In Haiti, a Building Fights Cholera

In Haiti, a Building Fights Cholera. New York Times, September 12, 2017.

Next month marks the seventh anniversary of the cholera outbreak that ravaged Haiti. The disease, which can cause death within hours if left untreated, came less than a year after Haiti was rocked by an enormous earthquake that left hundreds of thousands dead and millions injured, displaced and destitute.

Haiti is prone to earthquakes and tropical storms — the island was spared the worst of Hurricane Irma last week — but the cholera outbreak was an anomaly; the disease had never before struck Haiti. It was brought in, it is widely believed, by United Nations peacekeepers from Nepal.

A child with cholera symptoms being examined in the Cholera Treatment Center in Port-au-Prince, Haiti. Credit Dieu Nalio Chery/Associated Press

One of the world’s most infectious waterborne diseases, cholera spreads quickly and has proved extremely difficult to contain in Haiti. Over 10,000 have died and nearly a million have been stricken to date.

But one organization has managed to nearly eradicate it in a large slum in Port-au-Prince that lacks clean water and sanitation.

One of the game changers that would surprise most people, including global health experts, was actually a building.

It wasn’t just any building, but a very intelligently and beautifully designed one: the Cholera Treatment Center, operated by Les Centres Gheskio, an acronym that stands for the Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections.

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Water and Sanitation Services: Rural or Urban Haiti First?

Water and Sanitation Services: Rural or Urban Haiti First? Huffington Post, June 16, 2017.

Low coverage rates for clean water and sanitation leave Haiti exposed to significant health burdens. According to the latest estimates, 72% of Haiti’s population lack access to improved sanitation facilities and use either shared facilities, other improved facilities, or defecate in the open. 

Source: pexels.com

 

In urban areas, 66% of the population lacks access to improved facilities while in rural areas, 81% of the total population lacks access to improved facilities.

Between 2,000 and 4,500 people die each year from diarrheal disease. And the lack of basic water and sanitation services has contributed to the spread of waterborne diseases, including the cholera outbreak introduced by U.N. peacekeeping troops in 2010.

Better water and sanitation services would make it harder for such diseases to spread. But here, as in every other policy area, Haiti faces options.

Examining competing policy options is the purpose of the Haiti Priorise research project. More than 50 economists have written new research papers studying the costs and benefits of different proposals to improve the nation’s environmental, economic, and social conditions.

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A Photographer’s Journey Into Haiti’s Cholera Crisis – National Geographic

A Photographer’s Journey Into Haiti’s Cholera Crisis. National Geographic, December 13, 2016.

After Hurricane Matthew hit, a silent killer struck the fragile country—again

The same rains that were spreading cholera across southern Haiti were blocking Andrea Bruce from getting to the story.

The Elise Adventure Morija Church was completely swept away during Hurricane Matthew. Residents still hold services under a tent on the church’s foundation.

The National Geographic photographer had arrived a few weeks after Hurricane Matthew struck the island in October to document a new surge of cholera cases spreading across some of the country’s most remote areas.

When Bruce reached the mountainous epicenter of the cholera crisis, a town called Rendel, she found crumbled homes, some with just a door frame or a single piece of furniture left standing. Residents were scrapping together small shacks from the rubble.

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U.N. Admits Role In Haiti Cholera Outbreak That Has Killed Thousands

U.N. Admits Role In Haiti Cholera Outbreak That Has Killed Thousands | Source: NPR, Aug 18 2016 |

In the fall of 2010, months after a devastating earthquake struck Haiti, a new disaster began: a cholera outbreak that killed thousands of people and continues to sicken people across the country.

Cholera patients are treated at the Cholera Treatment Center in the Carrefour area of Port-au-Prince, Haiti, in December 2014. The Caribbean country’s cholera outbreak started in 2010. Hector Retamal/AFP/Getty Images

Experts determined that the source of the disease was a U.N. peacekeeping camp. And now, nearly six years later, the United Nations has admitted it played some role in the deadly outbreak.

At a briefing Thursday, U.N. spokesman Farhan Haq said that over the course of the past year, “the U.N. has become convinced that it needs to do much more regarding its own involvement in the initial outbreak and the suffering of those affected by cholera.”

He said the U.N. would announce new actions to address the issue within the next two months.

“Our legal position on this issue has not changed,” Haq said, adding that the U.N. was not describing any of its actions as “reparations.”

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Methane production for sanitation improvement in Haiti

Methane production for sanitation improvement in Haiti. Biomass and Bioenergy
Volume 91, August 2016, Pages 288–295.

• Full text

Authors: Stephanie Lansing, Holly Bowen,  et. al.

There is a great need for decentralized anaerobic digestion (AD) that utilizes wastewater for energy generation. The biochemical methane potential (BMP) of Haitian latrine waste was determined and compared to other waste streams, such as grey water, septage, and dairy manure.

Average methane (CH4) production for the latrine waste (13.6 ml ml−1 substrate) was 23 times greater than septage (0.58 ml ml−1 substrate), and 151 times greater than grey water (0.09 ml ml−1 substrate), illustrating the larger potential when waste is source separated using the decentralized sanitation and reuse (DESAR) concept for more appropriate treatment of each waste stream.

Using the BMP results, methane production based on various AD configurations was calculated, and compared with the full-scale field AD design.

Methane potential from the BMP testing was calculated as 0.006–0.017 m3 person−1 day−1 using the lowest and highest latrine BMP results, which was similar to the values from the full-scale system (0.011 m3 person−1 day−1), illustrating the ability of BMPs to be used to predict biogas production from sanitation digesters in a smaller-scale setting.

