Haiti: responding to a cholera outbreak in a context of acute crisis

The cholera outbreak that began in Haiti at the end of 2022 continues to spread, claiming many lives. Gang violence is exacerbating the situation, causing massive population displacements and preventing the implementation of aid measures. Despite the difficult context, HI continues to carry out support and prevention actions with the help of the communities to ensure aid reaches all those who need it.

Raising awareness and distributing chlorine products

In response to the cholera outbreak in Haiti, HI teams have been active in several of the country's departments and notably in Centre, where more than 600 cases were recorded between 1 and 18 September 2023. Over a period of ten days, the teams decontaminated more than 1,400 houses, cleaning them with chlorine, and informed more than 11,000 people about how the disease is transmitted and preventive practices. HI has installed three chlorination points so that residents can treat their water and make it drinkable. Six community members, known as "chlorinators", have been trained to support these actions. HI has also installed nine hand-washing points to improve hygiene conditions.

Finally, HI has distributed a number of essential products to combat cholera. For example, residents of infected communities have received some 4,300 soaps to disinfect their hands, more than 200,000 water decontamination tablets and 4,000 sachets of oral rehydration salts, which help cure the majority of patients.

All these measures, both preventive and curative, are designed to cure those who are sick, while containing the spread of the epidemic through protective measures.

Preventing contamination to contain the outbreak

Lozame Loransta, a widow and head of household, lives in Croix-des-Bouquets, north-east of Port-au-Prince, with her six grandchildren. When an outbreak of cholera was reported in April 2023, she and her family benefited from a hygiene kit and the preventive measures deployed by HI in the commune.

For Loransta, fetching drinking water every day was a real ordeal. She could no longer walk for miles to the nearest source and had to rely on her grandchildren. But due to a lack of funds, Loransta was not always able to buy the water treatment products essential to protect her family's health.

« HI gave me hygiene kits that helped me to prevent the disease. I also learned how to treat the water and improve the way it is stored so it doesn’t get contaminated. Hand washing is now an integral part of our daily routine, although there are still difficulties with the water supply. I would like to thank all the members of the team who have supported my family during this painful period. Thanks to your support, I was able to save my beloved grandson and prevent other members of my family from becoming infected," she says.

Access to water of sufficient quality and quantity was very difficult in Croix-des-Bouquets. Of the four water points in the commune, only one spring was protected from contamination. HI carried out bucket chlorination operations using chlorine tablets to eliminate most of the viruses and bacteria present in the drinking water and prevent further contamination. 

An outbreak exacerbated by a major crisis

Cholera is a disease transmitted through infected water or food. It is mainly caused by inadequate sanitation, overcrowding and insufficient access to clean drinking water. It can cause severe diarrhoea and potentially fatal dehydration if not treated quickly. The first case in this wave of cholera was reported in Haiti in October 2022. Since then, the outbreak has wreaked havoc. According to a report by the body coordinating the fight against cholera in Haiti, between 1 January 2023 and 15 November 2023, no fewer than 72,032 suspected cases were reported, including 1,079 deaths.

To make matters worse, the humanitarian situation in the country has deteriorated considerably since the beginning of 2023. Armed gangs are causing unprecedented violence, forcing people to hide away in their homes or flee, disrupting daily life and interfering with the running of schools and hospitals. This situation has further exacerbated the cholera epidemic, as water and sanitation systems are disrupted, with gangs blocking the main roads and preventing the supply or distribution of drinking water. People are on the move and have to find temporary, overcrowded and poorly organised accommodation, which can lead to an increase in contamination. In this context, poor access to drinking water is critical and, despite the efforts of national and international players, it is difficult for aid to reach those who need it most.

In this context, between January and November 2023, HI's teams went door-to-door to raise awareness of good hygiene practices, reaching more than 150,000 people. A further 280,000 people benefited from large-scale awareness campaigns. Around 6,400 hygiene kits containing soap, decontamination tablets and rehydration salts were distributed and 120 community leaders and health workers were trained in epidemiological surveillance and community-based initial care. Finally, 24 temporary chlorination points were installed at high-risk water points in the areas where cholera has broken out, helping 13,500 people.