The cholera epidemic that has killed over 1,300 people and left tens of thousands sick has reached the capital city of Port-au-Prince, and is quietly taking it toll on a population that lack proper access to sanitation and hygiene. Aid workers are not concerned so much with the disease reaching the larger tent camps, as many are provided clean drinking water and have such a heavy NGO presence that the necessary aid would likely be provided in the event of an outbreak. They are more worried about it spreading in the slums, especially in places like Cite Soleil, where shanty towns lack access to clean water, and where the sanitation infrastructure is non-existent.
From our perspective, it wasn’t clear that cholera had hit the city, even though news reports were claiming otherwise. You just don’t see it. Living in our house in a relatively nice part of town, the presence of cholera was not obvious, which stresses that this is not a disease that people who have the proper resources get. It’s a disease that affects the poor, but with the vast majority of people in this country living on less than $2 a day, almost everyone is vulnerable. All we needed to do was travel downtown last Thursday and the toll of this cholera epidemic slapped us in the face.
Ben and I were driving around PAP Thursday looking for protests when we drove by a man who looked like he was dead on the side of the road. We pulled over and looked down, “Yeah, he’s dead,” I said just as the man moved his head back and forth lethargically. We were shocked, so we asked people who were standing close-by how long he had been laying there. They explained that the man had cholera and that he had been there for a couple hours. Soon after his mother came and began to wail, saying that he was her only child and asking “Why is this happening?” in Kreyol.
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It turned out that there was a Cholera Treatment Center just 200 feet from where this man was dying, so we ran to the center and asked the staff to come and help this man who was fighting for his life. They delayed, and by the time they came to check on the man he had died. The mother wailed, stomping her feet and crying into her hands, and then a large truck with an open back pulled up carrying men draped in yellow rain coats and facemasks. They jumped off the truck and began spraying the body with a bleach-water mixture to disinfect the body and the surrounding area (including the mother).
The team wrapped the body in a white body bag and put it into the bed of the truck they had arrived in. They got back in the truck, drove to the cholera treatment center 200 feet away, picked up another 7 bodies, and then headed out. They told us they were heading to a mass grave that had been prepared, somewhere out in the mountains, and that we should follow. “You need to see how many bodies we have,” explained one of them.
The team is a rag-tag group of young Haitian men who have been tasked with the job of collecting those in the city who have died from cholera. There is a phone number that people can call when someone has died from the disease, and these are the guys that come to pick up your loved ones. They don’t ask for a name, they don’t ask for a phone number or any information about the victim, they just spray down the body, put them in body bags, and then load them in the car. The family members or friends will never know where the body is laid to rest, they will never be able to pay their respects.
Ben and I were following the truck as it pulled away from the cholera treatment center on its way to burial site when we were stopped by a crowd of people gathered around what looked like a pile of clothes surrounded by ‘Caution’ tape. We stopped with the truck, and were told that it was the body of a 10 year-old boy. He had died of cholera and they had put his body in the street so that someone would pick it up.
The crowd surrounding the body grew bigger, and the boy’s mother appeared amongst the throngs of people. According to her, her son had been in school just yesterday. “He got sick in the middle of the night, around 1am, and then around 10am he died,” she explained with her arm around her daughter, “I didn’t think he was that sick.”
And this case is a perfect example of why the cholera outbreak is hitting Haiti so hard. The lack of eduction amongst the people in regards to the disease is resulting in hundreds of people dying when it’s completely preventable. Severe diarrhea is prevalent here anyways, especially in the slums, so when people get the symptoms of cholera they don’t react much differently because Haiti hasn’t seen a disease like this in over 50 years. I’ve said in the past that cholera is 100% treatable as long as you get to the hospital in time, and it’s still true. Unfortunately, people wait too long to bring their loved ones to the hospital, and once they arrive it’s too late, OR they just don’t have the means to transport them, and they don’t make it to the hospital at all.
The team bagged the body of the 10 year-old boy and then jumped back in the truck on their way to the mass grave. Ben and I followed them the next day to the grave which is located just 30 minutes outside the city at the base of the mountains to the north. The truck barreled down the roads, leaving the scent of death behind it, and effortlessly passing through police checkpoints as just the mention of cholera gets you a free pass. They drove down a long gravel road off the highway, and behind a large hill sat a towering pile of dirt next to a hole large enough to fit at least 3 large SUVs. Inside the walls of the newly dug grave you could see pockets of remains from earthquake victims that were buried the same way. On the floor of the grave sat a single human skull.
They backed the truck up to the grave and started unloading the bodies into the hole. One-by-one the body bags tumbled to the bottom of the 20 foot-deep pit that resembled a trash dump more than a memorial to those who had just died. Another truck arrived to unload another 10 cholera victims, and in the end the grave had a disorganized pile of 22 body bags sitting on one end. The sheer enormity of the hole made the small pile of bodies sitting there seem that much less significant, as this wasn’t just their grave, it would be the grave of hundreds more. “We’ll keep on putting bodies in here until it’s full,” one of the team members explained, “and then we’ll cover it with dirt and dig another one.”
The sun set on the grave and the mosquitoes swarmed the living, causing everyone to flee to their cars, and then their homes. This will be their job for the foreseeable future, as this epidemic is not showing any signs of letting up. “It’s definitely increasing,” one of the workers explained, “On Monday we had 5, Tuesday we had 12, and today we have 22. It’s a lot of work.”
I normally wouldn’t write such a gruesome post but this seemed like something that needed to be put out there. The situation in PAP is bad, and the fact that it has resulted in this is terrifying. There is a ton of anger amongst the people regarding the source of the epidemic, and all signs are pointing towards Nepalese UN troops who have a base by the Artibonite River, where the epidemic began. The CDC has confirmed the strain came from southeast Asia, and there is video of latrines at the Nepalese base that leak their sewage directly into the river. The UN’s response to these accusations is that “the source of the epidemic doesn’t change our response to it medically,” but it is irresponsible to not take responsibility for being responsible for the deaths of thousands of Haitians when you are supposed to be here to protect them.
The numbers are grossly under-reported, as the number of deaths that the Ministry of Health announces every day is only including those who died in a hospital, or were brought there after they died. Hundreds, if not thousands of people are dying in their homes, or out in the countryside, because they didn’t get a chance to make it to the hospital. While it’s just an estimate, I would say that that number is probably only a 10th of the real number of deaths. Even the team that was collecting bodies admitted that they didn’t provide their data to anyone.
But the saddest part of all of this is that this epidemic is not going anywhere. Health officials here admit that cholera will be in Haiti for at least 20-30 years, and in the end will affect over 200,000 people. Until the infrastructure here changes into something that can sustain a proper sanitation system and deliver clean water, the disease will continue making people sick, and killing others. It’s scary because for the people who have lived with absolutely nothing, and could survive before the epidemic because they had learned to live with so little, this is uncharted territory. But now this disease has come and taken everyone by surprise, killing those who have been fighting for their lives for decades, in just a matter of hours.