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Georgianne Nienaber

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Who Will Respond to Haiti's Cholera SOS?

Posted: 04/24/11 11:29 PM ET

Ninety-nine years ago this month, on April 15 1912, the RMS Titanic hit an iceberg and sent over 1500 people to their deaths in the icy waters of the North Atlantic. Ironically, the ship Californian was floating not 10 miles away, but ignored the visual SOS from Titanic. It fell to the frustrated crew of the ship Carpathia, 58 miles away, to attempt a rescue that was too little and too late.

In January 2010 a 7.0 earthquake in Haiti killed 300,000 immediately, left 1.5 million homeless, and now threatens untold hundreds of thousands with a cholera epidemic that is certain to ramp up once the rainy season begins. Like the crew of the Californian, the international community seems to be watching this disaster unfold with little more than puzzled glances and impotent responses that offer less assistance than the Titanic's inadequate lifeboats. There is no Carpathia ready to set sail and pick up the survivors, and no one to bury the uncounted dead who still rest, mummified, in the rubble like the Titanic's victims who reside at the bottom of the icy Atlantic.

The Titanic metaphor is one I have used when writing about injustice in Congo, and it is fitting to revisit the literary conceit as Haiti faces the possibility of a reemerging cholera epidemic that could affect 800,000 people -- double the initial estimates. Haitian health workers, the Pan American Health Organization, UN's OCHA, The World Health Organization (WHO) and the displaced and dispossessed have been broadcasting urgent cries for help since the January 2010 earthquake that devastated the infrastructure of the Western Hemisphere's poorest nation.

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The epicenter of the outbreak outside the UN compound in Mireabalais by Georgianne Nienaber


Since the outbreak began in mid-October 2010, Haiti has recorded 280,450 cholera cases and 4,835 deaths -- over three times the deaths in the Titanic disaster. We do not need to rely upon a blinking Morse Code signal from a sinking ship's lantern to understand what is happening. The country-wide fatality rate is 1.7 percent, but rural Sud Est department stands at a disastrous 7.9 and Grande Anse is not far behind with a 5.4 percent death rate. The Ministere de la Sante Publique et de la Population (MSPP) provides statistics that usually lag behind real time, but you can find them on the webpage.

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The Face of Cholera in Mireabalais in November by Leah Millis

In a better assessment from the ground in Mirebalais, the epicenter of the outbreak, PBS reports that the Partners in Health cholera center saw 500 cases in the three weeks prior to the recent rains. They have seen 1,000 cases in the last two weeks.

While the UN has offered estimates of up to 400,000 total cases by October 2011, a new study in the British medical journal, The Lancet, predicts nearly 800,000 cases and over 11,000 deaths from the cholera outbreak.

Fighting cholera does not come cheap. A World Health Organization mechanism called the Consolidated Appeal Process provides a coordination mechanism for charitable and aid organizations. It claims to "foster closer cooperation between governments, donors, and aid agencies, in particular United Nations agencies, non-governmental organizations (NGOs), and components of the International Red Cross and Red Crescent Movement."

It costs $1 million to run a 200 bed Cholera Treatment Center (CTC) for three months. This includes 45 nurses, 80 support staff and 9 doctors. This represents an overwhelming list of needs, considering that many NGOs have left and cholera remains underfunded. It is ironic that some of the same agencies, who have created a comprehensive document on Haiti's needs, have packed up their tents, banners, and personnel. They say that they will return when the money flows along with increasing disease numbers.

Food shortages are predicted due to the devaluation of crops in the fertile Artibonite Region by misplaced foreign aid.

On April 6, 2011, the joint military and civilian Southern Partnership Station (SPS 2011) crew aboard the High Speed Vessel Swift (HSV 2) delivered more than 135 metric tons of donated food and humanitarian supplies, valued at nearly $1 million, to the Port-au-Prince wharf, according to an Embassy press release.

But, the Associated Press reports that the Navy's aid program, Project Handclasp, said the supplies got held up at the U.S. base at Guantanamo Bay, Cuba, because of various transport difficulties and the bulk of the food passed its expiration date and had to be tossed.

