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Battling to control Haiti's cholera epidemic

By Kerry Sanders, NBC News Correspondent
PORT-AU-PRINCE, Haiti – The victims of Haiti’s latest challenge lie in cots quarantined so as not to spread cholera.
The bacterial disease has killed more than 1,100 people and hospitalized more than 18,000 since the outbreak was first reported late last month and health officials here fear the epidemic is about to get far worse: The United Nations estimates as many as 200,000 Haitians will contract cholera within the next six to 12 months.

Kerry Sanders / NBC News

Pierre Dennis,9, suffers from cholera and clings to life in a Red Cross tent hospital.

In the worst hit area, Cap-Haitien, U.N. statistics reveal the death rate is an astounding 30 percent.

“It's an epidemic, it's a nationwide crisis now,” said Imogen Wall, the U.N.Humanitarian spokeswoman in Port-au-Prince.  “Cholera is in Haiti now, so this will go on for years.”  
Race to save lives
Cholera, a water-borne bacterial illness, can kill within hours if left untreated. But if treated quickly, survival is almost guaranteed. A simple mixture of salt and sugar water to replace lost fluids nearly always results in a cure, according to the World Health Organization.  

But when patients get treatment late, the administration of intravenous fluids may be necessary.
The faces of the youngest of the victims are haunting: Twelve-year-old Yvio St. Leger and his nine-year-old brother Pierre Dennis lay side-by-side in a Red Cross tent hospital 40 miles north of the capital city. Both are alive, but their parents and two siblings died en route to the clinic.

Dr. Henrike Meyer, who is in Haiti with the German Red Cross, slipped a finger-nail sized pill into Pierre’s mouth. Then she gave him a little water so he could swallow it down. As hard as he tried, Pierre couldn’t swallow. After three tries, he spit the pill into a bucket.

Health officials warn that Haiti's deadly cholera epidemic will strike at least 200,000 people in the coming months. NBC's Kerry Sanders reports.

He was trying to take Doxycycline, an antibiotic that is a long-tested medicine used to treat a variety of infections all over the world.

Pierre was hooked up to an IV. “The main problem is we need to provide fluid, fluid, fluid,” said Meyer. “He got already yesterday about four liters, and we have to continue.”

(The brothers were recovering well, according to doctors Friday, but they are still under observation at the hospital).  
Anger over source of illness 
Cholera is often spread due to poor hygiene. Despite rampant bad sanitation and poor access to clean drinking water in Haiti, cholera has not been recorded in the island nation for six decades. But cholera is endemic to Nepal, and thousands of Nepalese troops came to help Haiti in the wake of January’s devastating earthquake.

Outrage over the outbreak has erupted over the last several days, fueled by suspicions that U.N. troops from Nepal spread the disease from their base into the Artibonite River system, where the initial outbreak was centered last month. Those suspicions are shared by some prominent global health experts.
Anti-U.N. violence spread to the nation’s capital Thursday as protesters threw rocks at peacekeepers, attacked foreigners' cars, blocked roads with burning tires, and toppled light poles.  

But Wall, the U.N. spokeswoman, said where the illness came from is irrelevant at this point.
“It doesn't change the response knowing where it came from. We know everything we need to know about this illness from lab tests, and we know how to deal with it,” she explained. “So the origin is obviously of interest but not significant from a response view.”
Dealing with crisis at hand
In one of the quarantines, 12-year-old Emerson, cradled in his mother’s arms, said he believed he got sick after eating rice.

“It hurts inside. I cry a lot,” he said. As his mother gently poured cool fresh water into her hands and bathed his face, Emerson cried, “I’m hot. I’m hot. I’m hot.”

Doctors say all Emerson and his mother can do right now is wait.
Juergen Rostan, the logistics officer at the German Red Cross clinic, said he’s unsure what they’ll do if more patients arrive.

All 45 cots at their clinic are now filled. His hope is to cure those who arrive as quickly as possible, so they can leave and make room for the next patients.

“We do what we can here on the spot, and that’s all we can do from our side here,” he said.

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 Prevention education needs to spread
Unlike the outpouring of help that flooded into Haiti following the January earthquake, there’s little outsiders can do to help now.  Local aid organizations say the key to beating the cholera epidemic is education.
If word could spread quickly to explain that washing hands, boiling water for 20 minutes before drinking it and keeping fecal matter far from water sources will help prevent the spread of illness, experts believe the battle could be won.
But there are a limited number of Creole speakers with medical authority with the time to spread the word because they are increasingly dealing with the crisis at hand.
Another problem is millions of homeless packed together in tent camps in the capital city. Health officials say that close proximity means once cholera hits, it can spread to hundreds of others within days.
The Haitian department of health has launched a team of six men to scour the city for the dead. On Tuesday they found two bodies. Wednesday, another was found dead in a busy street. The team wears masks, protective yellow suits, and gloves, and they spray a chlorine disinfectant on the bodies. It’s a stunning image that scares residents as much as it calms them.
Haiti has a long history of uphill battles: political upheavals, hurricanes, earthquakes, and now, cholera. But deep in the soul of those I met, there is an energy that drives them to keep going and overcome the problem, not matter what the challenge. And in that spirit, there is hope for a nation that again is in crisis.