Tag Archives: Haiti

The Economist – cholera and the super loo

July 30, 2011 – Solving the sanitation problem is within reach, and it could avoid many deaths

“CHOLERA most forcibly teaches us our mutual connection. Nothing shows more powerfully the duty of every man to look after the needs of others.” So said Titus Salt, a Victorian wool baron who worked to put an end to cholera in Yorkshire. It was cholera, as much as the great stink, which led London’s masters to build vast sewers, install toilets, and promote hygiene. Cholera struck fear into 19th-century cities, sweeping away the rich along with the poor. America’s President James K. Polk died of the disease after a visit to New Orleans. His successor, Zachary Taylor, may also have succumbed.

Photo from the Economist

The liquid diarrhoea and vomit jetted out by a body infected by the bacterium Vib rio choleraeis a reminder, in extreme form, of the danger lurking in the excrement which flows from every human settlement, creating a problem few want to go near. Not all human waste has the deadly bacterium; but all of it is dangerous and better disposal of faeces would go a huge way to stopping cholera and other deadly intestinal diseases.

And with the urban population in poor countries soaring, cholera is still a pressing concern. In Haiti the health ministry recently announced that 5,800 people had died of cholera since October last year. Another 250,000 had recovered, often after having lost work or schooling. Those numbers do not include Haitians believed to have died, helpless, in remote places.

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Study suggests UN force brought cholera to Haiti

Evidence “strongly suggests” that a United Nations peacekeeping mission brought a cholera strain to Haiti that has killed thousands of people, a study by a team of epidemiologists and physicians says.

The study is the strongest argument yet that newly-arrived Nepalese peacekeepers at a base near the town of Mirebalais brought with them the cholera, which spread through the waterways of the Artibonite region.

The disease has killed more than 5,500 people and sickened more than 363,000 others since it was discovered in October 2010, according to the Haitian government.

“Our findings strongly suggest that contamination of the Artibonite (river) and 1 of its tributaries downstream from a military camp triggered the epidemic,” said the report in the July 2011 issue of the CDC journal Emerging Infectious Diseases.

In an email to Associate Press (AP), U.N. mission spokeswoman Sylvie Van Den Wildenberg didn’t comment on the findings of the journal article, referring only to a study released in May by a U.N.-appointed panel.

The article published in the CDC journal comes as health workers in Haiti wrestle with a spike in the number of cholera cases brought on by several weeks of rainfall. The aid group Oxfam said earlier this month that its workers were treating more than 300 new cases a day, more than three times what they saw when the disease peaked in the fall.

The CDC journal article comes as health workers in Haiti wrestle with a spike in the number of cholera cases brought on by several weeks of rainfall. Oxfam said earlier that its workers were treating more than 300 new cases a day, more than three times what they saw when the disease peaked in the fall of 2010.

The new study argues it is important for scientists to determine the origin of cholera outbreaks and how they spread in order to eliminate “accidentally imported disease.” Figuring out the source of a cholera epidemic would help health workers better treat and prevent cholera by minimizing the “distrust associated with the widespread suspicions of a cover-up of a deliberate importation of cholera.”

Read the full article
Piarroux, R. [et al.] (2011). Understanding the cholera epidemic, Haiti. Emerging infectious diseases ; vol. 17, no. 7 ; p. 1161-1167. DOI:10.3201/eid1707.110059

Source: Jonathan M. Katz, AP, 29 Jun 2011

Haiti: UN panel reports on source of cholera outbreak

The cholera outbreak that has so far killed 4,888 people in Haiti was caused by a strain “very similar but not identical” to current South Asian strains, a UN independent panel of experts said. The source of the outbreak was due to contamination of the Meye Tributary of the Artibonite River, used by tens of thousands of people for washing, bathing, and drinking.

Anti-UN protests in Haiti

Many people in Haiti blamed the epidemic on UN peacekeepers from Nepal, who had been accused of poor sanitation at their base near Mirebalais, the town where the epidemic first began. In November 2010, this led to violent protests against the UN peacekeeping forces. Others believed that the outbreak was linked to voodoo. More than 50 voodoo followers have been killed since the outbreak of cholera following accusations that they spread the disease with occult power. However, the U.N. panel declined to point the finger at any single group for the outbreak, saying it was the result of a “confluence of circumstances”.

“The introduction of this cholera strain as a result of environmental contamination with faeces could not have been the source of such an outbreak without simultaneous water and sanitation and health-care system deficiencies,” the report concludes.

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Jay Graham/USAID – Photos from Haiti

WASH in Haiti by Jay Graham 

Photos highlight two organizations – SOIL and Deep Springs International – working in earthquake affected areas

Haitians turn to waste to combat cholera, deforestation

April 17, 2011 – Desperately poor Haiti is finding a cheap source of fuel in recycling human excrement, a move that could help put a dent in a cholera epidemic and slow the country’s pervasive deforestation.