Double SOS

On April 6, United Nations Secretary-General Ban Ki-moon addressed the Security Council regarding Haiti and the withdrawal of humanitarian agencies.

And the withdrawal of some humanitarian agencies from cholera treatment centres and camps risks creating a shortage in the provision of services. The Cholera Appeal is 45 per cent funded, and the overall Haiti Appeal received only 10 per cent of the requested funds. Additional financial support is urgently needed. Strong coordination between UN agencies, the Interim Haiti Recovery Commission and the new Government will also be crucial.

Ban Ki-moon warned, "Only large-scale investments in Haiti's water and sanitation system will protect against another outbreak."

Haiti is drowning in sewage and only 17 percent of the $915 million in promised international aid has been funded.

There are also huge unmet water and sanitation gaps for camp and transitional shelter residents. The UN Office for the Coordination of Humanitarian Affairs (OCHA) published this grim March report.

Gap analysis from the Shelter, Water, Sanitation and Hygiene (WASH), CCCM Clusters and the Office for the Coordination of Humanitarian Affairs (OCHA) reveals the magnitude of the task ahead to meet basic water and sanitation needs of transitional shelter and spontaneous camp residents. The WASH funding requirement of US$175 million is 19 percent met ($32 million) and this lack of funds to support programs will have direct consequences on the health situation of vulnerable populations.
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Pleading for clean water in Chinchion by Georgianne Nienaber
Obviously, the absence of latrines, desludging activities, and safe drinking water, provides an opportune environment for cholera and other water borne diseases. Incredibly, temporary shelters do not include sanitation. People are defecating into plastic bags, or going on the ground or in streams. Water purification tablets are in short supply, if they can be obtained at all in rural areas. The villagers of Chinchion we visited in February were traveling miles to market to buy bleach for water purification. It works, but where are the promised purification tablets? Some villages were paying for the tablets on the black market.
As of April 7.39 percent of the 56,107 T-shelters hosting 235,649 individuals do not receive any WASH services, reports the Shelter Cluster. Not all of the 65 implementing partners have the capacity and the expertise to implement WASH programming and it is predicted that 42 percent of the additional 116,000 T-shelters to be built this year will not receive any sanitation and water services either.
OCHA also reports that the communes of Léogâne, Port-au-Prince, and Croix des Bouquets are the most affected by the lack of access to water and sanitation services by T-shelters residents. Other communes with a high number of cholera cases, such as Carrefour, are also particularly vulnerable.

The Truttier waste dump sits over the main aquifer that supplies Port-au-Prince with drinking water. As Ayiti Kale Je reports:

Near the capital, a giant, unlined, uncovered excreta pool contains thousands of gallons of feces, some of it likely infected with cholera. The pool a mile or so from the Bay of Port-au-Prince, and on top of the Plaine de Cul de Sac aquifer.

Medical waste, including sludge from cholera facilities was being dumped there in February:


The United Nations High Commissioner for Refugees' (UNHCR) Emergency Response Manual recommends the installation of one latrine per family, a maximum distance of 100 metres from a shelter to a water point, and two garbage containers per community of 80 to 100 individuals. It also recommends all kinds of other emergency responses that are not happening as Haiti's earthquake refugee crisis approaches its 16 month.

In his remarks to the Security Council, Ban Ki-moon promised "The United Nations will continue to stand shoulder to shoulder with the Haitian Government and people in the noble and necessary work of building a more just and prosperous future."

The April Haiti Health Cluster Bulletin #23 says an "independent evaluation mission has arrived in Haiti to assess the efficiency and effectiveness of the coordinated national and international response to cholera, both in terms of immediate and medium term impact. The results will assist the MSPP and its international and national partners to draw lessons from successes and shortcomings..."

More studies and promises flow from the United Nations.

Someone please give these people a Morse Code manual. Three dashes and three dots (··· --- ···). The 1918 Marconi Yearbook Marconi of Wireless Telegraphy Manual states, "Stations hearing this distress call were to immediately cease handling traffic until the emergency was over and were likewise bound to answer the distress signal, which can mean "Save Our Souls."

