Haiti's Cholera Death Toll Climbs
No Relief in Sight for the Battered Nation
The cholera epidemic in Haiti continues to grow. The latest information from the Haitian Ministry of Public Health reports 2,323 related deaths and over 104,000 cases. That report was dated Dec. 9.The unrest following the announcement of preliminary election results on Dec. 7 slowed or stopped relief efforts in a number of regions of Haiti. The violence halted efforts in the North West department, Centre department and in Leoganes, according to the United Nations. The communities of les Cayes, Cap Haitien and Gonaïves were unsafe and UN personnel were restricted to their bases. Some staff was evacuated from les Cayes.
Helicopters were able to make deliveries of medicine and cholera treatment supplies on Dec. 10 and 11. UN troops from Bolivia and Guatemala provided protection for the shipments. Cuban medical relief operations continue, with their relief mission now numbering 1,063.
The U.S. Centers for Disease Control (CDC) is actively involved in the cholera fight. They have 183 staff assigned to the outbreak, with 25 on location in Haiti. In addition, the existing CDC AIDS program office in Haiti is contributing to the effort with its 40-member staff.
Samaritan's Purse, a faith-based charity, brought attention to the many issues in Haiti with a visit to the country this past weekend by Sarah, Todd and Bristol Palin, along with SP president Franklin Graham and Fox News' Greta Van Susteren. Among the areas visited was the SP cholera treatment center in Cite Soleil, the huge slum in Port-au-Prince.
In Haiti's neighbor, the Dominican Republic, the Ministry of Public Health reports 22 laboratory-confirmed cases of cholera as of Dec. 6. Over 170 more are suspected. Of the confirmed cases, two cases came from Haiti and the remainder were local infections.
An anecdotal account of Haiti's medical situation created by structural violence and negligence. Go to Peoria's Medical Mafia and PMM Daily to see Peoria's role. Also see Live From Haiti and Haitian Hearts.
Tuesday, December 7, 2010
Renaldo's Obituary
Tuesday, December 07, 2010
No One Cries When An Old Man Dies of Cholera in Haiti
JONATHAN M. KATZ, Associated PressPublished: 01:58 p.m., Tuesday, December 7, 2010 PORT-AU-PRINCE, Haiti (AP) — A contingent of U.N. peacekeepers is the likely source of a cholera outbreak in Haiti that has killed at least 2,000 people, a French scientist said in a report obtained Tuesday by The Associated Press. Epidemiologist Renaud Piarroux concluded that the cholera originated in a tributary of Haiti's Artibonite river, next to a U.N. base outside the town of Mirebalais. He was sent by the French government to assist Haitian health officials in determining the source of the outbreak, a French Foreign Ministry official said Tuesday. "No other hypothesis could be found to explain the outbreak of a cholera epidemic in this village ... not affected by the earthquake earlier this year and located dozens of kilometers from the coast and (tent) camps," he wrote in a report that has not been publicly released. The report also calls for a further investigation of the outbreak, improved medical surveillance and sanitation procedures for U.N. peacekeeping troops and better support for Haitian health authorities. The AP obtained a copy of the report from an official who released it on condition of anonymity. Piarroux confirmed he had authored the report but declined in an e-mail interview to discuss his findings. Copies were sent to U.N. and Haitian officials, the foreign ministry confirmed. U.N. spokesman Martin Nesirky told reporters in New York that there is still no conclusive evidence that its base was the source of the outbreak. He said the organization "remains very receptive to any scientific debate or investigation on this." The report's revelation comes on a day of high tensions in Haiti, as people anxiously await the results of the disputed Nov. 28 presidential election and potential resulting violence. Piarroux could not prove there was cholera inside the base or among the soldiers, a point the U.N. has repeatedly used to deny its soldiers brought the disease to Haiti or that its sanitation procedures were responsible for releasing it into the environment. He writes that military doctors said there were no instances of cholera within the unit. But he also hinted strongly at a cover-up. "It can not be ruled out that steps have been taken to remove the suspected fecal matter and to erase the traces of an epidemic of cholera among the soldiers," he wrote. The report also notes that septic tanks and pipes that would have helped to confirm sanitation problems and the presence of the bacteria were no longer at the base when he visited. Nepalese troops earlier confirmed they had replaced a leaking pipe, which contained a foul-smelling runoff that the U.N. denies was human waste, between two visits by an AP reporter in October. The AP also found the local contractor dumped waste into overflowing pools dangerously close to a hillside that drains into the river. Piarroux's is the first scientific report linking the base to the epidemic, though many other epidemiologists and public health experts have said for weeks that the soldiers are the most likely source of the infection. Other scientists and experts say it is possible that ocean currents or other climate-related events carried the bacteria to Haiti. Further studies on bacterial samples that could address those questions are ongoing. The U.S. Centers for Disease Control and Prevention confirmed in October that the strain of cholera bacteria in Haiti matched one from South Asia, a region that includes Nepal, but said it had no further information about the cause of the