Haiti cholera intervention – 16 November

On Tuesday, the Haitian government announced that the death toll from the cholera outbreak that began last month had surpassed 1,000. MSF teams saw cases increasing across the country with particular spikes in the capital, Port-au-Prince, and the northern cities of Cap Haitien, Port de Paix, and Gros Morne.

The fundamental paradox remains in place: an easily treatable and preventable disease continues to claim lives. MSF has more than 150 international staff working alongside 1,000 Haitian staff to run cholera treatment programs and maintaining more than 1,000 beds of hospitalization capacity across the country. Since October 22, MSF has treated 16,500 people for suspected cholera in a total of 21 cholera treatment centers across the country.

Even as MSF continues to increase its capacity to treat there remains acute deficiencies in the well-established preventative actions that are essential to controlling the spread of the epidemic. The critical preventative activities such as the distribution of clean drinking water, positioning of oral rehydration points in affected communities, waste removal, and safe burial of victims of the epidemic, all remain far below the needs.

Cases continue to present in the Artibonite region, where MSF is working in Petite Riviere, St. Marc, and Dessaline; some 11,500 cases have been treated in MSF-run and MSF-supported structures since October 22. The caseload is also increasing in the northern cities of Cap Haitien, Port de Paix, and Gros Morne; MSF medical structures reported 280 cases during the week ending November 7, but that number jumped to 1,200 cases for the week ending November 14.

In Port-au-Prince, the number of cases presenting at the numerous MSF-run and MSF-supported medical structures in the capital has jumped from 350 for the week ending November 7 to 2,250 cases for the week ending November 14. MSF’s cholera treatment centers (CTCs) in Sarthe (70 beds), Tabarre (200 beds), and Carrefour (112 beds) are fully occupied. On Wednesday, new facilities will open in Sarthe (200 beds) and Delmas33 (20 beds). Efforts are underway to increase admissions to 250 per day at the MSF-supported Haitian Ministry of Public Health’s Choscal Hospital.

Teams can also increase capacity at the facility in Bicentenaire from 75 beds to upwards of 370 beds if the needs in that neighborhood make it necessary to do so. Additionally, MSF is providing approximately 280,000 liters of water per day in Cite Soleil, supplying enough drinking water for approximately 14,000 people, but still much less than the neighborhood needs.

MSF cargo planes arrived in Haiti on Sunday and Monday to bolster supplies.

MSF’s Ongoing Programs

All other MSF facilities and services are running normally during the emergency cholera response. MSF has more than 3,000 Haitian and international medical and non-medical staff providing assistance to the population through its ongoing programs. They run seven private, free of charge, secondary-level care hospitals and support two Ministry of Health structures in Port-au-Prince, accounting for nearly 1,000 hospital beds in the capital city. These facilities provide emergency, trauma, obstetrical, pediatric, maternal, and orthopedic care services. Mental health care and treatment and counseling for victims of sexual violence are also provided by MSF.

Outside the capital, MSF supports Ministry of Health hospitals in the cities of Leogane and Jacmel with nearly 200 beds of patient capacity. MSF opened a private 120-bed container hospital in Leogane in October.

From January 12 to September 30, MSF has treated more than 339,000 people, performed more than 15,700 surgeries; and delivered over 9,900 babies. MSF also provides primary medical care and relief supplies to displaced persons living in various camps in Port-au-Prince through mobile and fixed clinics, and is carrying out water-and-sanitation services to displaced persons in the Cite de Soleil slum.