CAP-HAITIEN, Haiti – Sometimes it seems as if there will be no end to the suffering here. I am in Cap-Haitien, sister city to Portland and one of the communities hit especially hard by the raging cholera epidemic.

Cholera is a disease that most of us have only the vaguest awareness of — something from the past that posed no threat to our daily lives. But for the 800 million people around the world living in abject poverty without access to clean water, or the 1.8 billion people who don’t have even the most basic sanitation, waterborne diseases like cholera are quietly occurring all of the time and largely out of view of the rest of the world.

Diarrheal illnesses due to unclean water have long been the major killers of children under the age of 5 here. Haiti has long ranked at the very bottom on a worldwide Water Poverty Index, which measures the availability of potable water in a country. Coupled with the fact that the vast majority of Haitians have no access to even basic sanitation, it is easy to understand how cholera has spread quickly throughout the country.

We expect clean water to come out of our faucets on demand. If a person with cholera were to come to the United States — and there have been a few — there is no real risk of it spreading because the very basic public health infrastructure is in place.

In Haiti, however, the disease has now infected more than 92,000 people and killed more than 2,000 in less than two months. A few days ago, the U.N. secretary-general predicted that the number of cases could rise to 650,000 in the next year.

The depth of the tragedy is amplified by the fact that this is an easily treatable and easily preventable disease. Simply put, it doesn’t happen in places where people have ready access to clean water, and access to clean water has to be viewed as the most basic of human rights.


For many of us in the Portland community, this is a very personal tragedy because we have developed such strong relationships with people in Cap-Haitien over the past nine years. When the epidemic started in October, Konbit Sante immediately began working with the Ministry of Health and with other nongovernmental organizations to treat the ill and to slow the spread of the disease among the vulnerable population in the hardest-hit communities.

Our Haitian and Maine-based staff helped the public hospital establish a cholera treatment center in the center of the city. At the time, we naively anticipated that we could have as many as 15 patients a day. Doctors Without Borders has now expanded the center to 600 beds.

When that was not sufficient to meet the need, we worked collaboratively with both Doctors Without Borders and Haiti Hospital Appeal — an organization that we worked with to provide care to people with spinal cord injuries after the earthquake — to set up an additional 200-bed treatment center on the outskirts of Cap-Haitien.

Now that treatment centers are well-established, Konbit Sante’s primary focus has turned to prevention, education and early intervention.

To help people protect themselves, we are taking the lead in coordinating a community-wide campaign, mobilizing many people and using all available media to help get the word out. Working with Oxfam GB, Haiti Hospital Appeal, UNICEF and others, we are setting up early rehydration and cholera prevention stations where water disinfection tablets, chlorine, water buckets, hand soap and oral rehydration solution are distributed.

So far, 55 new health workers have been trained to work in the most affected neighborhoods, and an additional 40 workers will be added in adjacent areas soon if the security situation allows. We are working hard to expand the coverage area even further, with the goal of covering the entire urban area of 325,000 people with up to 100 posts.

People in the community have been hungry to learn how to protect themselves from the dangers of contaminated water and are grateful to have and use the materials they are receiving. If people are empowered and equipped to protect themselves, these changes could end up saving more lives in the long run than the cholera epidemic claims in the short run.

We are committed to continue to work with our friends and partners in Maine and in Haiti to see that happen. Respect for the basic human rights of people here demands no less.


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