Haiti: Where is the UN? Where is the help?

Thousands may be dead as scale of cholera epidemic is underestimated

Thousands of Haitians infected with cholera could be suffering and dying without any help as aid agencies warn they are overwhelmed by the scale of the disaster. The official death toll of 800 is widely regarded to be a "serious underestimate", as only cases confirmed by the national laboratory are being counted. Thousands may already be dead.

Across the impoverished nation, the medical charity Médecins Sans Frontières has set up makeshift hospitals on the streets and in car parks, as its doctors and nurses try and cope with the daily influx of sick patients. The number of new patients doubled everyday this week in MSF clinics as hospital cases topped 12,000. But little is known about the fate of three-quarters of the population who live in rural areas, with little if any access to medical care or clean water.

Aid agencies last night took the unusual step of severely criticising both the government and the UN for failing to deal with an epidemic that has been threatening for more than a month. This comes amid clear evidence that the disease is spreading fast across the country and prevention efforts have thus far been woefully inadequate.

ActionAid yesterday confirmed the first cases in Lascahobas, a city in the central plateau which is located just an hour from the border with the Dominican Republic. On Friday there were reports of around 30 people "dropping dead" in the streets of Gonaïves, a city in the north of the country where the epidemic seems to be taking hold. The mayor is said to have joined residents in burying the dead, according to Jane Moyo of ActionAid. In rural areas surrounding the city, there were unconfirmed reports of whole families dying without any help, as local people shun the sick amid growing fear of the disease. The threat of contagion from improperly disposed of bodies is also causing increasing alarm, according to Jim Emerson, from the agency Plan International.

Cholera is caused by a highly contagious water-borne bacterium. Its spread is easily preventable but less than half of Haiti's population have access to clean water. In Cap-Haïtien, the country's second largest city, supplies were running dangerously low even in the medical centres where doctors struggled to cope with hundreds of people suffering from dehydration, vomiting and diarrhoea.

Stephane Reynier, MSF's director of operations, last night said: "The situation is very alarming. MSF structures are overrun by the number of patients, not just in Port-au-Prince, but nationally. We are fast and on the frontline but we cannot control a national epidemic alone. Where is the UN? Where are the NGOs? Where are the billions of dollars that were promised after the earthquake? There have been enough meetings, now we need action. "

The cause of the outbreak in Haiti is unknown but the bacteria strain causing deaths originates from south Asia, according to the US Centers for Disease Control. The bacteria can travel the globe in either contaminated food or water or through the movement of an infected person. It causes little trouble where water sanitation and hygiene controls are well established, but January's earthquake and last week's tropical storm Thomas have left the island extremely vulnerable. Less than 40 per cent of the aid pledged by all countries for 2010/11 has been delivered so far.

The arrival of cholera in the capital last week was no surprise, and authorities most fear the epidemic taking hold in the refugee camps of Port-au-Prince. More than one million people left homeless by the earthquake are still living in overcrowded camps, where there is no running water or sewage system and people share portable toilets. Aid agencies such as Oxfam are shipping in huge tankers of water but there is not enough to go round. Water waste, rubbish and sewage all run into ditches that run along the sides of roads.

Ms Moyo from ActionAid said: "Wherever you look there is dirty water. You see young men, entrepreneurs, selling sealed bottles of water and hand-sanitising products on street corners but most people are too poor to buy these products to protect themselves, especially those in the camps where there are few work opportunities.

"Cholera is highly contagious but it is preventable. Everyone knows what is needed: nationwide action to prevent the spread, but this is not happening. Even though the agencies are doing their best, the government is fractured, the infrastructure is limited and, with an election coming up, there are other priorities. People are very afraid and the government must step in and take affirmative action. There is still a window of opportunity to stop the spread but that window is getting smaller by the day."

Around 80 per cent of Haitians live in rural areas, most in abject poverty, and there are real concerns that hundreds of thousands of vulnerable people are cut off from medical help. The country had not seen cholera cases for decades before last month, which means its people are very susceptible to the bacteria, warned Gregory Hartl from the World Health Organisation. The current fatality rate of 6.5 per cent is much higher than normal, and now that cholera is in Haiti, the disease is likely to remain for years, Mr Hartl said.

On Friday the United Nations appealed for £102m from donors to fight the outbreak in an attempt to inject some much-needed momentum. The money would be used to bring in extra doctors, medicines and water purification equipment to treat the hundreds of thousands of people who could be affected by the disease, said Elisabeth Byrs from the UN.

But agencies on the ground say better co-ordination and expert medical advice is needed more urgently than cash. Mr Emerson from Plan International said: "This is a major medical emergency and we need much more technical advice. We have resources but we are not medical experts, so we need urgent advice on who and what to support. The UN must step in now. There is a very strong feeling among all the NGOs that the number of cases has been very seriously under-reported, especially in rural areas where there are few public health services, and we don't know how to handle that alone."

Personal view: Cholera - Terrifying, but easy to prevent and cure

I have been shouting at the radio at reports of cholera spreading through Haiti. There is no doubt that cholera is an ugly, stinking disease involving watery diarrhoea, vomiting and intense dehydration. The speed with which people decline and die gives cholera its terrifying reputation. Yet amid the fear-mongering I have not yet heard a sensible report on how easy it is to prevent and cure.

