On the occasion of my first post as a MADRE blogger, let me talk frankly about poop--more specifically, diarrhea. While in the West we may think of it as a schoolyard song or a day-ruining embarrassment, in poor areas of the world, it is actually terrifying. The World Health Organization estimates that at least 2.2 million people per year die from diarrhea-- a staggering four percent of annual deaths worldwide. And cholera--a waterborne bacterial infection--is one of its most common causes. Once cholera strikes, a patient can become dehydrated quickly, and if untreated, die within hours.
The disease, though, is heartbreakingly easy to prevent. Why? Well, for the same reason it's such a ruthless killer: it's all about access to clean water. Quite simply--since cholera lives in water--if you have access to clean water, you probably won't get cholera. If you don't, you're constantly at risk. On top of that, the disease only manifests itself in about 25% of those infected, and because it can take up to two weeks to make its presence known, it can be difficult to detect until it's too late. But when you look at the recommended methods of preventing cholera, you get a pretty good idea of why cholera is virtually unheard of in the Global North, but is a constant threat in the Global South: as I alluded to above, the best prevention methods are drinking clean water, handwashing, and using clean sanitary facilities.
You can connect the dots: it's a perfect disease of the world's poor. There's no reason anyone in this age should die of something so preventable, but without access to clean water, people in the Global South are sitting ducks.
The reason I say this, of course, is that relief agencies and the Haitian government are bracing for a cholera epidemic to reach the nation's capital, Port-au-Prince. Once there, it could devastate people uprooted by January's earthquake; still living in displacement camps. In short, prevention only works to contain an outbreak if people have the right resources, and enough of them. And Haiti just doesn't have enough-- while impressive public education campaigns are being mounted and supplies are being distributed, officials are planning for cholera to be a big problem in Haiti for the coming months.
But it's not as dire as it could be. Even though clean water and sanitation (and therefore, the most effective preventative measures) are unavailable to many Haitians, treatment is comparably simple and much more available. Treatment of cholera involves early detection, and an IV drip of simple electrolytes, sometimes accompanied by antibiotics. It's inexpensive and effective. And it can be done on a fairly large scale.
If Haiti can make it through this epidemic without the displacement camps being decimated, it will be a success of emergency efforts to contain and treat cholera. But emergency efforts aren't, in the long run, going to cut it for Haiti. Along with earthquake reconstruction will need to come serious investment in Haiti's water infrastructure. And the US has not been a good-faith player in Haiti's natural resource development in the past: our government has consistently supported anti-democratic forces and foreign control of Haiti's agricultural infrastructure. In 2000, the Bush Administration pressured the Inter-American Development Bank to cancel more than $650 million in development assistance and approved loans to Haiti -- money that was slated to pay for not only safe drinking water, but also literacy programs and health services, both of which also fight infectious disease.
The cholera epidemic is yet another reminder about post-earthquake Haiti: stopgaps aren't going to work. Once the threat of disease has been eliminated, let's get the problem at its source (no pun intended) and fund development that helps Haitians and not large American businesses. People shouldn't have to die from cholera, and it's in our government's power to help make that a reality for Haiti.