Cholera Outbreak Emphasizes Need to Rebuild Haiti's Critical Infrastructure

As if the massive earthquake of January 2010 that struck the poor island nation of Haiti were not enough, the displaced residents in and around the capital city of Port-Au-Prince have a new enemy.

As of October 25, 2010, an outbreak of cholera, an intestinal bacterial disease that can lead to extreme dehydration and kidney failure over a period of hours to days, has infected more than 3,000 residents, leading to more than 250 deaths. Even as relief agencies struggle to contain the outbreak on the doorstep of Haiti’s severely damaged capital, the long term challenges of rebuilding Haiti are invariably changed by this outbreak.

Prior to this most recent episode, the island of Hispaniola, which Haiti and the Dominican Republic share, hadn’t experienced a cholera outbreak in more than a century. In fact, the last outbreak of cholera in the Americas occurred in Peru in 1991. Now, as the cholera bacterium has re-established a foothold in Haiti, the rebuilding efforts will take place under the threat that another explosive outbreak could occur elsewhere in the country. That new threat will not subside for the foreseeable future, particularly in the context of a large portion of the population living in tent cities in the areas surrounding their destroyed cities and towns. So, this new challenge begs the question of how rebuilding efforts must evolve to meet new health concerns.

Even before the January quake, basic infrastructure in Haiti was inadequate, ineffective, and generally poor. Since the earthquake, essential human services, including water sanitation, have been managed under the umbrella of the international relief agencies that flooded Haiti. Those agencies have done an admirable job limiting the number of waterborne disease outbreaks in Haiti leading up to this recent cholera epidemic. However, this epidemic does clearly demonstrate that even the massive relief apparatus operating in Haiti cannot possibly compete with squalid conditions the more than 1.3 million displaced residents live in every day. Worse yet, the current relief efforts are unsustainable.

Moving forward, the international relief community needs to push for increased emphasis on the task of rebuilding critical infrastructure. While the damage to Haitian society was enormous and, in some cases, potentially irreparable, greater emphasis should be focused on the sustainability of basic human needs, including water sanitation, basic medical treatment, and safe food sources. It may take years to replicate even a simple electrical or phone grid, replace the houses and tourist industry, and foster sustainable economic growth.

But the people of Haiti don’t have years to wait for the most basic human needs. The sad truth is that life and safety concerns are as paramount to Haiti’s future at this stage in disaster response as they were during the hours and days when mass media showed victims being pulled from the wreckage of their collapsed homes.

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