Fighting cholera in Haiti after Hurricane Matthew

Seven hours on the road, or rather on a rocky trail that renders one grateful for a solid back and stomach, to Pestel. All along our way to the town, one of the areas where a significant increase in diarrhea cases has been registered over the past week, we pass destroyed houses and trees. People in front of their homes, stranded. Some still stunned, others busily seeking to bring order to the chaos.

The objective of our visit to Pestel – together with the NGO Acted, one of UNICEFs main partners in the response to cholera in the Grand Anse – is to follow a rapid response team. These teams exist in all high-risk areas across the country. They are part of the Government and UNICEF’s strategy to eliminate cholera from Haiti. Their task is to investigate each case that is registered, and to establish a large quarantine zone around the affected household to prevent the disease from spreading.

Three weeks ago – in a life before Matthew – Haiti’s medium-term plan to eliminate cholera was launched. It has three pillars: coordination and support in the decision-making process, access to health care, and measures to prevent the transmission of cholera. The rapid response teams with whom we are in Pestel contribute to both care and prevention. UNICEF is involved in all three pillars.

Cholera was a major problem before Matthew, and it is even more so now. And one in three cholera patients is a child!

© UNICEF Haiti/WaltherThe wreckage of houses and trees in Pestel after Hurricane Matthew.

Cholera may have been present in Pestel before Matthew, and the current situation favors its spread. There were three suspected cases between July and Matthew, and nine since. Several people may have died. Investigation is underway to confirm whether these cases of diarrhea were indeed cholera, or due to another cause. But cholera or not, people can die from diarrhea. An undernourished person, especially a child who is still growing, will not hold up long once their reserves are depleted.

For children, the impact is a double disaster. Even if they survive, the consequences for their physical and intellectual capacities will last forever.

The hurricane created an ideal environment for the spread of diseases – with access to clean water destroyed, lack of sanitation, the movement of people and their concentration in camplike settings. Water is one of the core causes of contamination, and UNICEF is working relentlessly with the Government and various partners to reestablish access in the most affected areas.

“A doctor in my commune handed out water purification tablets shortly after the hurricane. When I had used them up, I started to get sick,” says Noel, one of the patients in Pestel’s cholera treatment center. In the absence of a water system, people collect rainwater in open containers to meet their needs.

Noel lost his home, like so many others.

Elia, the mother of a little girl who occupies the cot next to Noel, also suspects that her daughter got sick from water. “But what can I do? I don’t even have money to buy food, how can I buy aquatabs?” It took her three hours by motorcycle to reach the center with her daughter. And “kay kraze, tout kraze kraze.” The house is destroyed, totally destroyed.

The absence of food is on everybody’s mind, just as pressing as the desire for shelter. “I haven’t eaten since the cyclone,” says Noel. “The catastrophe destroyed all my manioc.”

Matthew coincided with the harvest season and destroyed large parts of the crops. The fruit trees we drive by are all empty, surrounded by slowly decaying fruits, chadec (local grapefruit), avocado. These are currently the only foods that families in remote areas have to survive on.

“We are a bit pessimistic,” says Dr. Philip Cedec. He and the nurse are the only staff of Pestel’s health center and the adjacent cholera treatment center. “Already before, it was hard. Now it will be even more difficult. The people are going to pay. There will be hunger in Pestel.”

Dr. Cedec studied in Mexico, yet decided to return to Haiti, to his hometown in the middle of nowhere. He started his education in Pestel’s primary school, right next to the health center. Post-Matthew, the roof is gone, the building is flooded, and the furniture is trashed. Students didn’t return for the official reopening of the schools yesterday. An alternative must be found until the building is repaired.

Talking to Noel, Elia and Dr. Cedec – and passing dozens of villages similar to Pestel – the needs seem overwhelming. There is so much to be done, that the only thing to do is start. For UNICEF, this means working to provide safe water and sanitation – especially in emergency shelters, where many people live in close quarters – and getting children back to school.

In Creole, Nap vanse! Let’s go!


Cornelia Walther is the Chief of Communication for UNICEF Haiti. She’s worked with UNICEF for the past 13 years in Africa and Afghanistan. Since her PhD on the responsibility to achieve children’s rights, her motto is: change for good starts here and now, with every individual.

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