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Emergency Stacked upon Emergency

Direct Relief International Helps Fight Cholera in Haiti


Santa Barbara-based Direct Relief International (DRI) held a press briefing last week as it ramps up relief efforts for a cholera epidemic in Haiti that is entering its fifth week and still growing.

According to Thomas Tighe, CEO of DRI, there are about 10,000 cases of cholera countrywide and there have been 600 fatalities so far. Haiti’s Ministry of Public Health’s most recent counts are 12,303 and 796, respectively.

Symptoms of cholera, an intestinal infection, include watery diarrhea, vomiting, leg cramps, and dehydration. Left untreated it can cause death within hours. The body will shut down when it reaches a state of acute dehydration.

Ian G. Rawson, PhD, managing director of Hôpital Albert Schweitzer in Haiti, said that treating cholera, which is mostly comprised of keeping patients hydrated, “is not complex medicine” but that it is “urgent work.”

The bacteria that causes cholera is spread through drinking water, and with so many people homeless and living in tent cities, it’s tough to keep waste water separate from drinking water. A report filed yesterday on DRI’s Web site said, “The consensus is that what we’ve seen so far is just the tip of the iceberg. The population is mobile and many people don’t have access to clean drinking water.”

Tighe said, “DRI’s role has been focused primarily on the function of bringing in essential medical materials and distributing them free of charge.”

Haiti — already one of the world’s poorest nations before it was ravaged by an earthquake in January — imports all of its medical supplies. There is no manufacturing capability within the Carribean island nation

DRI specializes in cutting through the red tape of bureaucracy and getting supplies to disaster areas as quickly as possible. It is currently coordinating with 53 sites in Haiti. In the past two weeks, DRI has delivered 157 tons of material. Many of its donations have come from Baxter International, which sent four ocean freight containers of IV solution to Haiti.

The most immediate needs are lactated Ringer’s, normal saline, IV poles, oral rehydration solution, and bleach. A cholera patient can lose up to 15 liters of fluid in a single day.

Anybody entering or exiting the treatment tents where cholera patients are quarantined must wash their hands and feet with bleach.

Dr. Rawson said that Hôpital Albert Schweitzer served as ground zero for the outbreak, which was initially fairly localized around the Artibonite Valley in western Haiti. In October, the hospital treated the first confirmed case of cholera in Haiti in 50 years. In the past few days, though, the outbreak has mushroomed, spreading to six of Haiti’s 10 departments. It is expected to reach all 10 and is now officially classified as an epidemic.

Brett Williams, director of international programs at DRI, on the phone from Haiti, described the cholera outbreak as an “emergency stacked upon another emergency.” Making matters even worse is Hurricane Tomas which is causing flooding and further contamination of water sources.

Rawson said that Hôpital Albert Schweitzer attempts to keep a six-month supply of medical materials on hand, but that after the earthquake, they ran out in five days. The hospital’s resources are once again being taxed.

He added that DRI provided important relief in the aftermath of the quake. “When the helicopter came with materials from Direct Relief, I got to tell you what a pleasure it was to see them … we couldn’t do it without this kind of support.” DRI’s expertise will be needed once again.



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