First ever National Sustainable Sanitation Conference in Haiti

Sustainable Organic Integrated Livelihoods (SOIL) and UNICEF are organising Haiti’s first ever National Sustainable Sanitation Conference. It will be held in Port-au-Prince on 12-13 June 2012.

The conference aims to share information about innovative waste treatment technologies such as composting toilets and bio-systems, among NGOs and the Haitian government.

Agenda:

• Overview of National Sanitation Strategy presented by DINEPA’s Sanitation Office (DA)
• Presentations of lessons learned from previous projects and ongoing sustainable sanitation projects in Haiti
• Ateliers focused on different components of sustainable sanitation
• Stakeholder feedback
• Open forum to discuss National Standards for Composting Toilets and Biogas
• Production of a public document summarizing the findings of the conference

SOIL, US-registered non profit, has been promoting ecological sanitation solutions in Haiti since 2006.

For the full announcement and more information go to: www.oursoil.org/national-sustainable-sanitation-conference

Factors determining the effectiveness of Oxfam’s public health promotion approach in Haiti

Factors determining the effectiveness of Oxfam’s public health promotion approach in Haiti, 2012.

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Nadja Contzen, Hans-Joachim Mosler. Eawag.

In response to the devastating Earthquake of January 12th 2010 and the cholera outbreak of October of that same year Oxfam Great Britain, Oxfam Quebec and Intermón Oxfam conducted public health promotion and cholera response in Haiti. Different promotion activities were applied which aimed at changing hygiene behavior by changing perceptions and beliefs about healthy behaviors amongst people affected by crisis.

In February 2011 four Oxfam affiliates in Haiti in partnership with a team of behavior change researchers from Eawag launched the present research project to do an in-depth evaluation of the promotional activities that had been conducted with the goal of further improving the WASH situation for people in Haiti and worldwide by understanding how to make hygiene promotion more effective. The main focus of the research project was around the question which specific promotion activities were strongly associated with perceptions and beliefs about handwashing with soap and were thus capable of changing handwashing behavior at key times.

OXFAM – Hygiene promotion: determining what works

OXFAM – Hygiene promotion: determining what works, 2012. Humanitarian field studies | Cholera response in Haiti

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When a massive earthquake struck Haiti in January 2010, followed by a cholera epidemic that broke out in October of that year, Oxfam rushed assistance—clean water, sanitation, and hygiene materials and information—to hard-hit areas to protect public health.

Hygiene promotion is arguably the most important intervention in a cholera epidemic: the route of cholera transmission is fecal-oral, and contaminated hands are often the principal vector. So Oxfam engages in a wide range of hygiene-promotion activities to encourage washing hands—specifically, washing hands with soap at key moments, such as before eating and after defecation.

But which of our interventions have been the most effective, and why? Is it more important to put resources into hygiene-themed theater productions or radio call-in shows? There is little hard evidence to suggest that—in Haiti or in emergencies anywhere—one hygiene-promotion activity works better than another. But lives, not to mention valuable resources, may depend on the answer, so in the spring of 2011, Oxfam engaged Eawag, the Swiss Federal Institute of Aquatic Science and Technology, to study the effectiveness of our hygiene-promotion activities in Haiti.

Haiti: lack of proper sanitation is real cause of cholera outbreak, Clinton says

Woman at Leogane camp saying the latrines behind her are full and smell foul. Photo credit: Haiti Grassroots Watch

Haiti should focus on stemming the cholera outbreak that has killed more than 7,000 people since 2010, rather than on levying blame against the source of the disease, UN special envoy to Haiti, Bill Clinton, said. While studies have suggested that the cholera came from a Nepalese soldier serving as a peacekeeper, Clinton pointed out that the country’s lack of proper sanitation was the real cause of the outbreak.

Clinton made the remarks after he toured a new public teaching hospital in Haiti’s Central Plateau that was built by the Boston-based Partners in Health.

In November 2011, the Boston-based Institute for Justice and Democracy in Haiti (IJDH) filed a demand for hundreds of millions of dollars in compensation from Haitian cholera victims.

Money to empty refugee camp toilets has run out

Clinton’s own foundation, together with UNICEF and USAID, supplied some 11,000 mobile toilets for the refugee camps that emerged after the 2010 Haiti earthquake. The NGOs that distributed the toilets and paid for them to be emptied are now pulling out one by one, leaving overflowing toilets behind, according to an IPS report.

Donor funds are being used to set up excreta treatment centres, one is now in operation in Morne-à-Cabri while a second centre is planned for Titanye, but these are not servicing the remaining refugee camps, home to nearly half a million people.

Source:

• AP, Former President Clinton urges officials to stem Haiti cholera outbreak, Washington Post, 07 Mar 2012
• Phares Jerome and Valery Daudier, Money for cleaning toilets in Haiti down the drain? – Part 1, IPS, 07 Mar 2012

Haiti: Twitter data accurately tracked cholera outbreak

Twitter messages were providing data that would have been a quicker way of detecting and tracking the 2010 cholera outbreak in Haiti than traditional methods, according to a study [1] published in the American Journal of Tropical Medicine and Hygiene.

The study found that online social media and news feeds were faster than, and broadly as accurate as, the official records at detecting the start and early progress of the epidemic, which hit Haiti after the earthquake in January 2010 and has killed more than 6,500 people.

[…]

The authors used HealthMap, an automated surveillance platform, to measure the volume of news media generated during the first 100 days of the outbreak, and they also looked at the number of ‘cholera’ posts on Twitter.