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This Version of the Haiti MPHISE Has Been Archived.

The New Version of the Haiti MPHISE can be accessed through the link below.

Areas reporting confirmed and/or suspected Cholera in Haiti

View Overall Haiti Cholera Epidemic Map in a larger map

A Solvable Problem in Pestel


Mountains of Pestel (Photo by John Carroll MD)

by John Carroll MD - - January 16, 2012

When wandering around the mountains of Haiti and you are a blan (foreigner) it is easy to get disoriented and confused.

But we need to try and keep things as simple as possible to make sense of the Haitian mountains and the cholera that hides inside.

Right now there is a significant amount of cholera in the mountains of the Commune of Pestel. Pestel is located on the northern coast of the southern peninsula of Haiti.

During the last ten days we have documented cholera morbidity and mortality by talking to Haitian health care workers in the mountains of Pestel and have reviewed their written records. We have documented cholera cases in many different sections of Pestel. And these results have been published.

And we are caring for very sick patients now with cholera from four sections of Pestel. These patients are very sick. They need IV fluids and will die without it. And there are new patients each day in little CTU’s that have been recently set up in Desvereaux, Tozia, Pela, and Pavion.

Michael D. McDonald's picture

Cholera: "You Can Treat It Easily, But You Can Die Easily Too"


Cholera Treatment Center - Pestel, Haiti - January 16, 2012 (Photo by John Carroll MD)

by John Carroll MD - - January 16, 2012

“You can treat it easily, but you can die easily.”

This quote is from a nurse here at the CTC in the village of Pestel.

The CTC nurse reviewed the CTC books and I reviewed the dossiers here at the CTC in the Pestel Hospital yesterday.

There were 39 cases of cholera in December, 2011 with one death recorded. Most of the cases of cholera in December came from Desvereaux about 90 minutes by car south of here in the mountains.

The river in Desvereaux is Riviere La Clotte. People bathe, wash clothes and drink from this river. Cadavers wash into La Clotte and sheets that have been wrapped around cadavers who have died from cholera are washed in La Clotte.

Cholera in Pestel – January 14, 2012


Cholera Victim - Pestel, January 2012 - Photo by John Carroll MD

by John Carroll MD - - January 14, 2012

This is my narrative of the last four days in rural Haiti.

I am going to try and not beat dead horses.

I am going to try and not be too cynical or too sarcastic or too snarky. And I will not point fingers at the UN, at the Haitian government, at international governments, at the gran mange in PAP, at the billions of NGO’s in Haiti, at the “where did all the pledged money go questions”, at church leaders or the voodoo priests, at the adacemicians, the “do gooder” blan doctors, or at Catholic nuns or the little church lady Protestant missionaries who spend 30 years of their lives here doing as much good as they possibly can do.

There is no time to criticize anyone right now.

Cholera is infecting and killing many Haitians as I post this from Pestel, Haiti this afternoon– January 14, 2012.

I feel very rushed to post this. My access to internet is almost absent. Electricity is never a guarantee.

Michael D. McDonald's picture

Emerging Perspective on the Pestel Outbreak: Increased Cases Over Longer Period of Time

"Total: 445 cases since October, 59 deaths"

Given the very high case fatality rate, there are probably still more cases than are yet recorded.


An alternate view is emerging on the Pestel Outbreak.  We do not know enough yet regarding the methodology used and why we are just now hearing about earlier cases and changing evidence of current cases.  However, during this stage of an epidemiologic investigation, there is often confusion regarding new cases versus old cases that are just being recorded for the first time in an area requiring health system strengthening.  It appears that a new chronology is now being suggested by the cholera cases being presented for the first time with greater resolution regarding space and time of onset of illness.


That said, it still appears that there is a new upsurge in the Pestel Commune Outbreak in the January timeframe following heavy rains.

Important questions to ask:


What constitutes a case?

CNN - AC360 - Video: Haiti Two Years After the Earthquake

submitted by Shelly Chvotzkin

January 12, 2012 - Anderson Cooper returns to places devastated by the earthquake. He reports on the progress and challenges in Haiti.

Can a Vaccine Cure Haiti's Cholera?

submitted by Mike Kraft

Cholera is now well established in Haiti.

Wikimedia Commons/Tom Kirn/Ron Taylor/Louisa Howard/Dartmouth Electron Microscope Facility

by Katherine Harmon - - January 13, 2012

This article was originally published by Scientific American on 12 January 2012.

