(Adds detail, following information from IMC that IMC cholera mortality rate in para 4 refers to individual sites that experienced particularly high fatality rates, rather than the whole country)
By Alex Whiting
LONDON (AlertNet) - Thousands in Haiti are at risk of dying of cholera as cash-strapped medical aid agencies are forced to close their treatment centres and scale back deliveries of clean water, the International Medical Corps said.
Cholera has infected more than 445,000 people since the epidemic broke out in October last year, and killed over 6,000. Aid agencies have treated the vast majority of cases, but their funding for cholera is running out.
“There’s a risk that thousands of people will die if there’s not adequate coverage,” Sean Casey, International Medical Corps country director for Haiti, told AlertNet.
Although death rates have plummeted from nearly 20 percent in December, according to International Medical Corps, to just 1.4 percent now, they could rise again when agencies withdraw.
“We’re really concerned that the response so far has been a band-aid – it’s kept mortality rates low but it’s not really built a lot of capacity in the government or communities to maintain this response when these NGOs close down,” Casey said.
The waterborne disease is endemic across the country, and heavy rains in September and October have triggered fresh spikes in the number of cases, particularly in the North, Sud, and Nippes departments, and the capital Port-au-Prince, the U.N. Office for the Coordination of Humanitarian Affairs (OCHA) said.
Earlier this month, medical aid charity Medecins Sans Frontieres said the disease was returning to the capital “with a vengeance”.
And last week, International Medical Corps saw a major spike in cases in the Sud department which coincided with heavy rains. “We saw levels that we hadn’t seen since the start of the epidemic,” Casey said.
The Sud department is particularly vulnerable because of the few aid agencies working in the area, OCHA said. By the end of October, only International Medical Corps will be left, and its funds run out at the end of the year.
“There is lots of talk of handover to the government to manage the treatment sites, but the reality is that’s not always possible,” Casey said.
Cholera, which is spread through contaminated water, will continue to exist until the country builds adequate water and sanitation infrastructure – a project that will take years, experts say.
Eighty percent of Haitians have no access to latrines so they defecate outside, IMC said. Cap-Haitien city has canals overflowing with garbage, while Gonaives town floods every time it rains, so water wells become contaminated.
Most people in Haiti know what cholera is and have a sense of how to prevent it. “But until people have access to safe water and latrines, a lot of it is moot because they can’t always afford chlorine to treat their water, and they can’t always access a safe water point,” Casey said.
The state of water and sanitation facilities has deteriorated in camps housing tens of thousands of survivors from last year’s earthquake, because aid agencies have withdrawn, OCHA said.
Only 7 percent of people in camps had regular access to drinking water in August, compared to 48 percent in March. Out of a total of 12,000 latrines needed, 4,579 were working in August, down from 5,864 in July.
Donors are trying to move the massive aid operation in Haiti from emergency mode into development mode.
“People are saying we’re two years after the earthquake, we’re one year after the cholera outbreak so it’s time to hand over, but if there’s no one to hand over to it’s still an emergency scenario,” Casey said.
(Editing by Rebekah Curtis)