Friday, October 25, 2013

The Cholera Outbreak In Haiti-Three Years Later

UPDATE 4-1-14: UN: Haiti has more cholera than any other nation

I find this a bit hypocritical of the UN when they are seeking immunity from the reported spread of it in 2010 by UN peacekeepers. Hopefully their initiative includes infrastructure (sanitation and hygiene) and policies that uplift the people of Haiti and protect them from this ever happening again.

"Scientific studies have shown that cholera was likely introduced in Haiti by UN peacekeepers from Nepal, where the disease is endemic.

The United Nations has claimed diplomatic immunity from class-action lawsuits being filed by lawyers representing Haitian survivors and relatives of the dead who say the UN peacekeepers contaminated Haiti's principal river with cholera-infected human waste beginning in October 2010.

In 2012, the United Nations announced a $2.27 billion initiative to help eradicate cholera in Haiti."

Also see:

Abstract: Water, Sanitation and Hygiene in Haiti: Past, Present, and Future

I can't but wonder why progress comes so slowly to countries where people of color, indigenous people and people who are poor live. You know if this had happened in the US the pace of reconstruction and restoration would be at a record pace in comparison.

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Reflecting On The Cholera Outbreak In Haiti Three Years Later

By Rebecca E. Rollins/Partners In Health

Dr. Charles Patrick Almazor, from Port-au-Prince, Haiti, is director of clinical services for Zanmi Lasante, Partners In Health's sister organization in Haiti. He has worked for PIH and ZL since 2001, and was one of the doctors who saw the first cholera patients in St. Marc. He wrote the following reflection about the disease, which had never been reported in Haiti before the Oct. 19, 2010, outbreak three years ago.

Haiti is known for its torrential rains. Sometimes they begin slowly and build to a crescendo, and other times they fall suddenly and loudly and wildly. The sound of the Caribbean rain hitting your rooftop can be enjoyable and soothing if you are in a safe place—warm in your bed or lying on your sofa. The very same rains can be a nightmare for those living in flooded areas or tents. For me, the rains bring back a flood of unpleasant memories.

These memories include the hundreds of patients I saw during a past rainy season in cholera treatment centers (CTCs) in the Artibonite region of Haiti. The patients—the lucky ones who were taken to a clinic—were transported by family and community members on traditional stretchers, a straw mat on an iron bed supported by two thick sticks and carried by four men. Our patients’ eyes were sunken into their skulls, their skin as parched as the dry season. Because of their appearance, they were referred to as zombi lage, fleeing zombies. Patients of all ages laid on their cots, throwing up what they hardly found to eat, since for most of them food is a scarce resource.

I still remember a young man who was the head of his household. He was terrified of dying because he did not want to leave his family behind in dire poverty. I asked him where he lived. His wife was quick to tell me they lived in the Chaos Mountains, dramatically named for the steepness of the mountain chain. It took them six hours to walk to the hospital. Even more tragic, the patient told me he knew about the risk of cholera, but the family ran out of chlorine to treat their drinking water. His wife added that the market was closed because of the continuous rains.

When I left the CTC, the patient had already received eight liters of intravenous fluids to treat the deadly dehydration that accompanies cholera. His face had changed completely. He once again looked like a normal, living human being. I went away with the confidence he would make it.

Cholera is a good illustration of the vicious cycle of poverty and disease, in which the most vulnerable people are most likely to be victims. I’m a doctor and I have been working in Haiti for more than 10 years. This was my first exposure to such a severe diarrheal disease capable of killing so many people so quickly. On October 20, 2010, I cared for some of the first patients who came to St. Nicolas Hospital in St. Marc, Haiti, the epicenter of the cholera outbreak. It was painful to see so many patients and too few nurses and doctors.

I worked all night at the hospital with a few colleagues; we were two doctors and six nurses for more than 300 patients who needed IV fluids. We were overwhelmed by the immensity of this tragedy. Many of those 300 patients died that day. They came too late to the hospital and from too far away to be taken care of by too few providers.

Cholera is a good illustration of the vicious cycle of poverty and disease, in which the most vulnerable people are most likely to be victims. It is a water-borne disease. Haiti has been struggling to provide clean water to its citizens since its independence in 1804. Will it be feasible to do so in the next decade?

Cholera is spread through bacteria in fecal matter that contaminates water that people ingest; poor sanitation creates conditions ripe for transmission. How much time will it take before we can provide basic sanitation to the 83 percent of Haitians without latrines? It’s these questions and the lack of answers that frighten me—not the rains.