outbreak at the time. Many Haitians have long suspected the Nepalese base was the source of the disease, and anger at the troops sparked a week of riots in which U.N. soldiers were injured and several Haitians were killed. The report says that the first cases of the disease were from the village of Meille, where the base is located. The first confirmed case, a 20-year-old man from the village, developed symptoms on Oct. 14 and was found by Cuban doctors at a hospital in nearby Mirebalais. Haitian investigators "indicated that the first patients were obtaining drinking water from a tributary of the Artibonite River flowing just below the (U.N.) base," he said. It notes that the rotation of soldiers began arriving days before those first cases from Nepal, where there were cholera outbreaks over the summer. It goes on to describe how the disease flowed into the Aribonite River before "exploding" in the delta where the river meets the sea. Hundreds of cases were reported within days, before the outbreak spiraled out of control to infect the entire county. Until this outbreak there had not been a diagnosed case of cholera in Haiti as far back as records go in the mid-20th Century, Claire-Lise Chaignat, head of the global task force on cholera control at the World Health Organization, said in October. There were suspected cases a century before, but experts say it would have likely been a different strain than the ongoing El Tor pandemic. The disease was totally unknown to today's Haitians, who had developed no immunity against it and had no information on how to fight it until aid workers mobilized after the outbreak. Terror over its fast-killing power has triggered attacks on cholera treatment centers and a witch-hunt in rural Haiti. At least 12 people were killed on accusations they used magic to spread the disease. For the first critical month of the outbreak, the United Nations, U.S. Centers for Disease Control and Prevention, World Health Organization and others said that an investigation into how the disease arrived in Haiti was not necessary and could in fact be harmful. Those who asked questions about it were accused of playing "the blame game." It was not until AP reports of sanitation problems at the base and calls by experts including Paul Farmer, a physician and U.N. official, for a thorough investigation that the matter was seriously discussed in public. Farmer said there were compelling public health reasons to find the source of the infection, including finding information to help prevent its further spread, and that avoiding the questions was a matter of politics. The U.N. mission confirmed to AP last month that a French epidemiologist had met with met with U.N. peacekeeping mission chief Edmond Mulet in Port-au-Prince to discuss his findings. At the time the mission denied that he had implicated the peacekeepers, but acknowledged that it was now taking the allegations about its base more seriously than when rumors first arose. On Tuesday the mission said the report was still not definitive. "We have neither accepted nor dismissed his findings, as it's one report among others," U.N. mission spokesman Vincenzo Pugliese said. "The Nepalese contingent in Mirebalais is just one piece of the cholera puzzle, since there is no conclusive evidence at this point that the Nepalese camp was or was not the source of the epidemic." In roughly six weeks the disease has spread to every region of the country and sickened nearly 100,000 people. The U.N. says the death toll could be twice the official count and that up to 650,000 people in Haiti could get cholera over the next six months.___Associated Press writers Angela Doland in Paris and Edith Lederer at the United Nations contributed to this report
Monday, December 13, 2010
Cholera Claims Young Victim
Her mouth was gaped open and her eyes were also open and staring at the sides of her mother's cholera bucket. The baby's umbilical cord curved back up and ran back into the birth canal. So I started an IV into the back of the Magda's right hand as she sat on the bucket with her head down, and I opened up the infusion full bore. We then transferred Magda back to her cot. Magda's pain had diminished significantly and she seemed stable. I placed the aborted baby between her legs. After half hour had passed, we were able to deliver the small placenta. The placenta and umbilical cord were dropped through the hole in the cholera cot, I quickly baptized the baby, and let it slip through the hole in the cot. As the baby fell into the bucket with a thud, I asked myself if I realized that I just dropped a dead little human being into a filthy cholera bucket in a sweltering hot tent. I realized it but didn’t think this could hardly be happening in 2010. The unborn little baby girl had her chance for about five months, safe in Magda's womb, until cholera killed her. Magda's father showed up and watched all this from an adjacent cot. He was drunk on clarin and crying. So I continued the fluids and added 20 units of Pitocin to stop the bleeding in the uterus. Magda's blood pressure was a remarkable 136/80 and she seemed fine for all she had just been through. Nineteen year olds can withstand a lot. The nurses removed the baby from the cholera bucket and wrapped it in a plastic baggy and gave it to Magda's mother to bury somewhere. Will this baby be counted in the 2000 plus deaths that cholera has claimed in Haiti in less than two months? Probably not. But she sure looked human to me.
Nepal’s army denied Sunday that the cholera epidemic that has taken more than 2,000 lives in Haiti was introduced into the Caribbean country by Nepalese soldiers serving as U.N. peacekeepers, as claimed by a prestigious French physician in a recent study.
