Hurricane Tomas may complicate efforts to fight cholera outbreak

	PIH staff load supplies onto a UN helicopter for delivery to an isolated community.

With Hurricane Tomas looming in the Caribbean, Partners In Health is focusing its efforts on storm preparations in conjunction with its work to treat and control the outbreak of cholera.

Experts are predicting that Tomas will hit the southern coast of Haiti as a Category 2 hurricane on late Friday or early Saturday morning, bringing strong winds, flooding, and mudslides. PIH expects that the storm may exacerbate transportation issues into and within the Artibonite region—the area hit hardest by the cholera epidemic. Our procurement team is preparing to move extra supplies from PIH’s warehouses in the Central Plateau and Port-au-Prince to ensure that the 16 health centers supported by PIH remain stocked in the event that the roads become impassable.

Even now, road access is already one of the main challenges to addressing the cholera outbreak, both for patients trying to access health facilities, and for PIH teams trying to bring supplies and community outreach campaigns to remote communities. Over the weekend, PIH and the UN spent hours attempting to reach a health center in the mountainous Poste Pierrot district, where 18 deaths from cholera have been reported. After the off-road vehicles failed, medical supplies had to be delivered on foot and by donkey, reported PIH Chief of Mission Dr. Louise Ivers. A UN helicopter is scheduled to bring additional supplies and staff to evaluate the community tomorrow. 

As of Sunday night, the cholera outbreak has hospitalized 4,764 people in the Artibonite and Central Plateau regions, with 337 reported deaths, according to Haiti's Ministry of Public Health and Population (MSPP). PIH clinicians report fewer cholera patients arriving at the three PIH hospitals operated in partnership with MSPP. Hôpital St Nicolas in St Marc is now triaging 200-300 patients daily, compared with the 600 patients each day in the early days of the outbreak.

	Cholera patient being treated at the hospital in Lacolline.

However, despite shrinking numbers of cholera cases at hospitals in the Artibonite, the disease is still expanding geographically, reports Dr. Ivers. On Sunday, 30 cases of acute diarrhea (possibly cholera) were reported at PIH/MSPP’s Hôpital St Thérèse in Hinche. This is the first possible report of cholera this far north in the Central Plateau of Haiti. And new cases are still arriving at the PIH/MSPP medical facility in Lacolline in the southern Central Plateau—some from communities that previously did not have any reported cholera cases.

As of Monday morning, there have been no reported cases of cholera at the four Port-au-Prince settlement camps served by PIH health clinics, where 100,000 displaced earthquake survivors are currently living. The clinic teams are working in collaboration with the MSPP and other non-governmental organizations to prepare emergency responses for both a potential cholera outbreak and potential hurricane-related damage and flooding.