An “alarming”, “chaotic” situation, a “catastrophe”: in Haiti, humanitarian officials on the front line in the face of the cholera epidemic, which broke out three weeks ago in the country, have not words strong enough to express their concern.
A whole section of the population is currently isolated due to the control of large areas by armed gangs and the lack of fuel. However, sick patients can die of dehydration in a few hours if they are not treated.
” It’s a catastrophe. We are overwhelmed,” said AFP Dr. Jean William Pape, whose Haitian NGO Gheskio manages two cholera treatment centers (CTC), out of the fortnight set up in total in the country.
In one of them, in Port-au-Prince, the capital, “we have 80 beds, they are all occupied,” he explains. “Because of the shortage of fuel, people from the slums told me that there were several deaths in their areas, because we could not transport the sick”.
For weeks, the Varreux oil terminal has been blocked by an armed band, contributing to the paralysis of the country.
While Haiti has had no cases of cholera since 2019, some 960 suspected cases and 33 deaths had been detected in three weeks by the Ministry of Health as of October 19.
A number that could be largely underestimated, according to Bruno Maes, representative in Haiti of UNICEF.
The situation is all the more frustrating as the management of patients suffering from severe diarrhea is simple (rehydration for a few days maximum), and there is a vaccine against cholera. But it only remains effective for about five years, and the last major targeted vaccination campaign in Haiti dates back to 2017.
half children
About half of the cases detected concern children under the age of 14, many of whom are particularly fragile because of an immune system weakened by the lack of food, due to poverty.
“Many of them are very malnourished,” confirms Dr Pape. “It’s hard to find their veins to give them treatment” — fluids injected intravenously.
According to the UN, about 4.7 million people, almost half of the country’s population, are at a level of acute food insecurity.
Doctors Without Borders (MSF) manages four centers (250 beds in total), and around twenty oral rehydration points, explained to AFP Moha Zemrag, deputy head of mission.
One of the priorities is, according to him, to be able to “allow access to drinking water” in certain neighborhoods controlled by gangs, such as Brooklyn, in the commune of Cité Soleil (agglomeration of Port-au-Prince), without drinking water. for three months “.
Cholera is caused by ingesting water or food contaminated with bacteria (vibrio cholerae).
Because of insecurity and very frequent kidnappings, NGOs cannot go to these neighborhoods to disinfect housing with chlorine.
MSF has set up a system of shuttles to transport its staff to the health centers, but “in a few weeks” the lack of fuel could make these journeys impossible, explains Moha Zemrag.
Concern is also growing for the rural population, who without fuel often find themselves several days’ walk from any help. The first cases were detected in the Nippes (south) or Artibonite (north) regions.
The roads leading to the south and north of Haiti are blocked by armed groups, explains Bruno Maes: “Port-au-Prince is literally surrounded, strangled”. UNICEF offices have been looted, and medicine deliveries have been blocked at the port.
Humanitarian corridors
The return of cholera revives the nightmarish memory of the epidemic introduced by blue helmets in 2010, after an earthquake. It had killed more than 10,000 people until 2019.
But the country is not experiencing the same “explosion” in the number of cases this time around, said Sylvain Aldighieri, deputy director of public health emergencies at the Pan American Health Organization.
The authorities have “10 years’ experience of cholera”, and the important thing is to “reactivate the known mechanisms”.
Still need to be able to do it.
The UN imposed sanctions against the gangs on Friday (arms embargo…), but remains divided so far on the dispatch of an international force.
A measure which, according to Mr. Aldighieri, would allow “the creation of humanitarian corridors for complicated areas”, and that equipment “can leave the port”. For the moment, he said, the first planes with equipment are expected “in the next few days”.