Port-au-Prince -- At night the roads in the capital of Haiti, the poorest country in the Western Hemisphere, are dark except for the moon, the stars and the spontaneous methane fires of burning trash.
The acrid scent of raw sewage is the pungent threat of disease. The escalating cholera epidemic has killed more than 1,700 people and made 75,000 sick, according to the Red Cross. There is no sewage treatment plant in all of Haiti, and until this changes, the threat of cholera and other infectious diseases shows no signs of abating, experts say.
"The biggest challenge to battling the cholera epidemic is sanitation," said Henry Gray, a water and sanitation emergency coordinator for the Paris-based nonprofit Medecins Sans Frontiere.
While the Haitian government mulls plans to build a sewage treatment plant, "that would be drop in the ocean for the amount of sewage that's being produced," Gray said. The open sewers are the likely reason Alex Daristide, 5, arrived to the Sartre cholera treatment center -- among 32 treatment centers throughout Haiti -- Monday after a day of unceasing vomiting and
His family learned about the epidemic on the radio two weeks ago, his brother, Jean-Pierre Auguste, 20, said, and began to add chlorine tablets to their drinking water. But Port-au-Prince's open sewers present contamination threats even to the most cautious.
Since January, humanitarian organizations have installed 13,000 latrines, most of which are traditional portable bathrooms, concentrated mostly in the tent camps that average 50 people to every toilet, Gray said. "It's not the camps where we are seeing a disproportionate number of cases. It's the slums. The number of toilets in the slums is a worry. There are very few," he said.
MSF has appealed to the United Nations and the Haitian government to free up redevelopment funds to address the problem of the sewage, said Dr. Michel Janssens, an MSF press officer based at the southern treatment center.
"Critical decisions have to be taken now, open new sites special for cholera waste and treat waste disposal correctly to avoid a new epidemic coming from all that waste," Janssens said.
MSF trucks dispose of human waste and used medical supplies 20 kilometers away from the center, in a mountain heap of trash managed by the Haiti Recovery Group, the joint venture of for-profit Florida-based AshBritt, Inc. and the GB Group of Haiti. A community of homeless scavengers have used corrugated tin and plywood recovered from the pile to build makeshift homes.
During a recent trip to the site a reporter was not allowed to enter because employees of the U.S.-based Christian non-profit World Vision were on strike. The 60 workers say they were hired to direct incoming trucks full of waste to the appropriate dumping spot but they had not been paid since they began working Sept. 4.
In nearby Canaan, an estimated 12,000-family camp city spread over three miles of dusty plain, residents share 50 latrines -- holes surrounded by walls made of plywood. Residents burn trash to keep mosquitoes away.
"There is not enough water or food, and we have no place to put the waste. It's not healthy to breathe in the fumes of the fires but we have no other way to get rid of trash. We are living out here like animals," said Elie Elifort, 43, the president of an eight-member committee elected by residents to take charge of building roads and providing security. The committee dug a 20-foot-deep well, but because of overdrawing, the ocean water mixes with groundwater, so residents boil it twice, in vain hope of improving the taste and ridding it of contamination.