Two years after the earthquake and thousands of deaths later, the debate about whether to use the cholera vaccine in Haiti continues.

The cholera epidemic in Haiti has cast a stark light on deep development holes and disagreements about whether a short-term patch—in the form of a cholera vaccine—can help in the long-term fight for better health.

A developing nation, Haiti has long struggled to maintain modern public-health projects. Even before the January 12, 2010 earthquake the country was already falling behind. In 1990 more than a quarter of the population had access to sanitary facilities, but by 2008 only 17 percent of Haitians did.

Elimination of Cholera Transmission in Haiti and the Dominican Republic - January 11, 2012

Via The LancetElimination of cholera transmission in Haiti and the Dominican Republic. Excerpt:

The Second Anniversary


The second anniversary of Haiti's earthquake is tomorrow January 12, 2012.


Two years ago tomorrow, just before 5 PM, one-hundred and forty thousand Haitians perished in less than one minute. However, the earthquake did not kill them. Bad building construction did. 


And for the last 16 months Haiti has been hammered with the largest cholera epidemic in the world. There are 7,000 documented Haitian deaths from this preventable and treatable disease.


I am four hours south of Pestel, Haiti tonight. I plan on making it there tomorrow morning.


Pestel is located on the northern coast of Haiti's southern peninsula. Pestel includes multiple communes and has about 50,000 people over 120 square miles. 


A recent outbreak of cholera is killing people in this area. A few hours ago I heard from a good source on the ground in Pestel that there are 55 recent cholera deaths in that area...and there could be even more because the entire area has not been canvassed yet. 


If there is an internet signal in Pestel, I will post what I find.


John A. Carroll, MD

Haiti: UN Urges Investing in Water and Sanitation Services to Combat Cholera

UN News Centre


Women carry jerry cans of chlorinated water which is being used to contain cholera in eastern DRC

11 January 2012 – Dramatic improvements in water and sanitation services are needed to eliminate cholera in Haiti and the Dominican Republic, health experts who took part in a United Nations-organized briefing to outline concrete steps to stem the spread of the disease in the region said today.

The event, organized by the UN World Health Organization’s (WHO) regional arm, the Pan-American Health Organization (PAHO), urged governments and international organizations to boost investment in the infrastructure and institutional capacity required to provide water and sanitation in areas affected by the disease.

Cholera is an acute intestinal infection caused by eating food or drinking water contaminated with the bacterium known as vibrio cholerae. The disease has a short incubation period and produces a toxin that causes continuous watery diarrhoea, a condition that can quickly lead to severe dehydration and death if treatment is not administered promptly. Vomiting also occurs in most patients.

One Team Against Cholera - Call to Action: A Cholera-Free Hispaniola

PAHO-WHO - January 11, 2012


Photos - PAHO-WHO - A Cholera-Free Hispaniola La Hispaniola libre de cólera

Moving from cholera control to cholera elimination through essential investments in water, sanitation, and hygiene infrastructure

In a press briefing, the governments of Haiti and the Dominican Republic, together with the Pan American Health Organization/World Health Organization (PAHO/WHO), the U.S. Centers for Disease Control and Prevention (CDC), UNICEF, and other key partners, launched a Call to Action for a Cholera-Free Hispaniola (Haiti and the Dominican Republic).

Video messages from the presidents of Dominican Republic and Haiti

CDC / MSF - Cholera Kit - Medical Supplies Guidelines (English and French)


CDC / MSF - Cholera Kit - Medical Supplies Guidelines - English - (8 page .PDF file)

CDC / MSF - Cholera Kit - Medical Supplies Guidelines - French - (8 page .PDF file)

Michael D. McDonald's picture

Potential First Case in Haiti's Cholera Epidemic Identified?


Boston aid group thinks it has tracked down first case in Haiti’s deadly cholera epidemic


PORT-AU-PRINCE, Haiti — A mentally ill man who bathed in and drank from a contaminated river most likely was the first person to be infected in the Caribbean country’s deadly cholera outbreak, a Boston humanitarian group said Monday.

Partners in Health, which works in Haiti, reported the case Monday in a study it did on the outbreak and published in the American Journal of Tropical Medicine and Hygiene.