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Photo by Georgianne Nienaber

Aid Workers and funding institutions, answer your wireless cell phones, please. We don't need any more studies on what Haiti needs in the way of basic human rights of clean water, shelter and food. Don't watch, dumbfounded, as yet another disaster unfolds.

 
 
 

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Ninety-nine years ago this month, on April 15 1912, the RMS Titanic hit an iceberg and sent over 1500 people to their deaths in the icy waters of the North Atlantic. Ironically, the ship Californian w...
Ninety-nine years ago this month, on April 15 1912, the RMS Titanic hit an iceberg and sent over 1500 people to their deaths in the icy waters of the North Atlantic. Ironically, the ship Californian w...
 
 
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HUFFPOST SUPER USER
AcademicFreedom
Often banned; always factual
03:36 PM on 04/25/2011
I saw 60 Minutes where Sean Penn was down there all the time helping people.
03:20 PM on 04/25/2011
At one time Haiti was the wealthiest colonized country in the Western Hemisphere, mostly due to sugar. But it also "boasted" more slaves than the U.S combined. Like being born under a bad sign, Haiti was a country that was almost doomed to failure ever since the famous bloody coup d'etat and the slave rebellion of 1791. From that moment on, worried White super-powers: France (obviously), GB, and yes, the U.S., were determined to ensure that a) never happened again -- particularly on their home-soil (in particular the South was keen on ensuring that didn't happen) and b) that Haiti was made to 'pay' for it in a multitude of ways. Starting w/ the the threat of economic sanctions on Haiti's (at that time) rich resource by France, backed by the U.S. and GB, unless Haiti paid their former slave-masters more than $1 billion dollars in reparations, almost completely bankrupting the nation.

The U.S. threw in the infamous 'Rough-Riders' or Marines to "protect" their interests, when in fact, they essentially colonized it for the U.S. And we made sure to send down "polite" Southern diplomats who were also slave-owners, who essentially functioned as Governors. Add U.S.-backed Trujillo who slaughtered tens of thousands of Haitians and U.S.-backed Haitian dictators: Papa & Baby Doc, and then throw in a huge natural disaster(s), is it any wonder Haiti faces these challenges?
02:01 PM on 04/25/2011
What happened to hundreds of millions donated by US citizens? the hundreds of millions donated to Katrina victims. 10 years later and we are still looking for the money to be spent from the 9/11 fund. Better to donate goods and medical supplies directly to local aide organizations on scene than cash to gov't agencies
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HUFFPOST SUPER USER
Lindstr7
01:56 PM on 04/25/2011
So terribly sad. I donated money to jphro again after the quake hit japan because no one was paying attention to Haiti anymore. I just hope I donated to the right org. and that this story gets more coverage. Thank you ms. Nienaber for your story.
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01:53 PM on 04/25/2011
The problem is not rocket science and it is outrageous that this continues.
01:47 PM on 04/25/2011
Who care's....
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blitznstitch
BAZINGA!!!
02:54 PM on 04/25/2011
no apostrophe needed
01:33 PM on 04/25/2011
Further information on the Cuban Doctors Program and its on-going work in Haiti before and after the earthquake, from NPR and the BBC, for skeptics who may find the Cuban government's website a questionable source:

http://www.npr.org/templates/story/story.php?storyId=122919202

http://news.bbc.co.uk/2/hi/americas/1535358.stm
12:55 PM on 04/25/2011
Sorry Haiti too busy spending our money in the form of bombs on Lybia. Thank you Mr President!
12:52 PM on 04/25/2011
I am baffled by the absence of any mention of Cuba's services in this Huffpost report "Who Will Respond To Haiti's Cholera SOS?". That SOS was answered, and is being attended to, by hundreds of doctors sent by the Cuban government, so why this glaring omission of the on-going, pre-earthquake health services provided by Cuban doctors, specifically in the context of treating cholera? Cuba's doctors have been, according to a recent NPR report, in Haiti, and had established, long before the earthquake "...the health service of Haiti." From the Granma web site only 5 days ago:

"Haitian president honors Cuban Medical Brigade" PORT-AU-PRINCE, April 20.— Haitian president, Rene Preval, decorated the Cuban medical brigade with the National Order of Honor and Merit. This highest distinction from the Caribbean nation was awarded in recognition of the outstanding work of the medical brigade in the struggle against cholera which has saved many lives."
http://www.granma.cu/ingles/index.html

