The tent camps of Port-au-Prince have all the makings of disease breeding grounds; thousands of people living in temporary shelters, in very close contact, completely reliant on aid for clean water and sanitation services.
But as the disaster response from the Jan. 12 earthquake nears the seven month mark, not a single large outbreak has occurred. It’s a victory that that’s been heralded by Haiti’s president, prime minister and the many NGO actors in the country alike.
“It is truly one of the great successes of this response,” said Julie Sell, spokesperson for the American Red Cross in Haiti. “It is really quite remarkable that something hasn’t happened on a large scale.”
That’s not to say that the camps have been disease free. There are cases of malaria, dengue fever, and other illnesses endemic to the region, and an outcrop of typhoid cases required an intervention in one of the camps, said the World Health Organization Haiti office.
“We also see a lot of urinary tract infections and skin diseases because of the unsanitary conditions,” said Charles Lor, an epidemiologist with the International Medical Corps in Haiti.
What hasn’t happened is a widespread outbreak of any of the highly contagious illnesses like measles, diphtheria and water-borne conditions like diarrheal disease, which can be especially deadly to children.
Those results can be attributed to a massive effort to truck and pipe potable water to camps and provide latrines and sanitation services, a large vaccination campaign, and an early warning surveillance system for pockets of disease.
“It takes an incredible effort to prevent the disease outbreaks from happening in these kinds of conditions,” said Judith Timyan, USAID’s Haiti health program coordinator. “The situation was so bad even before the earthquake … so we were dealing with a disaster on top of a very chronic problem with sanitation.”
All of that effort has come with an equally strenuous price tag. USAID estimates it will cost a total of about $1.2 billion this year to provide necessary services to the camps.
And keeping the pontoon-sized, rubber water bladders in the tent camps filled is costing Oxfam, one of the largest providers of water and sanitation services, $160,000 dollars a month for 47 camps, and $42,000 a month just to empty latrines.
“That is a lot, it’s expensive, it’s unsustainable,” said Raphael Mutiku, Oxfam’s water and sanitation coordinator in Haiti.
The water cluster is working to connect more camps with Port-au-Prince’s existing water system and make repairs to that system, in order to continue providing clean water and prevent the spread of disease.
A prime example of the other side of Haiti’s disease control efforts can be seen at the Petionville Club tent camp, sprawling over a former golf course and tennis club.
It’s the site of one of International Medical Corps’ 13 clinics in the area, which have provided more than 118,000 patient consultations since the quake and offer free vaccination services each week.
Early on a Monday morning, there are always mothers lined up to have their children vaccinated and UNICEF estimates about 275,000 children have been immunized since the quake by all the partners working in Haiti.
“There have been campaigns to inform people of the importance. Radio, television, agents going around with loud speakers,” said Linda Rimpel, the primary health care coordinator for IMC.
The clinic also monitors cases of disease it sees, and teaches camp residents about early symptoms to watch for. Each week the clinic, and all the other health providers in Port-au-Prince, sends a disease report to the Ministry of Health, which compiles the data to determine if there is an increase in any disease that would warrant further investigation.
“It’s a joint effort with all the NGOs and probably one of the only things that is coordinated, it works really well,” said Lor.
Investigation has occurred several times, but the upticks in disease were either found to be isolated, or in the case of the typhoid increase, measures were taken to stop the disease from spreading.
Despite the successes that have been seen, USAID’s Timyan warns it is vital to start finding ways for people to return to their communities or move to new communities formed outside of Port-au-Prince.
“That initial high level of energy, adrenaline, high level of humanitarian outpouring to respond to an emergency is waning,” she said. “It’s very expensive to keep services up in these temporary camps.”
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