Cholera killed 5,000 Haitians in its first year. Today, three years after the outbreak, about 8,400 Haitians have died from cholera and more than 685,000 have become sick—approximately one in 15 people. The outbreak was quickly classified as the worst cholera epidemic in the world. In one year, a germ we never had was introduced into our country, followed by a disease we’d never seen. How can we protect our patients and their families from this disease? How can we protect the thousands more who live far from any health facility?

These days, it’s been raining heavily. If you are reading this, you are probably safe, warm, and dry. In Haiti, these rains put people at risk. In an ideal world, we would have a comprehensive approach for fighting cholera—preventing transmission with clean water sources, hygiene education, and latrine construction.

End of excerpt

More to this:

Cholera Introduced Into Haiti By UN Peacekeepers

Excerpt:

The U.N. peacekeeping mission was established in 2004 to help bring security and stability to Haiti. In 2010, after a deadly earthquake, the United Nations expanded its presence in the Caribbean nation.

In trying to identify the introduction of the cholera strain, the U.N. panel’s new report tracks the arrival of a contingent of Nepalese peacekeepers from Kathmandu to a U.N. encampment in the village of Mirebalais in October 2010. Within days, hospitals in the region registered a dramatic increase in deaths from diarrhea and dehydration, signature symptoms of cholera. The illnesses marked the opening chapter in an epidemic that quickly spread across the country.

The report stated that the United Nations had constructed a “haphazard” system of pipes from the U.N. camps’ showers and toilets to six fiberglass tanks. The “black water waste,” which included human feces, was then transferred to an open, unfenced, septic pit, near where children and animals frequently roamed. The system presented “significant potential” for contamination, the report said.

The members of the U.N. panel — who no longer work for the world body — defended their initial findings, saying that the “majority of evidence” at the time of their first report was “circumstantial.”

The latest findings will increase pressure on the United Nations to acknowledge responsibility for introducing cholera into the country. U.N. Secretary General Ban Ki-moon and his top advisers had invoked the panel’s ambivalent 2010 findings in arguing that the United Nations bore no legal responsibility for the epidemic, although they said the organization was committed to lead international efforts to respond to the health crisis and improve the Haiti’s sanitation infrastructure.

The Boston-based Institute for Justice and Democracy in Haiti filed a compensation claim in November 2011 on behalf of the families of 5,000 victims, and it is preparing lawsuits against the United Nations in U.S. and Haitian courts on behalf of thousands more.

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I find this to be appalling.

The fact that it happened is appalling enough. The fact so many still remain without potable water and sanitation throughout Haiti is beyond criminal. We always have billions to kill people or to finance extravagant projects based on ego. However, when it comes to truly caring for our fellow human beings we fail miserably. Shame on the UN for skirting responsibility for this epidemic.

BILLIONS WASTED ON WAR THAT COULD BE USED TO BUILD TOILETS AND SANITATION SYSTEMS.

Now it appears the strain spread in Haiti has spread to Mexico:

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Haitian Cholera Strain Spreads To Mexico

A South Asian strain of cholera that was introduced into Haiti three years ago this month has now spread to this continent's mainland.

Mexico is the fourth Western Hemisphere country to experience the cholera outbreak. It's a disease that's very hard to stamp out once it gets into an area with poor water and sanitation.

Mexican health officials first picked up on the problem Sept. 9, through routine surveillance of hospital cases of severe diarrhea. Since then there have been 171 reported cases in Mexico City and states to the north and east. One victim has died.

Dr. Jon Andrus, deputy director of the Pan American Health Organization, says it was all but inevitable that cholera would spread beyond the Caribbean. "It was always a major concern that it would be exported to other countries, as has recently happened in Mexico," he tells Shots.

Since it was introduced into Haiti — very likely by United Nations peacekeeping troops from Nepal who were billeted at a camp with poor sanitary facilities — cholera has sickened 715,000 people in Haiti and the Dominican Republic (which share the island of Hispaniola) and Cuba. Nearly 9,000 have died.

Andrus fully expects it will spread further. "We are advocating throughout the region for countries to be on their guard," he says.

Cholera is thought to have invaded Cuba via infected health personnel who work in Haiti and travel back and forth. Cuba has reported nearly 700 cholera cases and three deaths, although many are skeptical that that nation is fully reporting the extent of its outbreak.

Andrus says vacationers visiting Cuba — who probably got cholera from contaminated food — have exported the disease to Chile, Venezuela, Italy, Germany and Holland. So far those cases haven't touched off outbreaks. But as the Mexican epidemic shows, it can easily happen if an imported case contaminates water or food in an area with poor sanitation.

"You have those situations throughout Latin America," he notes. "We are the region of the greatest disparities."

