Haiti cholera deaths near 2,000; rapid spread feared (News Feature)

By Silvia Ayuso Nov 24, 2010, 10:22 GMT

Port-au-Prince - The official death toll from cholera in Haiti has exceeded 1,400, but UN officials say they believed the actual figure could top 2,000 and the epidemic shows no signs of abating.

The Health Ministry's latest figures, from November 20, put the total number of deaths at 1,415, an increase of 71 from the previous day. But health workers noted that the official statistics only include patients who were admitted for treatment, while an unknown number of victims received no medical care.

The data said 60,240 cases had been registered, of which 25,248 required hospitalization.

Artibonite, the north-western farming province where the epidemic began, has recorded more than 660 deaths, according to the ministry.

The official toll was 74 in the capital Port-au-Prince, where much of the population has been living in precarious conditions since the devastating January 12 earthquake, causing worries about a rapid spread of the disease.

All but two of the country's 10 provinces registered cholera deaths.

Nigel Fisher, the UN humanitarian coordinator in Haiti, said the real death toll was probably around 2,000, and he noted that the epidemic was advancing more rapidly than anticipated.

He predicted 'hundreds of thousands of cases' of infections in the coming months, because Haiti's population has no immunity to the disease that last appeared more than 100 years ago, and lacks proper sanitary conditions to prevent it.

Fisher said more cholera treatment centres are urgently needed, but that many people oppose having one near their homes for fear of contagion.

'The first thing that must be done is to calm the fears of the population,' he said, adding that he hoped more Haitians would volunteer at the centres.

Apart from identifying where treatment centres can be located, a key priority is to bury the dead.

The ministry issued a new directive on the weekend prohibiting hospital morgues from accepting bodies of cholera victims. Most are buried in mass graves, some near the sites where thousands of earthquake victims were interred.

Le Nouvelliste newspaper reported that many private morgues in the capital also refused to accept them.

'We are not going to accept the risk to ourselves and our community,' one private morgue official said. 'If you bring in a cadaver of that kind, you are not welcome.'

Epidemiologists say the disease will likely be prevalent for many years in Haiti, where sanitation and water treatment are poor.

But the situation 'is changing a little bit,' Aurelie Baumel, of Doctors Without Borders, said. 'People are starting to come in for treatment earlier now.'

At the site of the destroyed chamber of commerce building, the international medical group has installed its main treatment centre for Port-au-Prince.

They attend to patients on makeshift cots in tents. Workers are busy preparing more tents, to expand the capacity from 170 to 300 patients, and a diagnostic centre to help establish which cases need hospitalization, Baumel said.

The team has enlisted 1,000 locals to assist the 150 international health professionals, convinced that the epidemic will be around for a long time.

Under an umbrella, the family of one patient about to be sent home listens to the advice of Pierre Telin, one of the local recruits trained to explain basic prevention measures.

'We explain that they should not drink any untreated water, that they must wash their hands when they eat or drink anything, wash the clothes very thoroughly, clean the home and latrine,' he said.

'After the catastrophe of cholera infection, we have to make them aware so that they don't bring the disease home when they return.'

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