Fifteen years ago I was in Zambia making a film about cholera for the World Health Organisation and ITN. If I learnt one thing it was that cholera can be controlled. What is needed is clean water, decent sewage systems and, in the absence of these, education. Simple steps like hand-washing with soap before eating, or boiling water before drinking, will radically cut the chances of contracting cholera. Even when contracted, it is easy to cure with intense rehydration – clean water mixed with sugar and salt does the trick.

Cholera need not be rampant if agencies co-ordinate their strategies and resources to educate people and make clean water an absolute priority.

Charlotte Metcalf is a documentary film-maker

News
i100
News
people Emma Watson addresses celebrity nude photo leak
News
Katie Hopkins appearing on 'This Morning' after she purposefully put on 4 stone.
peopleKatie Hopkins breaks down in tears over weight gain challenge
News
peopleHis band Survivor was due to resume touring this month
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebooksAn unforgettable anthology of contemporary reportage
Arts and Entertainment
Robert De Niro, Martin Scorsese and DiCaprio, at an awards show in 2010
filmsAll just to promote a new casino
News
i100
News
people'It can last and it's terrifying'
News
In this photo illustration a school student eats a hamburger as part of his lunch which was brought from a fast food shop near his school, on October 5, 2005 in London, England. The British government has announced plans to remove junk food from school lunches. From September 2006, food that is high in fat, sugar or salt will be banned from meals and removed from vending machines in schools across England. The move comes in response to a campaign by celebrity TV chef Jamie Oliver to improve school meals.
science
Arts and Entertainment
tv
Life and Style
fashionModel of the moment shoots for first time with catwalk veteran
News
i100
Sport
Tom Cleverley
footballLoan move comes 17 hours after close of transfer window
Sport
Alexis Sanchez, Radamel Falcao, Diego Costa and Mario Balotelli
footballRadamel Falcao and Diego Costa head record £835m influx
Life and Style
fashionAngelina Jolie's wedding dressed revealed
News
Boris Johnson may be manoeuvring to succeed David Cameron
i100
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Creche Assistant or Nursery Nurse

£8 per hour: Randstad Education Leeds: The Job Creche Assistant to start asap ...

Nursery Nurse Level 3

£8 per hour: Randstad Education Leeds: The Job Nursery Nurse Leeds We are now ...

Web Developer/UI Developer (HTML5, CSS3,Jquery) London

£55000 - £65000 per annum: Harrington Starr: A Global Financial Service Organi...

Data Scientist (SQL, PHP, RSPSS, CPLEX, SARS, AI) - London

£60000 - £70000 per annum: Harrington Starr: A prestigious leading professiona...

Day In a Page

'I’ll tell you what I would not serve - lamb and potatoes': US ambassador hits out at stodgy British food served at diplomatic dinners

'I’ll tell you what I would not serve - lamb and potatoes'

US ambassador hits out at stodgy British food
Radio Times female powerlist: A 'revolution' in TV gender roles

A 'revolution' in TV gender roles

Inside the Radio Times female powerlist
Endgame: James Frey's literary treasure hunt

James Frey's literary treasure hunt

Riddling trilogy could net you $3m
Fitbit: Because the tingle feels so good

Fitbit: Because the tingle feels so good

What David Sedaris learnt about the world from his fitness tracker
Saudis risk new Muslim division with proposal to move Mohamed’s tomb

Saudis risk new Muslim division with proposal to move Mohamed’s tomb

Second-holiest site in Islam attracts millions of pilgrims each year
Alexander Fury: The designer names to look for at fashion week this season

The big names to look for this fashion week

This week, designers begin to show their spring 2015 collections in New York
Will Self: 'I like Orwell's writing as much as the next talented mediocrity'

'I like Orwell's writing as much as the next talented mediocrity'

Will Self takes aim at Orwell's rules for writing plain English
Meet Afghanistan's middle-class paint-ballers

Meet Afghanistan's middle-class paint-ballers

Toy guns proving a popular diversion in a country flooded with the real thing
Al Pacino wows Venice

Al Pacino wows Venice

Ham among the brilliance as actor premieres two films at festival
Neil Lawson Baker interview: ‘I’ve gained so much from art. It’s only right to give something back’.

Neil Lawson Baker interview

‘I’ve gained so much from art. It’s only right to give something back’.
The other Mugabe who is lining up for the Zimbabwean presidency

The other Mugabe who is lining up for the Zimbabwean presidency

Wife of President Robert Mugabe appears to have her sights set on succeeding her husband
The model of a gadget launch: Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed

The model for a gadget launch

Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed
Alice Roberts: She's done pretty well, for a boffin without a beard

She's done pretty well, for a boffin without a beard

Alice Roberts talks about her new book on evolution - and why her early TV work drew flak from (mostly male) colleagues
Get well soon, Joan Rivers - an inspiration, whether she likes it or not

Get well soon, Joan Rivers

She is awful. But she's also wonderful, not in spite of but because of the fact she's forever saying appalling things, argues Ellen E Jones
Doctor Who Into the Dalek review: A classic sci-fi adventure with all the spectacle of a blockbuster

A fresh take on an old foe

Doctor Who Into the Dalek more than compensated for last week's nonsensical offering