Thomas Adams, Special Coordinator for Haiti, gave a special briefing today on the U.S. government's response to the cholera outbreak in Haiti. He was joined by Mark Ward, the Acting Director of the Office of Foreign Disaster Assistance at USAID, and Dr. Manoj Menon, from the Centers for Disease Control and Prevention.
Special Coordinator Adams said, "After the earthquake in Haiti, we knew that the island would be particularly susceptible to water-borne diseases and other medical threats. And we, along with the Ministry of Health and the international community, set up a robust surveillance system which did indeed detect the outbreak of cholera which was confirmed on October 20th.
"The reasons this cholera is spreading, which also was predicted, are the poor sanitation in Haiti, which those of you who have been there certainly have seen. Also the fact that for at least 50 years and perhaps as long as a hundred years, Haiti has not had any cholera so there are no immunities amongst the population. Also, this strain of cholera seems to be more virulent than the normal strains. And CDC can talk more about that, and they're doing some investigations to try get a better picture of that.
"Because Haiti had such a poor health infrastructure, we, the United States, as part of our broad assistance there, have made this one of our pillars. We are going to invest a lot of money in the health system over the next five years, and we've already started on several parts of it. But the challenges as we go forward on cholera are many and we are meeting them and trying to overcome them, but this occupies us every day and our great team of people down there as well spend a lot of time on this."
Acting Director Ward continued, "...I think you know the numbers. The cases reported are going up, over 18,000 now, and unfortunately, the death toll is also going up, over 1,100 now. OFDA has provided about $9 million -- committed about $9 million so far. That number is going up every day, and you''ll hear why.
"Going forward, our strategy right now is to focus very much on prevention. Cholera's not very hard to prevent or treat if you get it early. But we've got to provide the tools to treat it and make sure the people know how to use those tools and take better care of themselves. If we are successful, the number of severe cases will decline, we won't -- they won't overtax the government's treatment facilities, and the death rate will drop.
"We've got an aggressive plan on prevention and it's got four parts. Number one, clean drinking water, a subject we talk about a lot. We talked about it certainly during the Pakistan floods. Clean drinking water is critical.
"...Many Haitians get their water, particularly in the urban areas, from government sources, from public sources. When I was in Haiti, in Port-au-Prince on Friday, we saw people gathering and filling water containers from public pipes, and we tested that water on the spot. Good news. It was chlorinated. But we've got to ensure that there is plenty of chlorine coming into the country over the next couple of months so that they don't run out and we will do that. And then for the rural areas where they do not have access to that public source of water, the public -- the government source of water, we're providing millions of aqua tabs that families can use to clean the water themselves.
"Second, oral rehydration therapy. Cholera causes, as you know, severe diarrhea and dehydration and this is what kills. It's easily treated with oral rehydration therapy, which is a simple mixture of sugar and salt and, very important, clean water.
"USAID's pretty proud of the fact that about 50 years ago we developed this therapy in South Asia. And all of us in the Foreign Service know it very well from our service overseas. We all keep a couple of sachets of ORS in our desks at work. It's easy to make. It's easy to administer. You don't need to go to a hospital or a clinic to use ORS. So it's critical to our prevention effort in Haiti. And we, the U.S. Government alone, among many donors, will be sending 2 million sachets of ORS to Haiti over the next month. About a third of it will be distributed through USAID's network throughout the country and the rest through the United Nations. There are 400 points in the country now where people can go to get ORS and we'll be adding more because we want to be sure that it's available in all departments of the country, even those where the disease has not yet shown up.
"Education and messaging -- the third part of our new strategy. Cholera as you'll hear, as you heard from Tom and you'll hear from Manoj, is new to Haiti, at least this generation. And we've got to redouble our efforts to be sure that the Haitians know how to care for themselves and prevent its spread and more severe cases.
"...And then finally, we know the fourth part of our approach -- we know there will be some severe cases still developing. The prevention efforts won't entirely succeed. And people need to have a place to go if they develop diarrhea and it's not going away. So we will be adding additional money to expand the facilities that are available either in cholera treatment units or cholera treatment centers in places where the disease is showing up so that if the diarrhea presents and people need to get additional help -- and that additional help is generally just an IV drip for a while and somebody to monitor your vital signs. But you need to get there quickly once the diarrhea develops.
"And so we need to be sure that these treatment facilities are available to people without too long a journey, so we will be working with NGO partners that we're already working with, particularly in the camps, to be sure that people have a place to get to quickly, and with the government to expand the bed space that they've got for people outside of the camps so that, again, if the diarrhea shows up, people can get to a treatment facility as quickly as possible."
You can read the complete transcript here.