The last time the Americas saw a major cholera epidemic was 22 years ago. It was allegedly brought by a ship that discharged its bilge water in a Peruvian port. The disease spread all the way up the continent, sickening more than 1 million people and killing 10,000 or so, until it hit the U.S.-Mexican border. There it was stopped by modern water- and sewage-treatment facilities in the United States.

Andrus says PAHO is worried this latest epidemic will have a similar impact.

"It's really, for us, a defining moment," he says. "To what extent are we concerned about spread? Well, it's really a regional threat and now a global threat to health."

End of excerpt



To the UN. YOU MUST MAKE THIS RIGHT.

Stand Up To Protect Your Public Water System

Editorial: The Veolia water contract is no ordinary City Hall kerfuffle

At first glance, the controversy over a $250,000 consulting contract for Veolia Water North America to review procedures at the St. Louis city water division looks like a typical City Hall kerfuffle.

Oh, but it is so much more.

A lot of heavyweights are involved, at least tangentially. They include Anheuser-Busch InBev, which doesn’t want its water costs going up too fast; the libertarian Show-Me Institute founded by conservative ├╝ber-donor Rex Sinquefield; John Temporiti, a lawyer and Democratic political operative who nonetheless has worked on Mr. Sinquefield’s causes, too; the Carpenters Union, which represents some water division employees; and the Missouri Coalition for the Environment.

Also involved — and this is where it gets really weird — are both sides of the Israeli-Palestinian conflict.

The immediate issue is whether city Comptroller Darlene Green should sign the contract with Veolia, as Mayor Francis Slay has asked. City Counselor Patricia Hageman has opined that Ms. Green has a “ministerial duty” to sign the contract, inasmuch as money for the contract already has been included in the city budget.

The budget, including $1.3 million for “professional services” for the water department, was approved last spring. Under the city’s normal convoluted procedures, the city’s three-member Board of Estimate and Apportionment — made up of the mayor, the comptroller and the president of the Board of Aldermen — must approve city expenditures. But since money for Veolia was included in the budget, and the budget was approved last spring, Ms. Green may not have the authority to withhold her signature.

Does all of this sound complicated? We’re just getting started.

Apparently the E&A board was supposed to receive notice from the water division that it planned to spend $250,000 on Veolia. The aldermen had been apprised of this fact, but the formal notice never got to E&A. Why? The water division sent it to Eddie Roth, the mayor’s operations director, instead. Mr. Roth, unaware that the document was solely in his email in-box, didn’t pass it on. (Mr. Roth, by the way, was a member of the Editorial Page staff before going to work for Mr. Slay in 2011).

The Veolia contract has become a big deal for several reasons:

Water division employees are worried that the contract will get Veolia a beachhead. Part of Veolia’s business is operating public water systems. While the contract specifies only that it will make recommendations on saving money, division employees worry that jobs could be lost. While the city charter appears to prohibit the sale or lease of “the waterworks” to a private entity, it says nothing about hiring a private firm to operate it.

The issue popped up during Mr. Slay’s re-election campaign this spring. His primary opponent, Aldermanic President Lewis Reed, enjoyed the support of some anti-Veolia interests. Mr. Reed lost the election but remains on the Board of E&A; his supporters aren’t interested in doing Mr. Slay any favors.

Mr. Sinquefield’s Show-Me Institute in 2010 suggested privatizing the water division, arguing that it “is worth hundreds of millions of dollars” and could generate “an enormous amount of money” for the city.

Mr. Sinquefield is a major political donor to Mr. Slay and to St. Louis County Executive Charlie A. Dooley. Mr. Temporiti, who has done work for Mr. Sinquefield’s lobbying company before, also has been hired by Veolia to press its interests.

The water division is a stand-alone “enterprise fund” that operates on its own revenues without tax support. It is facing a need for major capital expenditures in coming years. It has fewer customers than in years past and is selling less water, even though it has added some communities in St. Charles and St. Louis counties to its customer base. It operates two major intake and processing plants and doesn’t need all of its capacity, but can’t get by on just one plant.

That portends a need either to streamline its operations or to raise water rates for the second time since 2010. Major water-users, including Anheuser-Busch, are not thrilled with that idea.

As if any complications were necessary, Veolia Water North America, headquartered in Chicago, is a division of a French conglomerate that has operations in dozens of countries, not only in water supplies, but in wastewater management, solid-waste management, energy supply and public transportation.

End of excerpt

Also see:

Veolia Makes Profits At Expense Of Public Water Companies

Dump Veolia Coalition Plans Protest

Good to see protest because this is how these companies get a foothold ... by claiming they are only "consulting" firms...

