river is impassable and you are carrying a victim to get help. You have to put the person down and wait for the river to go down. By the time you reach, the person has already died in your hands.”