The Global Pulse Journal Blog

With heavy flooding covering much of the country and leaving millions of people homeless in Pakistan, concerns over the potential for a major outbreak of cholera are growing. With continuing rains throughout the region, Dr. Michael Merson, the founding director of the Duke Global Health Institute believes that ”Basically there is no question” there’s a major risk of an outbreak. With a lack of adequate aid to the area to ensure a consistent, clean water supply, the risk of this diarrheal illness is immense. While the flood has already killed over 1,500 people thus far, even more are at risk from a potential cholera outbreak with 3.5 million people in Pakistan lacking access to clean water. In the past year, cholera epidemics in Zimbabwe killed over 4,000 people with over 350 killed by the disease in Nigeria over the last three months, demonstrating the deadliness of this disease. Without adequate rehydration therapy, victims can die within a day or two from overwhelming dehydration secondary to extreme diarrhea with up to a liter of stool output every hour. But with adequate rehydration therapy to replace fluids and restore electrolytes, death rates can be lowered to less than one percent.

A recent article in the Christian Science Monitor by the SEVEN Fund’s Michael Fairbanks explores a potential approach to addressing Haiti’s need for long-term economic support. While several different groups have contributed to relief efforts after the devastating January 12th earthquake, many are looking to develop a more long-term solution. A challenge to building private-sector support is the atmosphere in a country where the elite and wealthy have often supported business initiatives which favor big business and are not developed to lend support to those most in need.

In order to create prosperity for the average Haitian citizen, innovative solutions are needed to develop “attractive export market segments to serve with unique products, building new distribution systems, lowering energy costs, and providing skills to Haitian citizens who will be compensated for the high value they create” according to Pierre Marie Boisson, a Harvard-educated, Haitian international banker.

Four months after the earthquake in Haiti, it is being argued that the poor are receiving better healthcare than before the quake due to the influx of medical volunteers and donated medicines, working under the supervision of the Ministry of Public health and Population.  In an effort to address the question of what will happen after the foreign medical aid leaves, the Post- Disaster Needs Assessment estimates that the earthquake resulted in US $169 million in damages to health infrastructure alone and in addition to that, their three-year plan to improve the country’s health profile beyond pre-January 12th levels will cost US $546 million. Currently, “Outside medical organizations are now the backbone of Haitian medical care,” says Dana Van Alphen, regional adviser for disaster management at the Pan American Health Organization who has been involved in discussions with a Haitian presidential health commission. In an effort to make these improvements in access to healthcare permanent, the PDNA identified primary health (along with  adequate  follow-up) and the establishment mobile clinics and health centers as a means to provide universal access, quality services and essential medications. This would allow care to be available nationwide instead of concentrated in Port-au- Prince.

The PDNA also recommends a massive investment in training for Haitian medical professionals because it is believed that now that the need for urgent care has subsided and the consequences of the earthquake are no ;longer front page news, the influx of foreign health professionals is fading. This transition would include pairing Haitian medical personnel with foreign staff for training and transferring functional control of hospitals and clinics to locals.

To begin the process proposed by the PDNA, a company called Containers to Clinics will transport a ready-made clinic, which will be transported in two pieces to the grounds of Graces Children’s Hospital in Port-au-Prince . The clinic is set to leave Boston around May 15 in a truck, which will haul it to Brooklyn, New York, where it will be loaded on a freight ship and be set up by June.

Please follow this link to read an executive summary of the PDNA.

Note:  The GP editorial staff’s thoughts and hearts go out in solidarity to the residents of Port-au-Prince and their families, as well as our colleagues in Haiti.  We will be updating this post as more information becomes available.

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Earthquake Crisis in Haiti

Original post by Wilnise Jasmin [01.14.2010 @ 6:53 AM EST]

As you may have already heard, a 7.0 magnitude earthquake struck about 10 miles southwest of Port-au- Prince, Haiti at about 5 pm Tuesday night. The quake ravaged the infrastructure of Haiti’s fragile government and destroyed some of its most important cultural symbols.

“Parliament has collapsed,” Mr. Préval told The Miami Herald. “The tax office has collapsed. Schools have collapsed. Hospitals have collapsed. There are a lot of schools that have a lot of dead people in them.” He added: “All of the hospitals are packed with people. It is a catastrophe.”

President Obama promised that Haiti would have the “unwavering support” of the United States.

Haitian authorities and humanitarian aid organizations are struggling to respond amid devastation. Read the rest of this entry →

What happens after the relief services pack up and the foreign volunteers go home?  Today’s article in the New York Times by Neil MacFarquhar writing from Gonaïves is an all-too-rare example of follow-up during the off-season of catastrophe.  Half a year after a succession of hurricanes left hundreds of people dead and Haiti’s desperately fragile infrastructure in tatters, the people of Gonaïves are still struggling to resume normalcy — two-thirds of the city have yet to be repaired — even as they fearfully muster their defenses against future storms.

No other city in Haiti absorbed so much punishment. More than 30 inches of rain fell overnight. The deforested hills, less than 2 percent of them covered by trees, sent the spill-off crashing down into La Quinte River, the wall of water and mud eventually cresting at 15 feet above its banks.

By the time it receded from the city streets, the flood had killed 466 inhabitants; another 235 just disappeared and are presumed dead. Of the city’s 33,000 buildings, 5,441 collapsed and some 22,300 others were damaged. Nationally, damages came to a total of $900 million, or nearly 15 percent of the gross domestic product.

“All it takes is one cloud, and everyone asks me when they will be evacuated,” groused the deputy mayor, Jean-François Adolphe, when asked about the mood here. The City Council tried to develop a plan, he said, but readily admitted it was basically fruitless. The city does not have a place to shelter anyone, not to mention the means to ferry its inhabitants to higher ground.

Earlier this month, UN Secretary-General Ban Ki-Moon and former US President Bill Clinton visited Haiti to meet with President Rene Preval to discuss Haiti’s predicament and the poverty trap affecting its people.  As has been clear for many years, any serious plans for the country’s recovery will have to address not only provision of basic services and securing food supplies, but also long-term job creation and environmental recovery efforts.  Another certainty is that such efforts will require thorough changes in North America’s relationship to Haiti in terms of support and funding; although the UN released a request for $108 million for hurricane recovery in Haiti, less than half of that has been raised.  A high-level donor conference will take place in Washington, DC, later this spring.

More on the hurricanes, Haiti’s future, and a putative new chapter in US-Haiti relations:

UNICEF: Surveying storm preparedness in Gonaives.

Paul Farmer and Brian Concannon: “Change Haiti Can Believe In”

US Conference of Catholic Bishops: Cardinal Francis George urges Obama to grant Temporary Protected Status to Haiti for the next 18 months.