Haitian Health Officials Try to Stem Cholera Epidemic

A massive education campaign aims to slow a disease that has taken 2,100 lives.

PORT-AU-PRINCE -- Using celebrities, text messages and billboards, Haitian health officials and international aid agencies have unleashed a massive public-education campaign to stem the rapid expansion of the cholera epidemic that threatens to destabilize this fragile Caribbean nation.

Meanwhile, a French scientist has pinpointed the source of the disease, which had not been seen in Haiti in more than 100 years. It is spread by bacteria in contaminated water or food, often through feces.

Like almost everything in Haiti, this campaign displays a sense of humor. In one television commercial, comedian Tonton Bicha is counseling a bedridden Joseph "ti Joe" Zenny of popular band Kreyol La on how to treat cholera. "Don’t be afraid of cholera," Bicha says in his best country twang, wearing a straw hat and fake salt-and-pepper beard and mustache. "All you need is to rehydrate yourself and go to a clinic."

Although people are not afraid of this wretched disease, it is the talk everywhere and has affected how Haitians interact. People rarely shake hands with strangers, and even in churches, parishioners merely nod to one another during the traditional handshaking ceremony of the Catholic Mass.

The disease, if untreated, can kill within a day through dehydration, with the old and the young most vulnerable. Health officials in Haiti declared Tuesday that the death toll had passed 2,100. They are expecting thousands more deaths and roughly 400,000 people to be affected before cholera can be brought completely under control -- which could take as long as two years.

"This is catastrophic," says Dr. Jean Claude Compas, a Brooklyn, N.Y., physician who has been monitoring the cholera situation in Haiti. "For every one death that is reported, at least three more go unreported because officials have no way of reaching them."

After the January earthquake that destroyed this capital city and left more than 1.5 million people living in tents and other temporary shelters, health officials were relieved that cholera and other diseases did not sweep across the country as sanitary conditions deteriorated. But when the first cases of cholera were reported in the Artibonite region in November, health officials were caught flat-footed and pleaded with the international community for financial aid to deal with the disease. The primary fear was that the disease could spread across the country because many people did not know the symptoms or how to protect themselves.

During a recent visit, a Haitian Times photographer and a writer spent a few hours with a team of doctors and health workers treating the sick at a small clinic located in the Port-au-Prince slum of Martissant and run by the French group Doctors Without Borders. The clinic, identified by a low sign behind a high metal fence with a gate and covered with a tarp, was cool compared with the heat outside. To the right, there was a tent where cholera victims were housed and evaluated. Those with serious symptoms were taken to another tent for IV treatment.

While health officials deal with the disease, a source from the French foreign ministry has told journalists that the cholera began at a camp for United Nations peacekeepers from Nepal. According to the French news agency AFP, respected French epidemiologist Renaud Piarroux conducted a study in Haiti last month and concluded that the epidemic began with an imported strain of the disease that could be traced back to the Nepalese base. That information has been a source of tension between Haitians who resent the presence of MINUSTAH, the acronym in French for the U.N. forces in Haiti, and U.N. peacekeepers.

"The source of the infection came from the Nepalese camp," the source told French news agency AFP, speaking on condition of anonymity, since he was not authorized to discuss a report that has not yet been made public. "The starting point has been very precisely localized," he said, pointing to the U.N. base at Mirebalais on the Artibonite River in central Haiti. "There is no other possible explanation, given that there was no cholera in the country, and taking into account the intensity and speed of the spread and the concentration of bacteria in the Artibonite delta," he said.

The U.N., which has faced violent protests in Haiti over its alleged role in the outbreak, insists that there is no evidence its troops were to blame. Haitian officials say that the first cases of cholera, a waterborne illness, broke out on the banks of the Artibonite, downstream from the U.N. base.

Last month Edmond Mulet, head of the U.N. mission in Haiti, said that no U.N. soldier, police officer or civilian official had tested positive for cholera, and he defended the Nepalese, who have been the target of protests. All samples taken from the latrines, kitchens and water supply at the suspect Nepalese camp have proved negative, Mulet pointed out. "There is no scientific evidence that the camp at Mirebalais is the source of this epidemic," he said, complaining of "a lot of disinformation, a lot of rumors around this situation."

Garry Pierre-Pierre is the publisher of the Haitian Times, a weekly based in New York.

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