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EDITORIALSCholera Cripples Haiti
By Parsa Shahbodaghi
The effects of last year’s earthquake have been absolutely devastating to Haitian society. It is estimated to have killed 230,000 people and destroyed 250,000 buildings, including a nursing school, one of the country’s few sources of healthcare workers. However, this isn’t the only problem afflicting the land. 1 Haiti is now in the midst of a cholera epidemic, one that has the potential to introduce both short- and long-term challenges to the country. From October to November there have been 72,000 cases of the disease and 1,721 resulting deaths. 1 The numbers themselves seem fairly serious, but they belie the severity of the issue. It is necessary to have some background on the disease in order to have an understanding of how dire the situation in Haiti is. Cholera is a disease of the poor; it is virtually non-existent in the developed world. It surfaces in nations that have poor sanitation systems where human waste is mixed in with drinking water. There have been seven pandemics attributed to cholera, documented periodically from the early 1800s to the present day. It is one of the deadliest diseases in human history, spanning the globe and killing millions. 2 But what is the mechanism by which this disease is able to kill so many people in such a short period of time? Cholera is an intestinal infection that afflicts individuals who ingest water or food contaminated with the bacterium Vibrio cholerae. 3 This bacterium produces a toxin that causes intense diarrhea and severe dehydration, a potentially fatal condition if left untreated. 3 Fortunately, the disease can be easily dealt with: rehydration therapy and antibiotic regimens can effectively treat most of those affected by the disease.4 This is one of the major reasons that cholera is a disease of only the poor; it is easily controlled when sufficient resources are available. In addition to rehydration therapy and antibiotic regimens, there are other evidence-based interventions that should be carried out to alleviate this crisis. The Haitian government and other organizations could set up water treatment centers where people could bring their drinking water for decontamination. Furthermore, these institutions could issue chlorine tablets or tell people to boil their water before drinking it in order to kill the bacterium before ingestion. Fortunately, aid organizations are already carrying out these interventions in Haiti. Partners In Health has set up treatment centers where the severely ill can receive intravenous therapy and antibiotics. 4 Oxfam has set up public latrines so that people do not defecate in areas where their contaminated feces could spread into the water supply. 5 They have also provided 300 million liters of chlorinated drinking water and 120,000 personal hygiene kits to reduce the likelihood of individuals encountering the bacterium. Doctors Without Borders and several other aid groups have taken up similar interventions. 6 However, resources for these interventions are lacking and the response has been too slow, according to Dr. David Walton of Partners in Health. 4 He states that the infrastructure is in place, but the funds are insufficient for implementation. What is more troubling is that a few cases of the ailment are already appearing in the population-dense capital of Port au Prince. It would be disastrous from a public health perspective if cholera gets a foothold there because it could spread far more rapidly than it already has.4 It could entrench itself in the country’s water supply, making it more difficult to treat on a larger scale. Consequently, cholera would be killing people in Haiti for years to come. Money has been the limiting factor for all the aid groups trying to help in Haiti. Most if not all of their treatment and prevention efforts are made possible by donations. By donating money towards this cause, you could prevent a potential disaster that might affect Haiti for years to come. The earthquake itself was a fleeting event, whose devastation will have a lasting impact. Cholera, on the other hand, could be a permanent aspect of Haitian life, continuing to kill individuals for years to come. Therefore, it is vital that aid organizations receive the funds necessary to prevent a potential public health catastrophe. References 1. Carlowe, Jo. “Coming to Haiti’s aid”. Nursing Standard 25.14 (2010): 20+. General OneFile. Web. 15 Jan. 2011. Subject: Global Health
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