“The report is based on suppositions, not proof,” said army spokesman Ramindra Chettri, adding that three independent studies have demonstrated that no Nepalese peacekeeper was responsible for having carried the disease into Haiti.
The soldiers of the South Asian country who participate in U.N. missions are subjected to assorted medical tests before they are deployed, Chettri said.
“We don’t send anyone on the peace missions who has been infected by a contagious disease,” Chettri said.
He acknowledged, however, that the Nepalese soldiers were not given the test for cholera, since that test is not required by the United Nations.
“There have been no (cases of) cholera in the last year-and-a-half” among Nepal’s troops, Chettri said.
The French Foreign Ministry sent to U.N. headquarters in New York on Dec. 7 the report prepared by Dr. Renaud Piarroux that pointed to Nepalese peacekeepers as the ones responsible for introducing the disease into Haiti.
Piarroux, who is considered to be one of the world’s foremost specialists in the study of cholera, alleged that the disease spread because the sewage from the Nepalese troop encampment drained into the same river from which the residents of the town of Mirebalais draw their drinking water, and that is the town where the epidemic was first noticed a few days after the arrival of the blue-helmeted peacekeepers.
In its own investigation based on several analyses of the river water, the United Nations concluded that the watercourse could not be where the epidemic, which so far has sickened some 100,000 people, originated.
Nepal, where cholera is endemic, is one of the countries that contributes the most forces to U.N. peacekeeping missions.
For the original report go to http://www.laht.com/article.asp?ArticleId=381371&CategoryId=14092
>via: http://repeatingislands.com/2010/12/13/nepalese-army-denies-role-in-haiti-cho...
______________________________________
December 8, 2010
MINUSTAH and the Epidemic
Cholera in Haiti
By FIDEL CASTRO
About three weeks ago news and photos were published showing Haitian citizens throwing stones and protesting in indignation against the forces of MINUSTAH, accusing it of having transmitted cholera to that country by way of a Nepalese soldier.
The first impression, if one doesn’t get any additional information, is that this deals with a rumour born out of the hatred caused by any occupying army.
How could this be proven? Many of us were not aware of the characteristics of cholera and how it is transmitted. A few days later the protests ceased in Haiti and nobody said anything else about the matter.
The epidemic followed its inexorable course, and other problems, such as the risks from the electoral battle, took up our time.
Today we are getting reliable and believable news about what really happened. The Haitian people had reason aplenty to express their indignant protests.
The AFP news agency textually reported that: “The renowned French epidemiologist Renaud Piarroux led research in Haiti last month and came to the conclusion that the epidemic was generated by an imported strain and spread from the Nepalese base” of the MINUSTAH.
Another European agency, EFE, reported that: “The origin of the disease is in the small town of Mirebalais, in the centre of the country, where Nepalese soldiers had set up their camp, and it appeared a few days after their arrival, thus proving the origin of the epidemic...”
“Up to the present time, the UN Mission in Haiti (MINUSTAH) has denied that the epidemic entered along with the blue helmets.”
“…French doctor Renaud Piarroux, considered to be one of the main specialists in the world in the study of the cholera epidemic, leaves no doubts about the origin of the disease…”
“The study was ordered by Paris at the request of Haitian authorities, a French diplomatic spokesman declared.”
“…the appearance of the disease coincides with the arrival of Nepalese soldiers who, moreover, come from a country where there is a cholera epidemic.
“There is no other way to explain the sudden and powerful outbreak of cholera in a small town with a few dozen inhabitants.
“The report also analyzes the way the illness spreads, since the fecal waters in the Nepalese camp were draining into the same river from which the townspeople were getting their drinking water.”
The most surprising thing, according to the abovementioned agency, the UN did was to “…send a research mission into the Nepalese camp, and it concluded that it couldn’t be the origin of the epidemic.”
Haiti, in the midst of the destruction by the earthquake, the epidemic and poverty, cannot now dispense with an international force cooperating with a nation ruined by foreign interventions and the exploitation of the transnationals. The UN not only must fulfill the elementary duty of fighting for reconstruction and development in Haiti, but also of mobilizing the necessary resources to eradicate an epidemic which threatens to spread to the neighbouring Dominican Republic, the Caribbean, Latin America and other similar countries in Asia and Africa.
Why did the UN insist on denying that MINUSTAH brought the epidemic to the Haitian people? We are not blaming Nepal which in the past was a British colony, and whose men were used in their colonial wars and today seek employment as soldiers.
We inquired among the Cuban doctors who are today providing their services in Haiti and they confirmed to us the news transmitted by the abovementioned European news agencies with remarkable precision.
I make a brief summary of what was communicated to us by Yamila Zayas Nápoles, a specialist in comprehensive general medicine and anesthesiology, director of a medical institution with 8 basic specialties and the diagnostics of the Cuba-Venezuela Project inaugurated in October 2009 in the urban area of Mirebalais with 86,000 inhabitants in the North Department.