For More Information, see:

Pocket Guide - Development and Operation of a Cholera Treatment Center (CTC) - (English, French, & Spanish)

 submitted by Shelly Chvotzkin


Pocket Guide - Development and Operation of a Cholera Treatment Center (CTC) - English - (2 page .PDF file)

Pocket Guide - Development and Operation of a Cholera Treatment Center (CTC) - French - (2 page .PDF file)

Pocket Guide - Development and Operation of a Cholera Treatment Center (CTC) - Spanish - (2 page .PDF file)

Video - Cholera Still Rife in Haiti

submitted by Stuart Leiderman

BBC News - January 8, 2012

It is nearly two years ago that a devastating earthquake killed thousands of people in Haiti.

Yet a cholera epidemic in and around the capital, Port-au-Prince, is still infecting 200 people a day, and there is little sign of life improving for ordinary people.

Russell Trott reports.

Post-Earthquake Assistance in Haiti Shifts to Reconstruction – UN


UNDP Associate Administrator Rebecca Grynspan (foreground) visits a cash-for-work project in Port-au-Prince, Haiti

UN News Centre

6 January 2012 – The allocation of resources for Haiti’s recovery from the devastating earthquake two years ago has shifted to reconstruction, infrastructure restoration, debris removal, job creation and capacity building, senior United Nations officials said today, noting, however, that considerable humanitarian needs remain.

“We… had a year of transition from the humanitarian phase to the recovery and reconstruction phases,” Rebeca Grynspan, the Associate Administrator of the UN Development Programme (UNDP), told reporters in a teleconference organized by UN Foundation to give an update on the situation in Haiti since the 12 January 2010 earthquake.

“It has been a major challenge since that we know that Haiti still needs a combination of humanitarian support… but slowly the emphasis and allocation of resources is shifting towards recovery and reconstruction,” she said.

WHO - CDC - Global Task Force on Cholera Control - First Steps For Managing an Outbreak of Acute Diarrhoea

World Health Organization (WHO) - Centers for Disease Control (CDC)


WHO - This leaflet aims at guiding health workers though the very first days of an outbreak. It addresses the following questions:

  • Is this the beginning of an outbreak?
  • Is the patient suffering from cholera or shigella?

The leaflet also has sections on how to protect the community, how to treat patients and what to do if an outbreak is suspected. - (2 page .PDF file)

CDC - Haiti - Cholera - Clinical Management (Haitian Creole version) - (4 page .PDF file)

€3 Million More Allocated by the European Commission to Haiti

European Commission Press Release - December 23, 2011

Reference:  IP/11/1601

"So long as Haitians need us, we'll be there": The European Commission allocates further funds for Haiti

Brussels, 23 December – As the two-year anniversary of the devastating earthquake that hit Haiti in January 2010 approaches, the European Commission has allocated a further €3 million to the 2011 humanitarian aid budget for the country, bringing the total of humanitarian funding by the European Commission in 2011 to €38.5 million.

Despite significant progress over the last 2 years there remain many challenges to reducing the vulnerability of the population. Hundreds of thousands are still homeless because of the earthquake and the population as a whole is at risk of cholera.

Mexico Offers Cooperation in Fight against Cholera - December 24, 2011

PORT-AU-PRINCE, Haiti ( - The Mexican government said in the context of strengthening bilateral relations with Haiti, it has sent a large cache of cholera treating items to the Haitian government and hopes to build clinics, send health caravans and offer vocational training in the future.

One hundred (100) barrels of calcium hypochlorite and five hundred thousand (500,000) latex gloves were handed to the Ministry of Public Health and Population (MSPP) by the Mexican ambassador accredited to Port-au-Prince, Luis Manuel Lopez Moreno and the ambassador for cooperation, Daniel A. Cámara Ávalos.

The gift was received by the Haitian Minister of Public Health and the Population, Florence D. Guilliame, on Friday, December 23.


Platform of Haitian Human Rights Organizations (POHDH) - Position of the Oral Vaccine Against Cholera - December 29, 2011

Searching the Sea for Scum-Busting Cholera Killers

by Meghan D. Rosen - - December 26, 2011


Microscopy images of intact cholera biofilms (left) and those treated with chemical compounds that disrupt clump formation (right). (UCSC Chemical Screening Center)

SANTA CRUZ, Calif. — Bacteria-scanning robots have helped researchers discover scum-busting chemicals that could potentially cut rates of cholera infection.

The robots are part of an award-winning system developed at the University of California, Santa Cruz that fuses fast-paced automatic screening techniques and neon bacteria with undersea hunts for new disease-fighting bugs.

