Haiti cholera epidemic reaches Port-au-Prince

By Tom Eley
26 October 2010

The cholera epidemic that broke out last week in central Haiti, so far killing 259 people, has now reached Port-au-Prince, raising fears that the disease will take root in the capital city’s squalid refugee camps that sprang up after the January earthquake that left as many as 300,000 dead.

As of Tuesday morning, five cases had been found in Port-au-Prince, all among Haitians who had traveled to the city from the Artibonite area 50 miles to the north where the disease emerged and several thousand cases have been reported.

The five have been isolated and treated, but it is all but certain other cases will emerge. Medical aid workers are reporting some success in slowing the disease’s spread—only six new deaths were reported Monday—but they warn it can only be contained if it is prevented from contaminating the water supply in Port-au-Prince and its surrounding refugee encampments, where an estimated 1 million people reside.

The outbreak exposes the inadequacy of the international aid operation in the aftermath of the earthquake. Public health experts and aid workers had warned for months that water-borne diseases could develop if steps were not immediately taken to ensure a clean water supply. They have also repeatedly warned that the effects would be disastrous if such diseases take hold in the refugee encampments and slums of Port-au-Prince.

From the beginning, the Obama administration’s response to the earthquake disaster in Haiti has been shaped by the predatory aims of US imperialism. The first reaction was to launch a major military operation to encircle the island and prevent Haitians from escaping. Even those in desperate need of medical attention were barred passage to American hospitals, while the US military effectively choked off the attempts of aid organizations to rush food, water and medicine to the wounded and homeless.

After a degree of stability was achieved and the corrupt and incompetent regime of President René Préval propped up, the White House turned its attention to further opening the island to sweatshop exploitation in the garment industry. This is the specific task of former president Bill Clinton, who heads the US response to the disaster. Clinton is seeking to lift trade barriers to the products of Haitian garment factories, where workers earn less than $3 a day.

The US pledged $1.5 billion in relief money, but as of July, six months after the earthquake, no money had arrived to the international relief commission. Presented as a staggering sum, the figure is less than the personal fortunes of hundreds of US billionaires. Overall, only a small percentage of the aid and pledges of private charities and other national governments have been released for use in Haiti.

The result is that Port-au-Prince and nearby cities remain in a state of ruin, and ripe for the spread of disease. As of July, 98 percent of the rubble from the earthquake had yet to be cleared. Almost no new housing has been built. The teeming encampments have little or no access to electricity, running water and sewerage.

A September report from Refugees International called the relief operation “dysfunctional,” concluding that the “people of Haiti are still living in a state of emergency, with a humanitarian response that appears paralyzed.”

The cholera bacterium is a danger only under conditions of extreme deprivation. The intestinal disease that killed millions in global pandemics in the 19th century and early part of the 20th century has been eliminated wherever there is rudimentary water and sewage treatment. It is now once again on the rise, particularly in sub-Saharan Africa where the majority of the estimated 100,000 yearly cholera-related deaths take place. There is also a current outbreak in Pakistan.

Once contracted, cholera is easy to treat with “with cheap and simple antibiotics, fluids and oral rehydration solution,” according to Christian Nordqvist of Medical News Today. In the absence of medical attention the death rate for those who exhibit symptoms can rise as high as 50 percent.

Poverty is thus at the root of the rapid spread and deadly effects of the disease in Haiti. The disease was likely communicated to people through untreated water consumed in the Artibonite River valley, either directly from the river or from some other source. There is now speculation that the bacterium, Vibrio Cholerae, may have been present in Haiti for years, and conditions created by the earthquake have allowed for its epidemic spread. It is also possible the bacterium came into Haiti during the international relief operation.

Local hospitals in the Artibonite area were “overwhelmed” by the epidemic, according to multiple accounts. Federica Nogarotto of the medical aid group Doctors Without Borders, which is treating patients in St. Marc, said that the city does “not have the capacity to handle a cholera emergency.” The Miami Herald’s Jacqueline Charles described scenes of patients packed into small rooms in overcrowded regional hospitals, many lying on the floor.

CNN reported that after the outbreak, “people with buckets lined roadsides in and around villages, hoping that passersby might have clean water.”

Though the Artibonite area escaped the earthquake with minor damage, its population swelled through the migration of Haitians from Port-au-Prince, many of whom set up tents or crowded in with relatives.

Aid workers in Port-au-Prince are now advising residents to wash their hands with soap and drink only purified water, but most residents can use such products only if they are distributed for free.

“People don’t have the money to buy these things—they don’t even have the money to eat,'” Vilason Francois, a 34-year-old painter and resident of the tent city in Petionville plaza told the Miami Herald.

“I know they say don’t drink the water, but we can’t afford not to,” said Adievi Miralus, 53, of the Sou Pic encampment in Port-au-Prince, where tens of thousands reside. “If we can survive the quake, it would be stupid for us to die because of lack of water.”

Meanwhile, a new report from researchers at Purdue University warns that there is a possibility of another, perhaps larger, earthquake. They discovered that the January 12 quake emerged from a previously unmapped fault, which they named the Léogâne fault.

Eric Calais, a Purdue professor of earth and atmospheric sciences, explained that the newly discovered fault runs alongside the Enriquillo fault, which was originally thought to be the source of the earthquake.

“This means that the Enriquillo fault is still capable of producing large earthquakes and that Haiti has to adapt to this seismic hazard,” he said. “Preliminary measurements indicate that the Enriquillo fault did not release any accumulated seismic energy and, therefore, remains a significant threat for Haiti, and Port-au-Prince in particular.”

Calais pointed to the “need to focus attention, energy and funds on proactive measures to help the country adapt to earthquake hazards and, eventually, reduce economic losses and save lives. Our finding raises many important scientific questions and we are working to find the answers, but we already know that the earthquake threat in Haiti is inexorable.”

There is no indication that any improvements have been made to Haiti’s shoddily constructed buildings and infrastructure, which were responsible for much of the death toll in the quake.