Friday, November 19, 2010

John Wain, Country Director, Port au Prince

Hi all,

Just a note on yet another eventful week in Haiti.

Official figures we have at the moment, as of the last report published by the UN, is that 16,799 people have now been hospitalized, and 1,039 people have lost their lives.

Again I must stress however that Dr Jim Wilson of Haiti Epidemic Advisory System (HEAS) believes that there is serious issue regarding under –reporting. It is estimated that that current official figures that have been clinically confirmed only represent a quarter of the true situation.

In Port au Prince where I am based, fear of the unknown is starting to set in. Distress is spreading among the population of the capital. People are now becoming aware of the dangers of Cholera, and are hearing about the growing death toll from the infection which originated in the Artibonite/Central Plateau region of Haiti.

The community’s of Port-au-Prince: Carrefour, Cite Soleil, Delmas, Kenscoff, Petion Ville, and Tabarre have seen increased numbers of case of cholera in recent days. As Port-au-Prince braces itself for a potential full-blown outbreak in the campsites, there is now significant air-time given to health advisory notices about prevention and treatment in advance.

People no longer shake hands when they meet and the subject of cholera is widely spoken about with anxiety among the estimated one million homeless still living in tents, ten months after the earthquake that devastated Haiti.

Medcin sans Frontiers (MSF) expect that they will soon run out of space to treat cholera patients in Port-au-Prince and are anticipating having to treat patients on the pavements, on the side of the road. Many may lose their lives as a result. Some people are fearful about having Cholera Treatment Centres located in their vicinity, while at the same time many realise that this can be of great benefit if you require treatment rapidly.

International NGO's and Haitian NGO's are all working together to treat those affected. These NGO's, have established lines of communications from extremely rural locations using online groups to request medical assistance simply just by using Blackberrys and iphones.

Thanks to these modern means of communications an SOS message can be sent and received within seconds, requesting, for example, medical staff, IV Fluids, antibiotics and re-hydration salts. These messages are reaching a community of hundreds of experienced people who are ready and willing to help with supplies, contacts and advice.

The approaching election is without doubt causing tension on the streets. You can see it on people’s faces when you meet them in the street. There has been some media coverage of the protesters who took to the streets in Cap Haitien on Monday last, setting fire to two buses used to block the main road across the main bridge into Cap Haitien.

Medical teams, and indeed Haven staff were evacuated from the region as riots broke out targeting the United Nations Stabilization Mission in Haiti (MINUSTAH) and UN personnel. Of course these evacuations ultimately impact on the administration of much needed medical supplies, as staff we were no longer available to treat the sick.

I cannot over state how the full extent of this epidemic has yet to be realised.
Today a case has been confirmed in the Dominican Republic. Due to the problem of suspected official under-reporting and the rate of spread of the outbreak throughout seven departments, cholera has got a choke-hold on Haiti, and perhaps the entire island of Hispaniola.

Until next week,


Monday, November 15, 2010

John Wain, Country Director, Port au Prince

Every week in Haiti is a busy one, but this one has been particularly rough.

Cholera is spreading throughout the country rapidly. Every day the numbers are getting higher, now approximately 917 people have lost their lives to the infection and 14,600 are currently battling against it.

But these are just official numbers. I have been speaking with my colleagues based in rural Haiti and they insist that these figures do not even come close to the reality of the situation.

There are murmurings that those that co-ordinated the response effort did not move fast enough, and this infection has been allowed to take hold, and have a far greater impact on the country than what was anticipated just a few weeks ago.

For the last 10 months since the earthquake took place, the aid agencies have been focusing their efforts on Port au Prince, to the detriment it seems to the rest of the country.

But the aid community is now ploughing ahead. The Cholera Inter-Sector Response Strategy for Haiti published just a few days ago by the UN and its partners, anticipates a total of up to 200,000 people expected to show symptoms of cholera. The strategy calls for a total of $163,894,856, or €119,532,727.80 to be provided to fund the response to the outbreak.

On top of that Hurricane Tomas hit just off the west coast of Haiti last week.

Unfortunately Tomas brought heavy rain with him, in the bucket loads. Approximately 21 people lost their lives as a result of the hurricane and over 1,000 people were displaced from their homes, on top of the 1.3 million people already living in crowded camps and under tarps in the capital city for the last 10 months.

Haven have developed three operational sectors namely shelter (temporary & permanent), WASH (water & sanitation) and Community Development (CD) which is an integral component of all our projects.

In Port au Prince we have three major Transitional Shelter projects funded by Plan International, American Red Cross and Oxfam America. Our current target is for 700 T-Shelter units along with supplementary WASH and CD services. During the emergency phase of operations Haven constructed 1,360 latrines in 57 of the 1,300 internally displaced person (IDP) camps.

Haven are currently maintaining these latrines. This is a major task when you consider the fact that they were built with an initial six month lifespan and ten months have now passed.

Thankfully Tomas did little damage to the WASH programmes we have in place in the campsites. This was a huge relief as proper sanitation is now more crucial than ever to prevent cholera from reaching the people in the camps.

The hurricane put our T-Shelters to the test also, and I am glad to report that our projects passed with flying colors! All shelters were able to withstand the pummeling that came with the downpour.

The camps were extremely wet and we had to respond with some flood relief activities, but as usual the camp residents got involved, and a major catastrophe was avoided.

In an effort to mitigate against the spread of Cholera in the IDP camps, Haven have commenced a cholera prevention project. Our Community Development team was immediately dispatched to Gonaives to carry out an immediate ‘good hygiene’ practice exercise and distribute hygiene kits. Additionally, our Hygiene Promoters have been giving workshops in schools to teachers, students and student-peer groups about the dangers, symptoms and methods of prevention of cholera.

We are also in the process of implementing additional hygiene awareness training in the Haven camps, engaging the community on hygiene issues, using simple messages like ‘always wash your hands’, ‘never drink untreated water’, or ‘never walk barefoot’.

Our activities have started in 19 camps reaching out to about 35,000 people. This team are receiving $20 per week for two weeks and they will monitor the camps and submit reports to Colin Price, our WASH programme manager based here in Port au Prince.

Country wide Cholera is gaining momentum, and the number of people affected by the epidemic is growing. Haven volunteer, Dr John Morris has sent some grim reports back from Milot hospital, northern Haiti, where he is based, the situation there appears very bad.

Comparatively speaking, Haven is a young and small organisation. We are doing what we can to promote good hygiene and to try and mitigate against this latest scourge to descend on the Haitian people.

Of course, Presidential elections are still scheduled to proceed on 28th November and we are bracing ourselves for possible trouble. Another exciting week in the Caribbean!