Three previous articles on the crisis can be accessed through the following links:
More will follow as events dictate.
In America, especially on TV, Haiti's epidemic gets scant, if any, coverage. In contrast, daily independent news reports are alarming. Yet, despite raging cholera across Haiti, aid is woefully inadequate. A November 19 Doctors With Borders (Medecins Sans Frontieres - MSF) press release headlined, "Cholera in Haiti: MSF Calling on All Actors to Step Up Response," saying:
"While cholera spreads, slow deployment of relief is (a) major concern. Critical shortfalls in the deployment of well-established measures to contain cholera epidemics are undermining efforts to stem the ongoing cholera outbreak in Haiti."
Head of Haiti mission, Stefano Zannini, "call(ed) on all groups and agencies present in Haiti to step up the size and speed of their efforts to ensure an effective response to the needs of people at risk of cholera infection."
"There is no time left for meetings and debate - the time for action is now." The epidemic has spread to at least eight of Haiti's 10 provinces.
Essentials needed include:
-- safe chlorinated water;
-- latrines and regular waste removal;
-- mass distribution of soap;
-- effective waste management and removal at medical facilities to prevent contamination;
-- waste disposal sites near urban areas;
-- adequate oral rehydration points in affected areas;
-- establishing enough safe, effective treatment centers; and
-- quickly locating, removing, and burying dead bodies.
Since the outbreak, MSF set up over 20 treatment centers throughout Port-au-Prince, the Artibonite region (where the outbreak originated), and in Haiti's north. So far, MSF teams have treated over 16,500 people through November 16, likely many more by now.
MSF also brought in over 240 tons of medical and logistical supplies, and has more than 1,000 Haitian staff and 150 of its own international professionals concentrating on this disease. Press officer Caroline Seguin stressed that cholera is easily preventable and treatable if done in time. "It may be new to Haiti, but the ways to prevent and treat it are long established."
However, without a major, immediate "scale up of necessary measures by international agencies and the government of Haiti, we alone cannot contain this outbreak." So far, that effort has been disturbingly lacking, despite hundreds of newly sick reported daily, adding more to the growing toll.
As of November 16, Haiti's Ministry of Public Health and Population (MSPP) acknowledged 19,646 cases and 1,186 deaths. Even by the most conservative estimates, those numbers are much higher.
Partners in Health reported more cases in the Artibonite/Central Plateau region as well as in Haiti's Central and Western departments. Metropolitan Port-au-Prince is also affected, including in Cite Soleil, Carrefor, Delmas, Kenscoff, Petion Ville, and Tabarre. Since mid-November, the North and Northwest departments experienced a significant rise in cases.
On November 20, Operational Biosurveillance said the most conservative estimate is nearly 80,000 cases, stressing:
"we have confirmation that in-patient statistics are underreported by as much as 400%. In many areas of Haiti, we are documenting outbreaks that are not being accounted for in the official statistics. We therefore estimate the upper bound of estimated case counts to be 300,000." Counting "subclinical infections....the true community load will be (close) to 800,000. We err on the side of over-estimating because this is a 'virgin soil' epidemic and expected to aggressively spread throughout the country and across the border into the Dominican Republic....We expect to see medical clinic inundations inside the DR in the near future."
Florida also reported one case in a returned traveler. America will experience more. However, "Implications for the United States are negligible," given many treatment facilities in most areas.
Street Protests Continue
Anger across Haiti is visible and visceral, given inadequate aid, hatred of the oppressive UN force, and confirmation that Haiti's cholera strain is Asian, introduced by UN Nepalese troops in the Artibonite region where the first outbreak occurred. On November 18, Claes Hammer, Sweden's Haiti ambassador, told the daily Svenska Dagbladt that tests showed:
"Unfortunately that is the case. It has proved that the cholera came from Nepal....It is 100% true. Tests were made and the source was traced to Nepal....This is obviously a strain of the disease that is prevalent in Nepal and now it seems that (it) ended up in Haiti. I have received the information from a diplomatic source. It is 100% accurate. We have taken samples and traced the infection to Nepal."
The UN humanitarian coordinator, Nigel Fisher, also told Canada's CBC that a French epidemiologist's study confirmed the cholera strain was Nepalese. He added that under appalling conditions, "The epidemic is not going to go away. It is almost impossible to stop."
America's Centers for Disease Control (CDC) tried to downplay it, saying little about its severity and only that the strain is "most similar" to South Asian ones. Nepal's Army spokesman, Ramindra Chettri, denied his country's origination, saying:
"The UN has already issued a press release saying the Nepalese forces were not responsible for the cholera outbreak after conducting a series of tests."
The last refuge of a scoundrel caught red-handed is lying, this one based in the originating Artibonite region, its waters fouled by cholera. It's now also confirmed that Nepalese troops dump sewage into the Artibonite River, increasing its contamination.
On November 19, Al Jazeera headlined, "Cholera unrest hits Haiti capital," saying:
Along with outbreaks in other parts of the country, Al Jazeera's Cath Turner said rioting escalated in Port-au-Prince. In response, police fired tear gas:
"into a camp for internally displaced people....The military wing of the National Police (struck) homeless camps across the road from the national parliament - Champ de Mars. Sources are telling us that there are scenes of parents and kids running around there trying to escape" the effects. "There are also UN troops monitoring this, and there are reports that they earlier fired tear gas at protesters. So really things are coming to a head now."
According to Radio Metropole, police and protesters clashed near the National Palace. In other parts of the city, Haitians erected barricades, burned tires, and tore down campaign posters for President Rene Preval's hand-picked successor, Jude Celestin. First round presidential and legislative elections are still scheduled for November 28 despite the epidemic, appalling conditions in earthquake struck areas, the effects of Hurricane Tomas, and 14 parties banned, including by far the most popular, President Jean-Bertrand Aristide's Fanmi Lavalas.
A Final Comment
Post-quake, minimal amounts of aid were provided, despite billions of dollars pledged or delivered. Now cholera, a raging epidemic likely to claim many thousands of lives because of Western indifference, especially by Washington that delivered nothing. UN efforts also fell far short, OCHA spokeswoman, Imogen Wall, telling Reuters that only $5 million of its $164 million request to fight cholera was received.
"The response is completely inadequate and in this situation where we are against the clock we urgently need support if we are going to save lives. (Yet), We don't have what we need to do it....Cholera is a race against time. If we can get to people, and if we have what we need, we" can save lives.
Lack of enough aid prevents it, leaving most Haitians on their own, especially those unable to access treatment. Reports now say dead bodies are on streets and in homes. It's a shocking indictment of indifferent rich nations, easily able to provide enough help but won't. Haitians are devastated for lack of it. Daily their situation worsens, the final toll too disturbing to imagine.
Stephen Lendman lives in Chicago and can be reached at email@example.com. Also visit his blog site at sjlendman.blogspot.com and listen to cutting-edge discussions with distinguished guests on the Progressive Radio News Hour on the Progressive Radio Network Thursdays at 10AM US Central time and Saturdays and Sundays at noon. All programs are archived for easy listening.