The “biodigester“, which converts organic waste to biogas and a liquid fertilizer rich in nutrients, requires little infrastructure: toilets linked to a sealed, brick-lined well connected to a basin. Seventy of these devices are up and running, while another 70 are in the works.

Deprived of air, the bacteria thriving in human excrement eat 85 percent of the refuse while producing methane gas, explained Martin Wartchow, pointing his lighter above a small tube hanging out of the rank. A powerful flame was immediately set ablaze.

“The remaining 15 percent of organic waste is thrown out with the excess water in a green area where they biodegrade,” continued the hydrologist, who is working with the Brazilian nongovernmental group Viva Rio in Port-au-Prince.

“Not a single chemical product is used and at the end of the line, the water we collect is completely clean.”

The engineer plunged his hand in a basin filled with filtered, clear and, incredibly, odorless liquid. “We even raise fish here.”

Recently completed at a Viva Rio center that hosts over 600 young Haitians each day, the installation is due to be linked to a cafeteria under construction to replace wood coals.

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Haiti: disease model predicts more cholera and potential impact of clean water

The number of Haitians infected with cholera may reach 779,000 by the end of November 2011, nearly twice as many as UN estimates, according to a new study [1].

The UN estimate is “essentially a guess, based on no data, and ignoring the dynamics of cholera epidemics” co-author Dr. Jason Andrews told SciDev.Net.

Using a mathematical model of the epidemic, the study projects 779 000 cases of cholera and 11,100 deaths between March 1 and November 30, 2011, if there are no new interventions to curb transmission and treat victims.

The researchers estimate that 170,000 cases of cholera and 3,400 deaths could be averted by a combination of clean water, vaccination and greater distribution of antibiotics.

A 1% per week reduction in consumption of contaminated water would the greatest effect by averting 105,000 cholera cases and 1,500 deaths. Vaccination of 10% of the population would avert 63,000 cases and 900 deaths. The extension of the use of antibiotics to all patients with severe dehydration and half of patients with moderate dehydration would avert 9,000 cases and 1,300 deaths.

Andrews told SciDev.Net that the interventions could be achieved if the international community was willing to invest in them.

But Marcos Espinal, head of health surveillance, disease prevention and control at the Pan American Health Organization (PAHO), defended the UN’s approach. He told SciDev.Net that “the model used up to now is consistent with reality. We have seen just over 250,000 people with cholera in six months”.

A cholera epidemic broke out in Haiti in late October 2010, in the wake of the earthquake in January of the same year. The latest UN figures for the epidemic, published on 31 March 2011, are 267,224 cases, 4,749 deaths and a mortality rate of 1,8%.

[1] Andrews, J.R. and Basu, S. (2011). Transmission dynamics and control of cholera in Haiti : an epidemic model. The Lancet, 16 March 2011 (Article in Press). DOI: (free registration is required to view this article)

Source: María Elena Hurtado, SciDev.Net, 28 March 2011

Battling cholera with NFC RFID-tracked drinking water in Haiti 

Deep Springs International (DSI), a non-profit organization based in Pennsylvania, USA, and Nokia Research Center (NRC), Palo Alto, California, are teaming up to ensure the supply of clean drinking water in Haiti with NFC (near field communication) technology.

DSI has been delivering water treatment systems (which essentially consist of a covered 19-liter bucket with a spigot at the bottom) and a locally manufactured chlorine solution it has labeled Gadyen Dlo (Creole for "water guardian") since 2007.. Photo: Michael Ritter, DSI

Water treatment kits are being provided to track chlorine levels in household drinking water using NFC-enabled cell phones. NRC provided the health workers with approximately 50 Nokia 6212 NFC-enabled phones while UPM RFID supplied UPM BullsEye™ NFC tags with NXP Mifare Ultralight chip. Joseph “Jofish” Kaye, Senior Research Scientist, NRC, initiated the project together with David Holstius, a student and Ph.D. candidate at the University of California, Berkeley’s School of Public Health, who developed the software application for mobile phones.

Families in the most rural areas in Haiti will have one water treatment kit consisting of a five-gallon (19 litre) plastic bucket with a lid and spigot. The RFID (radio-frequency identification) tags are attached to buckets for storing the treated drinking water and delivered to families together with a chlorine solution and written instructions for using the kit. When DSI’s water technicians visit their homes, they check whether they are using the kits properly and provide additional chlorine solutions. The technicians will read the tags using NFC cell phones loaded with software guiding them to ask relevant questions about the water being tested. They then send the data to DSI’s headquarters via SMS. The software application uses the Frontline SMS platform.

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