Haiti could literally not be more unlucky. Just 10 months after a devastating earthquake killed over 200,000 people, left 1.3 million homeless, and practically destroyed any semblance of government, a cholera epidemic has swept through the central plateau region of the country killing over 300 people, and leaving thousands of sick in its wake. Last week the U.S. embassy sent out an email saying to avoid the region because about a hundred people had gotten diarrhea, which seemed like a pretty weird reason not to go somewhere to me. But sure enough, the next day it was confirmed that the diarrhea had been caused by cholera, a disease that hasn’t been seen in Haiti for over a century.
I covered the story for NBC over the past few days, and went with my friend Ben to the Hospital Albert Schweizer in Deschapelles, a small town just 30 minutes from the epicenter of the outbreak. The managing director of the hospital told us that they were seeing a constant stream of cholera patients, and that they were now forced to operate two hospitals in one: one for the cholera patients, and the other for everyone else. Cholera patients were spilling out into the hallways, as there were not enough beds for the sick. Mothers held their children’s IV bags while sitting on the floor, the elderly were simply too weak to move.
The issue is the water. Somehow the disease got into the muddy water of the Artibonite River, which is Haiti’s largest, and infected thousands of people. The problem is that many poor Haitians who live in the countryside are, at times, forced to drink this water because they have no other options. There are no grocery stores there, and shops to buy clean water are few and far between. Many of the hospitals have noticed that the majority of their patients are workers from the nearby rice paddies, which are irrigated by the Artibonite. The workers get thirsty, they drink the water, and 3 days later they are deathly ill.
I visited the Artibonite on Monday with an NBC team that had come down, and as we walked into the market that sat besides a bridge that crosses the river, it became abundantly clear why this epidemic is not going away anytime soon. Sitting on the outskirts of the market were three women selling the catch of the day, which just happened to be fish fresh from the river. I tried to explain to them in my terrible Kreyol that the fish were no good, and that you can get sick from eating them, but they argued back: “The fish are fine,” as swarms of flies flew over their catch, “the water here is not bad.” In reality you can’t blame them, this is their livelihood, but the water there is very bad, and those fish could soon be someone’s last meal.
The UN, and other organizations, has stressed the need for education and messaging to make sure that the population here knows the facts about this disease, but it just doesn’t appear to be working. Almost everyone in the city of Saint Mark, which holds the hospital that has seen the most cholera cases, wears a face mask, yet cholera is not an airborne disease. Those who don’t have masks cover their mouths with their hands, which is exactly what you are not supposed to do. You get the germs on your hands, you put your hands in your mouth, and then you get sick.
The UN has also begun a program to build “Cholera Treatment Centers”, which they were originally calling “Isolation Clinics” before they realized how inhumane that sounded. The people in Saint Mark burned the first CTC down because Doctors Without Borders decided to build it on a soccer field next to a school. While the school children would have most likely been safe from the disease, it appears there is a disconnect between the community and the humanitarian aid organizations that could eventually cost people their lives.
But the ignorance isn’t only in the countryside. After returning to PAP, I had conversation after conversation with Haitians who just didn’t know anything about cholera. Whether it’s a certain kind of vegetable that they heard carries the disease, or a lack of knowledge regarding the issue in general, the people here are going by the most recent rumor they hear on how to get (or not get) the disease. While driving to Saint Mark on Sunday, one of our drivers said, “I would rather have AIDS than get cholera!” Everyone in the car gasped, looked at him, and simultaneously asked, “Why?!” He downshifted to avoid a pothole, and then explained, “At least if I have AIDS I will have 15 or so years to live. When you get cholera you die in four hours!”
While our driver was right about cholera killing people in a matter of hours, 95% of the people who make it to the hospital are able to get treatment and be discharged a few days later. The hospitals have the supplies, they just need you to get on to one of their beds so that they can treat you. The problem is that so many people live so far away from a hospital that many just don’t make it there in time, or if they do it’s already too late. Not to mention, Haitians are already chronically dehydrated and malnourished, so it doesn’t take much to finish the job that everyday life here in Haiti has already started.
The numbers have continued to rise steadily, and aid organizations here are planning for the worst case scenario. One of their worst fears has already come true in that 5 cases have been confirmed here in PAP, but they all traveled from the central plateau region, and had been infected there. What NGOs in the capital are fearing most is it spreading in a tent camp or slum where tens of thousands of people could get sick in a matter of days. There are dozens of unconfirmed cases in PAP, but many fear the number released by the government is much lower than the reality, and that this could spread amongst the displaced people in the camps like wildfire.
For Jillian and I, we are just being extra cautious, washing our hands, drinking water we know is clean, and not eating street food. There’s only so much you can do, but as long as we are vigilant we feel that we will be OK. Many here have stopped shaking hands, instead using an elbow bump as a greeting in an effort to reduce germ proliferation. Also, for a few days we couldn’t find water anywhere in the city, as cars would drive from store to store with trunks filled with empty Culligan water jugs ready to be refilled. That’s toned down a little bit, but all it takes is one radio host to say there’s going to be a clean water shortage and all of a sudden water will be sold out everywhere. But in reality, Jillian and I also have the added benefit of being healthy individuals who eat well and drink plenty of water. While cholera would not be pleasant, we wouldn’t have the same four hour time-line that many of the population here has.
Only time will tell whether this becomes a nationwide disaster or just a major public health issue. No matter what, people know they are at risk, and it’s a situation that has left the country stunned. The UN is expecting the numbers to continue to rise, but with education and an increased focus on hygiene (which is horrible here), they are hoping to slow down a deadly epidemic that could possibly last for years. Because Haiti needed another hurdle to stumble over, right?