Safe water and sanitation, vital tools to combat the current cholera epidemic, are absent in most communities in Haiti, reports IRIN. The death toll rose to 501 on 6 November 2010, up from 442 on 3 November, and hospitalisations for cholera totaled 7,359, up from 6,742.
Haiti is one of the few countries in the world where both urban and rural sanitation coverage has steadily decreased between 1990 and 2008, according to the WHO / UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation (WHO/UNICEF, March 2010).
Historical legacies of inequality, corruption, and extreme poverty all contribute to the Haitian government’s systemic inability to deliver safe water and sanitation.
In the village of Deslandes in the Petite Rivière d’Artibonite District, there is one well for 600 people that rarely functions, there are no toilets and reaching the nearest health centre requires crossing a river.
Most people use the River Artibonite – thought to be the source of the epidemic – as their primary source of drinking, bathing and laundry water.
“Everyone uses the river,” resident Melinda Sineas told IRIN. “But the river is dangerous now.”
In Deslandes, open defecation is the rule.
“When people get sick they relieve themselves in the woods like all of us,” Deslandes resident Ovid Floville, 50, told IRIN. “[Once they are too weak] and cannot stand any more, they stay at home and their whole body gets covered in diarrhoea.”
He said people scrub their homes with river water. NGOs have brought bleach and other supplies to nearby villages but Deslandes is isolated and access difficult, noted local pastor Solomon Tomas.
In the absence of safe water and sanitation, NGOs like the Boston-based Partners in Health (PIH) are trying to cope by handing out soap and water purification tablets.
PIH and three other institutions in 2008 published a report  about the widespread lack of access to clean water in Haiti. This lack, the report said, “ranks as one of Haiti’s most significant obstacles when it comes to meeting basic human rights standards. Historical legacies of inequality, disempowered or corrupt governance, and persistent levels of extreme poverty have all contributed to the Haitian government’s systemic inability to deliver clean water to its people.”
[PIH chief medical officer Joia Mukherjee] said developing a water and sanitation system must be the job of government. Since the January 2010 earthquake PIH has been wary about how little funding the government has received, she said. “The infrastructure cannot be done by an NGO. It’s important to assist the government in getting some of the resources coming in – that’s critical.”
 Vaira, M.K. .. [et al.] (2008). Wòch nan soley : the denial of the right to water in Haiti. Health and human rights ; vol. 10, no. 2. View abstract and link to full text [open source].
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