Crisis in Haiti: Cholera, Elections, and Economics

November 10th, 2010

International public health responders were once confident that the recent outbreak of cholera could be controlled through use of an aggressive education effort, expanded water decontamination, and medical treatment. Unfortunately, it has become increasingly evident that they are mistaken. The number of cases of cholera has reached more than 9,000 confirmed cases with at least 583 fatalities. While these numbers have grown rapidly, there are two factors that indicate that this might merely be the tip of the iceberg; 73 confirmed cases were found in Port-au-Prince, Haiti’s beleaguered capital city, and the flooding conditions induced by a hit from Hurricane Tomas.

History doesn’t hold much solace for international relief efforts and their ability to curb the spread of the disease in these conditions. The last epidemic of cholera in the Americas lead to more than 600,000 cases over a 6-year period starting in 1991. A similar epidemic in Haiti would likely infect greater than 200,000 with large numbers of those affected coming from the area in and around Port-au-Prince where poor conditions and inadequate medical access could likely produce a significant mortality rate.

All of these conditions are set in the background of upcoming national elections scheduled to take place on November 28. Many of Haiti’s citizens were already distressed by their government’s inability to assist them both before the earthquake and in the months that followed, so the governmental and international relief efforts to stop the spread of cholera could have a direct impact on turnout. Candidates have already begun to suspend or otherwise alter their campaigning efforts. Haitian health authorities have also stepped in and asked candidates not to hold rallies in affected areas as well. A surge in the cholera epidemic could potentially lead to postponement of the elections themselves.

The economic cost and impact cannot be ignored. While much of the burden will likely fall on international relief efforts, an expanded epidemic in Haiti could have large impacts both for Haiti’s struggling economy, but also the Western hemisphere. Estimates put the cost of the last epidemic in Peru at $770 million in lost trade and travel revenue. How the international community is going to help support economic growth and development, curb the spread of cholera and assist in ensuring the sanctity of Haiti’s first post earthquake elections will be a source of great contention over the coming weeks, months and years.

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