If you live in an American city chances are your water supply may now be in the hands of a private company like Veolia. It is known fact that such arrangements lead to big profits for the companies involved but usually lead to decrease in quality of service and water quality while leading to increase in rates. Privatization of the water system was a big part of what made Detroit go bankrupt. Veolia also isn't the only company doing it either. My town's water was recently sold to United Water with the same results- Decrease in water quality with increase in rates yearly with someone pocketing a lot of money. This is happening right under our noses to OUR PUBLIC TRUST.

Veolia Stock Falls For Fourth Day

Hopefully a continuing trend. This is where companies like this need to be hit hard.

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Please sign:



Tell Veolia: Stop Undermining Our Right To Control Our Water

Veolia Environnement: A Profile of the World’s Largest Water Service Corporation

This is a must read report.

Tuesday, October 22, 2013

Super Typhoon Francisco Now Heading For Japan



Typhoon Francisco May Follow Wipha's Path

Wipha dumped 33 inches of rain on Japan just last week causing mudslides that killed 18 people. Seeing Super Typhoon Francicso taking the same path is beyond catastrophic. There were also reports of spiking radiation as rains from Wipha entered soil at Fukushima. Again, quiet hurricane season in Atlantic does not mean anything when you speak about global. This is one to watch. My prayers are with the people of Japan.

UPDATE 10/25/13:



Francisco Sideswipes Japan

Hmmm, divine intervention? Second big bullet dodged by Fukushima so I would hope a greater force is watching out for us regarding it... Actually, it's colder air and wind shear. Of course that doesn't in any way allay the fears regarding what has been and continues to take place there that is being totally blacked out by the US media.

Everytime It Rains Fukushima Plant Is Pushed To The Edge

Great Respect to the author of this blog.

It All Comes Down To Hubris



In writing about water accessibility, scarcity and quality it is very easy to get caught up in statistics. Statistics can also influence the amount of urgency one places on a particular problem. However, I think that is something we need to be careful of when looking at the global water crisis as a whole. Where it concerns water, even one person going without the essential amount necessary for life is too many. Just one child dying of a waterborne disease is too many. Just one waterway overcome with poisons is too many. However, how we quantify these amounts comes down to one thing: hubris. The thinking that we control all water and that it is then here for our use and our abuse. The thinking that money can buy anything and that as long as you have it nothing else is ever really that bad. That the one child who died of a waterborne disease or of famine due to lack of food due to drought because of our hubris is an acceptable amount.

There is no acceptable amount.

I have been writing on this topic for a few years here and reporting on all of the crises we face regarding water globally. The recent Blog Action Day here showcased how water is a human right for all. There are entries here on drought, floods, fracking, Fukushima, climate change, agriculture, dams, accessibility, sanitation, privatization and scarcity. There are also entries on ways we can work to conserve this precious resource. However, once again it comes down to hubris. To placing that dollar sign on it. To putting a price and a statistic on it so we don't have to feel guilty about that one child or that one person who died because of it.

I am writing this because I am at a crossroads in my thinking about humanity as a whole. I have always tried to have hope for the future and the power of the human spirit to see beyond the dollar signs and the hubris. I have to be honest and state I don't feel that as much anymore because I see the crises of water and climate are so many times just made into PR slogans now where the urgency is downplayed in order to sell it for the profit of others.

Will we ever get down to being truly serious about where we are headed as a species and really do something about it? As an example, I no longer support UN climate meetings anymore specifically because they are mostly PR and accomplish nothing. The next UN COP conference in Warsaw this November looks to be like all the rest where deadlines are set without realizing the true reality of the condition of our planet. The UN doesn't see ratification of anything meaningful until 2020... Planetary emergency? You would never know it. All of the delegates get to fly on the Concorde to Paris next year however to try to make us think they will actually be able to do something concrete- as we pass the tipping point. It seems like we do a lot of "talking" and a minimum of doing... just enough to not make real progress while keeping the status quo in place.

While people go without potable accessible water, sanitation, nutrition and hope in our world as the effects of climate change become more prevalent all many organizations think about now is using PR and pretty faces to sell a crisis to make profit from it without us seeing any real action. Is the higher consciousness we truly need to put that all aside and really care about this and DO something we can really see into the future too far beyond our grasp because of the allure of money on all sides and our hubris? How many more years of meetings, talks, special events and hangouts will it take?

Seriously, what has to happen to collectively wake us up and mobilize us? I see some signs but not enough and not fast enough to overtake the effects of our hubris. Just the fact that we now have an epoch named after us- the Anthropocene brings that point home. We will not move forward as a species nor solve these crises that threaten our existence until we can move from hubris to humility.

I will keep hoping for that. Perhaps nature will have the final word in perpetuating that shift.

Humanitarian Disaster in the Sahara

Algeria has stranded 13,000 migrants in the Sahara forcing them to walk across it in response to EU directive to North Africa to lessen mi...