As I mention in today’s article about the cholera outbreak, authorities are holding emergency meetings here in Port-au-Prince to coordinate their response.

I just spoke to Nick Preneta of SOIL, a sanitation-oriented Oxfam-affiliated NGO that’s installed composting toilets in camps across the capital city. Nick speaks Haitian Creole and has worked in Haiti for several years.  He attended a 4pm meeting at DINEPA (Haiti’s Ministry of Water and Sanitation) headquarters and relayed the following:

• “There is definitely concern that it will hit Port-au-Prince.  People are reporting diarrhea in different areas, but no confirmed cases.”
• “A lot of focus on what actors are doing what in St. Marc and Artibonite area… they are consolidating the stockpile of chlorine and aquatabs and changing the chlorine standard for how much chlorine to put into the water to effectively chlorinate it.”
• He said the International Organization for Migration and smaller groups like SOIL will begin a tent-to-tent hygiene promotion in Port-au-Prince. The Haitian Ministry of Health has to approve sets of public health messages before they can be sent out by radio, text message and other means, which is causing delays.  He said SOIL received flyers from UNICEF they’d like to pin up on their toilets, but they’re awaiting approval.
• “One of the recommendations was to concentrate education at traffic centers.”  I said that sounded like a no-brainer to me, to which Nick responded, “There were a lot of no-brainers at the meeting.”  He went on to say, “There were conversations around shutting down schools and transportation routes… but if those are the conversations now, however many hours after the first confirmed case, it’s already too late – considering that there’s a lot of traffic between here and St. Marc and given the amount of produce that goes back and forth.”

Also, the Haiti Documents Index now updates in real-time as I upload documents to Crocodoc, a website that allows anyone to view and annotate the documents without registering.  Below are some highlights of the latest reports:

• According to the Logistics Cluster, “The Artibonite River is likely to be the source of the outbreak, after heavy rains spurred its banks to overflow and flooded the area.”
• According to MINUSTAH, “DINEPA plans to intensify  coverage of chlorination in PaP as a preventive measure especially in IDP camps. On 21 October,  UNICEF contingency-plan partner ACTED initiated distributions of pre-positioned supplies of  ORS and aquatabs for 6,000 people in Grande Saline in the villages of Drouin, Laporte, Latapie,  Boc D’Aquin, and in the fifth communal section of Bocozelle.”  Dr. Megan Coffee, based in Port-au-Prince’s General Hospital, said on Twitter earlier she hoped such distributions had already begun in the capital. To my knowledge, none have.
• From tonight’s Pan-American Health Organization’s Situation Report, the map below shows the enormous area of central Haiti where cholera cases have been detected.

Watch this space and the Haiti Biosurveillance website for further updates.

Published by Inter-Press Service. A shorter audio version of this story airs today on Free Speech Radio News. Photo by Operation Blessing showing hospital in St. Marc

PORT-AU-PRINCE (IPS) – Some 1.3 million people have lived in makeshift camps throughout Port-au-Prince since the January earthquake devastated the city. Living conditions are “appalling”, according a recent report by Refugees International.

But one bright spot of the multi-billion-dollar relief effort, touted by the United Nations and Haitian President Rene Preval, has been the prevention of the spread of a highly infectious, catastrophic disease.

Until now.

At least 160 people have died this week from an outbreak of cholera in the central Artibonite region, according to Zanmi Lasante, the Haitian arm of renowned health organisation Partners in Health.

The fear now is that the disease will reach Port-au-Prince and wreak havoc in the crowded camps.

There are already six suspected cases of the illness in the capital city, Monica Ferreira, a Portuguese medic, told IPS on Friday. Her team has operated a health clinic for quake victims since January.

“All defensive countermeasures should immediately focus on Cite Soleil and Lafiteau if they want to save Port-au-Prince,” said Dr. James Wilson of the Haiti Epidemic Advisory System (HEAS).

A HEAS partner reported that a market woman and child died from cholera in the small town of Lafiteau, just 25 kilometres from the capital.

Melinda Miles, director of the Haitian organisation KONPAY, told IPS she witnessed a man die of cholera Friday afternoon at the Hospital Centre of the Haitian Academy in Lafiteau. Doctors at the hospital could not be reached for comment before publication.

“We went into the room and he died right in front of us,” she said. “He came from St. Marc. The doctor said there are a lot more patients on their way with cholera.” Read more →

From Mac Mclelland’s latest Haiti dispatch (photo from Gaetantguevera’s photostream):

When I showed this amazing picture to my friend, after she registered what she was looking at, her eyes went huge while she exclaimed, “Oh my god!” with her hand over her mouth. The scene is a protest last week in Port-au-Prince. The guy on the left is a clearly unarmed and videotaping journalist from Texas named Ansel Herz, whom I happened to work with when I was in Haiti last month. The uniformed fellow pointing a gun directly at his face is a United Nations peacekeeper.

I didn’t meet many (okay, any) Haitian fans of MINUSTAH, the UN stabilization force that’s been in the country since 2004. I have, for the record, met some MINUSTAH who are definitely good guys and have, for example, helped a woman in labor get to the hospital, and helped stop a man who was trying to kill his wife for refusing to have sex with him. But the force has also shot civilians. It’s had to have meetings about how not to sexually abuse the Haitian population. In fact, last week’s protest erupted after the UN officially renewed MINUSTAH’s mandate. Some of the protesters’ complaints, which echo those I heard while in-country, are that MINUSTAH doesn’t actually do anything to protect civilians living in filthy, violent, rape-infested displacement camps, and that the money could be better spent dealing with those issues.

I asked Ansel how he ended up on the business end of a UN gun, just in case there was any kind of conflict or missing context surrounding this photo. Not so much, he says: “Maybe they felt threatened by my camera.”