On Saturday October 15, 3 patients were admitted with symptoms of diarrhea and acute dehydration: on Sunday the 16th , 4 more were admitted with similar characteristics, but all from the same family, and they made the decision to isolate them and communicate what happened to the mission; on Monday the 17th, 28 patients were admitted, surprisingly, with the same symptoms.
The Medical Mission urgently sent a group of epidemiologists who took blood, vomit, stool samples and information that was sent immediately to the national Haitian laboratories.
On October 22nd the labs informed that the isolated strain corresponded to the one prevalent in Asia and Oceania, the most severe type. The UN blue-helmeted Nepalese unit is located on the banks of the Artibonite River which flows through the small town of Méyè, where the epidemic broke out, and Mirebalais, where it spread later very quickly.
Despite the sudden form in which cholera appeared in the small but excellent hospital that is at the service of Haiti, of the first 2,822 patients initially looked after in its isolation areas, only 13 people died, for a death rate of 0.5%; later on, when the Cholera Treatment Centre was created separately, of 3,459 patients, 5 of the very serious cases died, for a rate of 0.1%.
The total figure for persons ill from cholera in Haiti today, Tuesday December 7th, comes to 93,222 persons, and the death rate reached 2,120. Among those looked after by the Cuban Mission it went to 0.83%. The death rate in the other hospital institutions it is 3.2%. With experience acquired, proper measures and the reinforcement of the Henry Reeve brigade, the Cuban Medical Mission, with the support of Haitian authorities has offered the assistance to any of the 207 isolated subcommunes, so that no Haitian citizen is lacking care in confronting the epidemic, and many thousands of lives can be saved.
>via: http://www.counterpunch.org/castro12082010.html
______________________________________
Cubans lead campaign
to fight cholera in Haiti
(feature article)
BY SETH GALINSKY
The Cuban government has more centers to treat cholera in Haiti than any other government or non-governmental organization there. Now it is greatly expanding its medical mission.
An additional 300 doctors, nurses, and other medical personnel are joining the 965 members of the Cuban Medical Brigade, bringing the total Cuban contingent in Haiti to more than 1,200. Cuba is also expanding its 37 medical centers to 49 and adding 1,100 hospital beds.
Two hundred members of the contingent are graduates of Cuba’s Latin American Medical School (ELAM), which trains students from all over the world, including Africa and the United States, free of charge. Hundreds of Haitians have also been trained at the school; many of them are now collaborating with the Cuban medical mission.
As of December 2, an estimated 84,000 Haitians had been infected with cholera; nearly 1,900 have died in the six weeks since the first case was confirmed. The countryside has been much harder hit than the capital city Port-au-Prince.
The group Doctors Without Borders has 30 cholera centers, more than a third of them in Port-au-Prince, with doctors from several European countries. Cuba operates some centers jointly with Doctors Without Borders, the United Nations, and other aid groups.
Most of the Cuban-run centers operate in rural areas, often in the most isolated and difficult to reach parts of the country. The mortality rate for cholera victims treated by the Cuban brigade is less than 1 percent; for the rest of the private, Haitian government, and international-run centers it is about 3 percent.
One Cuban brigade is in L’Ester village, in the Artibonite region where the cholera outbreak began. When health workers there learned that dozens of people in the even more isolated Plateau hamlet were severely ill, they quickly sent nine people, including five doctors and two nurses, to set up a treatment center. Four of the doctors, from Uruguay, Paraguay, Nicaragua, and Haiti, are ELAM graduates.
In a letter to family and friends, published in the on-line CubaDebate, Emiliano Mariscal, describes how the mission functions and why the death rate at the Cuban-run centers is so low. He is an Argentine doctor who graduated from ELAM and is volunteering with the Cuban mission in Haiti.
According to Mariscal, the Cuban brigade has trained 15,000 Haitians on how to deal with the cholera outbreak. In addition, he explains, the Cuban doctors have been in Haiti “without interruption for more than 12 years, generating empathy and confidence among the population that does not exist with other forms of cooperation.”
Mariscal also touches on the powerful example of having a revolutionary workers government in power in Cuba. “The experience of practically 50 years of internationalist action,” he writes, has inspired young people from around the world with the “conception of solidarity” practiced by Cuba.
Cuba’s aid to the Haitian people stands in sharp contrast to the inaction of the U.S. government. A November 15 article on a U.S. State Department Web site said that the U.S. embassy was working to “enhance their surveillance system” in Haiti for reporting cholera cases. In addition Washington is “helping to support seven cholera treatment centers in Port-au-Prince,” the article said. The U.S. Centers for Disease Control will soon be conducting a survey to determine how residents of that city “obtain and store water.”
>via: http://www.themilitant.com/2010/7448/744850.html