“The cool thing is we can find entirely new bacteria with novel compounds that no one has ever seen before,” said microbiology graduate student Nicholas Shikuma.


Press Conference - PAHO-WHO - One Team Against Cholera


Press Conference, January 11 2012, One Team against Cholera - Call to Action for Accelerating the Elimination of Cholera in Haiti and the Dominican Republic (Island of Hispaniola)

What: Press Conference
Call to Action for Accelerating the Elimination of Cholera in Haiti and the Dominican Republic (Island of Hispaniola)

Who: Governments of Haiti and the Dominican Republic, Pan American Health Organization/World Health Organization (PAHO/WHO), Centers for Disease Control and Prevention (CDC), UNICEF/TACRO Regional Office for Latin America, and other key partners

Where: PAHO//WHO, 525 23rd Street, NW, Washington, DC; Port-au-Prince, Haiti; and Santo Domingo, Dominican Republic

When: Wednesday, 11 January 2012, 9:00 a.m. (EST)
(Light breakfast 8:15 a.m.)

Health Diplomacy Monitor

submitted by Albert Gomez

The Health Diplomacy Monitor aims to report and inform readers about international negotiations currently underway which have a significant impact on global health. The objective is to “level the playing field” by increasing transparency and making information about the issues and proposals being discussed more readily available.

Distributed electronically five times a year and free of charge, the Monitor seeks to facilitate the active participation and constructive engagement of a wider diversity of countries and actors in health-related negotiations. The Monitor is published by the Centre for Trade Policy and Law and receives financial support from the Rockefeller Foundation.


HEALTH for HAITI - Health Professional Education and Training in Haiti - Assessment and Proposal for Action

OVERVIEW - updated October 2011

INTERVIEW - Haitian Democracy Depends on Scrutiny of Aid - Watchdog

by Anastasia Moloney - Reuters / AlertNet - December 20, 2011


A Haitian woman walks on a highway carrying a bag on her head on the outskirts of Port-au-Prince January 13, 2011. REUTERS/Jorge Silva

BOGOTA (AlertNet) - When the earthquake hit Haiti almost two years ago journalist Jane Regan, who was living in Washington at the time, knew she had to return to the Caribbean nation and watch where the aid was going.

Training local journalists to ask tough questions about how the billions of dollars of aid money is spent is a perquisite to building a strong democracy in Haiti, she told AlertNet, a year after co-founding a watchdog that reports on the country’s reconstruction.

“Haiti is trying to build a democracy, and without good journalists and a strong media sector you can't have informed citizen participation or accountability,” said Regan, a U.S. citizen who has lived on and off in Haiti for the last 20 years.


Caricom Helps Fight Haiti Cholera Outbreak

Haiti had requested Caricom assistance to bolster its national strategy to fight the epidemic that struck last year.

PORT-AU-PRINCE, Haiti, Friday December 16, 2011 - Some 15,000 Haitians are down to benefit from a Caricom spearheaded project geared to help combat the cholera outbreak that has killed more than 6,600 Haitians and sickened in excess of 475,000.

The Water, Sanitation and Hygiene (WASH) initiative seeks to improve sanitation infrastructure and sensitize residents of a community in Cite Soleil of safe personal and community hygiene.

It would improve access to 25 toilet blocks and hand-washing stations for approximately 3000 families in the neighbourhood of Brooklyn, a section of Cite Soleil in the Port-au-Prince metropolitan area, the Caricom Secretariat said.


Children’s Champion

by Annie Maccoby Berglof - Financial Times - December 16, 2011


Father Rick Frechette with patients at St Damien’s

The American priest has spent 25 years building orphanages, hospitals and schools in Haiti’s slums

Father Rick Frechette, an American priest with 25 years’ experience in Haiti, has just built 30 houses. They have sparkling Caribbean views, open porches and come in pink, lime-green and blue. Each house costs just $7,000, and they may soon have solar power. But these are not holiday villas, they are houses for the very poor – replacement shelters for the shaky shacks and trash-strewn rubble in Cité Soleil, the notorious slum at the edges of Port-au-Prince.


Video - TEDxTalks - David Damberger: What Happens When an NGO Admits Failure

See video

submitted by Florence Gibert

People from Engineers Without Borders found that the same mistake was happening again and again: the maintenance and repair costs are never provided for, leading water pumps and other devices to have a length of life of only over a year.

They thought they could at least value this experience and therefore they created a website : Admitting Failure

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