When Dr. Edwidge Michel joined the Ministry of Public Health and Population in 2012, hundreds of people with symptoms of cholera were arriving in the various treatment centers around the country. Today, while he is not yet proclaiming victory, Dr. Michel is delighted that efforts to contain the disease have thus far been successful. .
Cholera broke out in Haiti in October 2010, following the tremendous earthquake that struck the country on January 12 of that year, killing 250,000, injuring 300,000, and leaving 1.3 million people homeless. In 2011, Haiti recorded the greatest peak of the cholera outbreak, with around 352,000 people exhibiting symptoms. According to data from the Ministry of Public Health and Population, between October 2010 to December 2018, 819,000 people showed signs of the disease and 9,700 died, making Haiti one of the countries most severely impacted by cholera.
Mobile support for treatment and prevention
The Ministry of Public Health and Population (MSPP), with technical and financial support from partners including the World Bank, developed several initiatives to contain the cholera outbreak. In 2011, the US$15 million Projet de Réponse d'Urgence au Choléra was initiated, aimed at improving health and hygiene practices to reduce the spread of cholera and strengthen the institutions that respond to epidemics. With the support of the subsequent Improving Maternal and Child Health through Integrated Social Services Project (PASMISSI), launched in 2013, and partners such as UNICEF, the MSPP was able to set up Mobile Rapid Response Teams (Emira) in Haiti’s ten geographical departments to attempt to contain and eliminate the disease. This was one of the key elements of the government’s National Plan for the Elimination of Cholera.
Beginning in March 2014, each time a new suspected case was identified, a mobile team supported by the World Bank or other health partners visited the patient’s household and their neighbors to contain any potential outbreak within 48 hours. These mobile teams provided a targeted response and prevented further community spread. They organized community outreach on hygiene promotion and cholera control methods, including distribution of soap and oral rehydration salts, while also working with authorities to improve the water quality. Finally, they sprayed the homes and latrines of cholera patients with chlorine to sanitize them and stop the spread.
"These interventions are all the more important in the most vulnerable communities because the access to water and sanitation conditions are the most precarious there, which further exposes the population," explains Dr. Michel. “The strategy of having mobile teams increased the proximity between the population and the health authorities. We better understood the living conditions of the affected populations. On site, we helped people identify potential sources of contamination, sensitized them to risk factors, and filled in staffing gaps in institutions or in treatment points.”