Cholera in Haiti

Case Study: Cholera Outbreak in Haiti

This section focuses on the 2010 cholera outbreak in Haiti.  By comparing how both major news sources and ethnographic studies covered the cholera outbreak, we learn how these differing accounts influence how the disease is studied and understood.  This portion outlines how the cholera outbreak affected the Haitian community, while also examining this contemporary health issue as a result of wider structural problems of poverty, oppression, and corruption.

What is Cholera?

Cholera is an acute intestinal infection caused by ingesting food or water that is contaminated by the bacterium, Vibrio cholorae.  The major symptoms of cholera are diarrhea and vomiting, which can lead to extreme dehydration.  When the dehydration is not treated, a person can develop acute renal failure and severe electrolyte imbalances, and/or enter a coma.  If the individual continues to be untreated, the severe dehydration can ultimately lead to death.

Testing and Treatment

Cholera is tested through a culture of a stool specimen or a rectal swab. Less than 20% of people who have cholera develop typical cholera with signs of moderate or severe dehydration (WHO, 2012).  People who have severe cases must be treated and evaluated quickly through a rehydration therapy.  The rehydration therapy replenishes lost fluids and salts so that electrolyte levels are balanced.  Antibiotics are administered in severe cases to reduce fluid requirements and duration of illness.

Spread of Cholera

The first case of cholera was reported on October 16, 2010.  Haiti, whose infrastructure was destroyed by the devastating earthquake that struck in January 2010, had very little health or governmental resources available.  With deplorable living conditions and poor sanitation, Haiti had little strength to fight the cholera outbreak.  Housing camps were set up for internally displaced persons (IDP) who lost their homes and livelihoods in the earthquake.  These camps, which lacked adequate access to water and toilets, later became key brewing areas for cholera.

Prime Conditions for Cholera in Haiti:

  • 40.5% of camps lacked access to water
  • 30.3% lacked a toilet
  • On average, each toilet in the camp was shared by 273 people
  • 20% of IDP camps had a clinic; mean walking distance to nearest camp was 27 minutes
  • Haiti ranked lowest (147th) on the 2002 Water Poverty Index
    (Schuller 2011: 6)

The World Health Organization was a key player in trying to control the cholera outbreak.  In partnership with the Global Task Force on Cholera Control, WHO performed a country report on Haiti’s outbreak, which explains:

“The rapid spread of the disease was mainly due to the lack of immunity and the very limited access of the population to safe water and basic sanitation in a context of internal migrations after the January 2010 earthquake. A limited spread was observed in internal displaced persons camps with access to water and sanitation” (WHO 2011: 1).

The New York Times included this multimedia picture to explain how cholera spread from the rural plateau to the capital city

The New York Times included this multimedia picture to explain how cholera spread from the rural plateau to the capital city.

“Cholera most definitely played a role in individual families’ migration decisions.  People are, have been, and will continue to move around.  Cholera tipped the balance in favor of leaving the camps” (Schuller 2011: 13).

Number of Cholera Cases

Within the first week of the initial cholera outbreak, cholera ravaged thousands of individuals lives. The diagram below illustrates the rapid spread.

The New York Times visually describes the rapid spread of cholera cases by analyzing both the number of cases and the geographic locational spread of the outbreak.