While the celebrated influx of US, Israeli, and other NGO efforts made network news in the US, those groups came and went. Before and after they were gone, the Cuban doctors had been and continue to be quietly working, out of the US corporate media spotlight, without compensation, doing their good work, as usual.
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HUFFPOST SUPER USER
Lindstr7
03:26 PM on 04/25/2011
I'd never heard of this. Thank you for that information.
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HUFFPOST BLOGGER
Georgianne Nienaber
Author, Investigative journalist
06:05 PM on 04/25/2011
Thanks for reminding people. The Cuban Brigade was not in the scope of this piece, but we have covered them extensively over the past year, and visit their clinic on Highway 1 regularly. Here is one story you may have missed about them, among several.
http://www.huffingtonpost.com/georgianne-nienaber/haiti-tracking-the-trail_b_782554.html
07:56 PM on 04/25/2011
Thanks for the link to your piece and to Elizi. As a journalist who took many trips to Havana to research Ernest Hemingway's life there ('92-2001), I found, as you mention in your Artibonite piece, the disarming candor, honesty, and enthusiasm of Cuba's museum officials, directors, and ordinary citizens contrasted so much with the guarded, conceited behavior I often ran into with their counterparts in the US, my country. Your comments about the MSN behavior seems typical; they seem to be there for their own self-congratulatory aims, rather than helping. To me, it is about pride versus ego, and the Cubans are proud, humble, and there for the greater good, not just a weekend junket in the tropics. If only your reporting on the Cuban Doctors could make it onto network broadcasts; wishful thinking, like imaging that W could have accepted Fidel's sincere offer to send paramilitary medics to help save lives during Katrina.
09:42 AM on 04/25/2011
Unfortunately, this is another example of governments and NGO's confronting acute problems (ie: the Haitian cholera epidemic ) while ignoring the big picture. Very little has been done to prevent another major epidemic with the upcoming rainy season. Cholera is now endemic to Haiti ( nothing can change this), and unless there is a major effort to increase access to clean drinking water, thousands more will die every year.
Mysteryprincess
Liberal Libertarian
01:00 AM on 04/25/2011
I feel for the people of Haiti, but how long are we supposed to poor untold billions into them when we're telling our own people they can't have health care?
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PrimusElijah
Serial; semi-colon abuser
02:34 PM on 04/25/2011
Most of the money for Haiti is still sitting on the sidelines, waiting for a "legitimate" government to come into power after the stalled recount.
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blitznstitch
BAZINGA!!!
02:54 PM on 04/25/2011
not spending billions in Haiti. More like millions.
12:37 AM on 04/25/2011
Great article, Georgianne, bringing together so much of what we investigated in one focused piece. This SOS has to go right to Micky Martelly, Hilary Clinton and the US Navy. You can't rebuild a country when the foundations are sinking in a toxic waste pool.
12:19 AM on 04/25/2011
I often have no words to describe what I saw in Haiti, fortunately we have a few good writers that can find the words and analogies to call for the changes needed. Very sad that international aid and intervention is killing Haitians. Re-Evaluate, retask, deliver the funds promised, stop the BS with so called "long term" rebuilding (excuse to hold the $) and spend the money donated to save lives, get people into shelter, with clean water, food, safe sewage handling, jobs/training for Haitians (not foreign aid workers), Haitian self determination and self help is the only way. NGO's need to put themselves out of business as they hand off the operations, in order for Haiti to prosper.
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HUFFPOST SUPER USER
sweetiebird
11:36 PM on 04/24/2011
Thanks Georgianne for your continuing efforts to focus attention on the on-going forgotten crisis in Haiti. Now that the election is over, the media is no longer paying attention to the humanitarian crisis in Haiti preferring to focus its resources and attention on the on-going nuclear crisis in Japan and the war in Libya, when not discussing the "royal" wedding in England. Perhaps if some of the moneys expended for the royal wedding could be spent to redress the humanitarian crisis in Haiti, it would be put to far better use than it will be, and lives would be saved in the process.