Haiti Cholera Update #9

As of writing there have been no further reports of cases or deaths from cholera from MSPP (Ministère de la Santé Publique et de la Population). The MSPP’s last release three days ago noted 6,742 hospitalized cases of cholera and 442 deaths since the outbreak began. This represents a crude mortality rate of 6.6%. Cholera promptly treated has a crude mortality rate of 1-2%. Cholera is now found in five départements: Artibonite, where the outbreak began, and Centre, Nord, Nord-Ouest, and Ouest. It is important to note that even this information was stale at the time of its release, and represented data three days old, from 31 October 2010, meaning effectively, there has been no official release of information for nearly a week. James Wilson at Haiti: Operational Biosurveillance (HOB) believes this number represents significant underreporting:

Current official stats are 6,742 cases and 442 fatalities. This is definite under-reporting. If we assume the case counts are 1/4 the true community load, then we now have nearly 27k cases shedding pathogen into the environment. We believe the true statistic to be closer to 50k based on the degree of under-reporting.

Tropical Storm Thomas has passed Haiti, though rainfall associated with the storm continues; 2.5-5 cm of additional rain is expected to fall over the country. HaitiLibre reports significant flooding, and authorities have evacuated hospitals in Leogane, Les Cayes and Saint Louis Hospital in Delmas (Port-au-Prince). HaitiLibre is providing updates on the flooding on their website. According to PAHO (Pan American Health Organziation) the storm produced:

rain accumulations of 5 to 10 inches over much of Haiti and the Dominican Republic, with possible isolated maximum amounts of 15 inches. This brings additional challenges to the current health situation, with reduced availability of drinking water, difficult hygienic conditions, and limited access to health services and to waste management.

HaitiLibre continues to report violence on the Border with Dominican Republic, associated with the outbreak-induced closure of the transnational markets on the Dominican side of the border.

Medical supplies obtained by PAHO seem to suggest the health organization is digging in for the long haul:

Immediate distribution [of medical supplies] covered over 3,500 liters of IV fluids, more than 64,000 sachets of oral rehydration salts, and 180,000 antibiotic tablets. Additional distribution to hospitals and health facilities in Haiti can cover at least 600,000 ORS doses, 50,000 liters of Ringer’s Lactate, and more than 3,500,000 antibiotic tablets. In addition, 10 complete WHO Diarrheal Disease Kits, each able to treat 400 to 500 people, have been purchased and are arriving Nov. 4

Crawford Kilian writes on the cognitive gap between the hype of humanitarian relief  and the reality on the ground, sentiments I tend to agree with:

The NGOs, UN agencies, and individuals who are blogging this disaster on the ground are remarkable people, doing wonderful things. Many of them are putting themselves in harm’s way. Haiti would be far worse off without them.

But a lot of them are using Haiti as a sales pitch for donations or political support. They describe the frightful conditions the Haitians are dealing with, and then they describe their own heroic efforts to improve those conditions. Much as I admire them, I’m beginning to gag a little when I read their self-congratulating posts.

(But read the whole post.)

Also via Crawford’s blog, H1N1, American earthquake relief to Haiti is still held up in the U. S. Congress:

The US Congress put up another obstacle today to delivering the $1.15 billion (£600 million) in reconstruction money that it promised to Haiti in March but has so far failed to deliver.

The State Department will have to prove to Congress’s satisfaction that the money will not be stolen or misused, which may be a difficult target before the cash even reaches the country.

Without the reconstruction money, temporary shelters have gone unbuilt, rubble has not been removed and 1.3 million people remain homeless because they are unable to afford safe places to live.

More resources:

Haiti: Operational Biosurveillance (Twitter)

H5N1

HaitiLibre (English) (français) (Twitter — English and French)

Mediahacker: Independent multimedia reporting from Haiti (Twitter)

PAHO’s Haiti Cholera page. (PAHO Situation Reports and other documentation.) (Blog.)

On the ground, good sources of information and of course needing donations:

Partners in Health (Twitter)

Médecins sans frontières

[Cross-posted at Those Emergency Blues]