Haiti's progress in achieving its 10-year plan to eliminate cholera: hidden sickness cannot be cured

Area of Science:

• Public Health
• Epidemiology
• Environmental Science

Background:

• Cholera remains a significant threat in Haiti, causing suffering and deaths, particularly among impoverished populations.
• Despite a national 10-year plan, cholera transmission rates increased in early 2015 compared to 2014, highlighting ongoing challenges.
• The study focuses on Bocozel, a rural, poverty-stricken rice-producing region with critical infrastructure deficits.

Purpose of the Study:

• To evaluate the progress of Haiti's 10-year Plan for the Elimination of Cholera.
• To analyze the multifaceted factors contributing to persistent cholera transmission in a vulnerable rural community.

Main Methods:

• Drawing upon epidemiology, clinical knowledge, policy, ecology, and political economy.
• Utilizing ethnographic data collected in Bocozel, Haiti.
• Assessing water access, sanitation infrastructure, agricultural practices, and governance capacity.

Main Results:

• Widespread poverty, decrepit irrigation, unaffordable fertilizer, and limited government capacity hinder agricultural productivity and economic stability.
• Contaminated water sources are used for drinking, cooking, and bathing, with limited access to functional water treatment.
• Scarce and shared latrines, coupled with prevalent open defecation, indicate severe sanitation deficiencies.

Conclusions:

• Structural vulnerabilities across water, sanitation, health, agriculture, and governance impede cholera elimination efforts in Haiti.
• Addressing these interconnected "hidden sicknesses" is crucial for effective cholera control and prevention.
• Integrated, multi-sectoral interventions are necessary to overcome the deep-rooted challenges to public health in Haiti.