In Haiti camps where Oxfam works, hygiene education helps guard against cholera

By Coco McCabe
Education about good hygiene is one of the keys to preventing the spread of cholera. Oxfam has been working on public health education in the camps. Photo by Oxfam America

The cholera outbreak that is now sweeping Haiti has sickened more than 19,640 people and killed 1,186. But in the camps where Oxfam has been working with displaced people since the devastating earthquake in January, there has not been one single confirmed case of the deadly waterborne disease.

“Our programs in the capital are in full swing, reaching over 315,000 people with clean water, sanitation services, and hygiene education,” said Raphael Mutiku, head of Oxfam’s water and sanitation operation in Haiti.

All together, Oxfam is reaching nearly 700,000 people with these services and fighting the spread of the disease on three fronts: in the Petite Riviere area of the Artibonite province, in camps scattered across the hills of Port-au-Prince, and in Cap Haitien, a large city in the northern part of the country.

The program in Cap Haitien started again on Monday when calm returned following violent demonstrations that had blocked the roads. Oxfam had suspended the program for a week.

“We’re working in a slum area of Cap Haitien with terrible sanitation and where good, basic hygiene is often not practiced,” said Elodie Martel, Oxfam’s program manager there. “ We’ve helped to treat water for the local water network, but we couldn’t complete the job because of violence. If we’re able to circulate freely and safely, we’ll be able to reach over 250,000 people in and around Cap Haitien.”

Haiti is preparing to choose a new president from a crowded field of candidates in a national election on Nov. 28. The winner will face the enormous—and immediate challenges—of a country in the grip of deadly cholera, a capital in ruins, and more than a million people still homeless after the quake. Demonstrations, some of them violent, continue sporadically in Port-au-Prince and Hinche. But these have yet to affect Oxfam’s programs.

The organization now has 700 staffers dedicated to stopping the spread of cholera—and public health education is key.

“Good hygiene practices can’t be adopted overnight, but we’re doing our utmost to get hygiene information out to as many people as possible,” said Mutiku. “Most of the cases of cholera in Port-au-Prince are in the slums that did not receive post -earthquake relief. Now we have to all work together to ensure that every last person in Port-au-Prince  has clean water and information about good, basic hygiene practices. This is the only way to stop the spread of cholera.”

Though experts don’t know yet the exact origin of the disease, the government tested the water in the Artibonite River—in the province where the outbreak began—and found it contaminated by the cholera bacteria.

What’s needed?

On Monday, the United Nations reported that the appeal it’s leading for $164 million to fight cholera has received less than 10 percent of that amount—not nearly enough for an adequate response.

“Critical supplies and skills are urgently needed,” said Nigel Fisher, a UN humanitarian coordinator. “We need doctors, nurses, water purification systems, chlorine tablets, soap, oral rehydration salts, tents for cholera treatment centers, and a range of other supplies.”

The disease has now reached six of Haiti’s 10 departments. Across the country—the poorest in the western hemisphere—less than a quarter of Haitians have access to adequate sanitation and most do not have access to clean water, all of which increases the chance that cholera will continue to spread.

Among the challenges Haiti faces as it combats the disease is a shortage of cholera treatment centers. The capital, Port-au-Prince, has just 1,000 beds available for cholera patients, and there are only another 1,000 scattered across the country.

An urgent investment in more public health education is also needed: Contradictory and inappropriate messages—some spread by uninformed commentators on the radio—are feeding panic and confusion. And limited communication networks have prevented clear information from reaching isolated areas.

Additionally, health risks are increasing because medical institutions are not processing adequately their contaminated solid wastes and the burial of bodies has been delayed or poorly managed—in some cases because no appropriate land has been allocated and in other cases because neither body bags nor chlorinated lime is available.

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