1.C - Cholera in Haiti Flashcards
1
Q
how does “people moving after a disaster” lead to epidemics after natural disasters?
A
- the risk factors for outbreaks after disasters are associated primarily with population displacement
2
Q
how do the the 4 key factors lead to epidemics after natural disasters?
A
- the availability of safe water and sanitation facilities
- the degree of crowding
- the underlying health status of the population
- the availability of healthcare services
all interact with the context of the local disease to influence the risk for communicable diseases and death.
3
Q
how are poor countries worse off in epidemics after natural disasters?
A
- developing countries are disproportionatly affected because they may lack resources, infrastructure and disaster-preparedness systems
4
Q
how do “worries over corpses” lead to epidemics after natural disasters?
A
- the sudden presence of large numbers of dead bodies in the disaster affected area may heighten concerns of disease outbreaks
- when death is directly due to the natural disaster, human remains do not pose a risk for outbreaks
- dead bodies only pose health risks in a few situations that require specific precautions, such as deaths from cholera.
5
Q
how do “nearby toilets” lead to epidemics after natural disasters?
A
- the risk for communicable disease transmission after disasters is associated primarily with the size and characteristics of the population displaced
- specifically the proximity of safe water and functioning latrines.
6
Q
how does “malnutrition” lead to epidemics after natural disasters?
A
- malnutrition increases the risk for death from communicable diseases and is more common in conflict-affected populations, particularly if their displacement is related to long-term conflict
7
Q
how does “lack of good tap water” lead to epidemics after natural disasters?
A
- diarrheal disease outbreaks can occur after drinking water has been contaminated and have been reported after flooding and related displacement
8
Q
how do rats lead to epidemics after natural disasters?
A
- leptospirosis is an epidemic-prone zoonotic bacterial disease
- rodents shed large amounts of leptospires in their urine, and transmission occurs through contact of the skin and mucous membranes with water, damp soil or vegetation (such as sugarcane), or mud contaminated with rodent urine
9
Q
how does “overpopulation in one area” lead to epidemics after natural disasters?
A
- crowding is common in populations displaced by natural disasters and can facilitate the transmissoin of communicable diseases
- crowded living conditions facilitate measles transmission and neccessitate even higher immunization coverage levels to prevent outbreaks
10
Q
how does “Malaria getting better at first” lead to epidemics after natural disasters?
A
- while initial flooding may wash away existing mosquito breeding sites, standing water caused by heavy rainfall or overflow of rivers can create new breeding sites.
- this situation can result (with typically some weeks delay) in an increase of the vector population and potential for disease transmission
11
Q
how does “mosquito based vector diseases doing well” lead to epidemics after natural disasters?
A
- the crowding of infected and susceptible hosts
- a weakened public health infrastructure
- and interruptions of ongoing control programs
- are all risk factors for vectorborne disease transmission
12
Q
how does “conditions which make it worse for migrants” lead to epidemics after natural disasters?
A
- communicable diseases are common in displaced populations that have poor access to basic needs such as safe water and sanitation, adequate shelter and primary healthcare services
- these conditions are favourable for disease transmission
13
Q
what do populations at risk to epidemics after natural disasters need?
A
- assuring access to safe water and primary healthcare services is crucial
- as well as surveillance and early warning to detect epidemic prone diseases known to occur in the disaster affected area
14
Q
what are the key reasons why infectious diseases usually break out following a disaster?
A
- dead bodies and disease
- displacement. infrastructure gets destroyed. mass movement of people into slum conditions (internal migration)
- water related communicable diseases (after flooding and related displacement)
- destruction of homes/infrastructure
> people move into temporary camps/slums = ↑ neighbourhood effect
> close proximity = ↑ disease spread - toilets
- healthcare and education
15
Q
what happened in Haiti in 2010?
A
- hit by a powerful magnitude 7 earthquake
- 220,000 people were killed, 300,000 injured and 1.3 mill were made homeless
16
Q
give a piece of evidence that shows Haiti is poor
A
60% of the population survives on less than $2.5/day
17
Q
where did people move after the earthquake in Haiti?
A
- hundreds of thousands of homeless people were housed in makeshift camps
18
Q
what were the living conditions for the majority of the population prior to the event?
A
- in the captial, Port-Au-Prince, prior to the EQ 86% of the population lived in slums, 50% the population had no access to toilets
- given the insanitary conditions, drinking water contaminated by sewage and overcrowding, an outbreak of cholera was inevitable
19
Q
statistics for the cholera outbreak
A
- between the initial outbreak and Nov 2014, nearly 720,000 cases of cholera were recorded, with 8700 deaths
20
Q
summarise the main reasons why cholera easily spread in Haiti
A
- situated alongside the Meille River, the UN camp hosting peacekeepers from Nepal discharged its waste directly into the river
- at the time, Nepal was suffering a cholera outbreak and the peacekeepers are suspected to have transmitted the disease through their waste.
- the river was a primary source of water for thousands of people, and lacking sanitation options, the water may have been consumed without proper treatment
21
Q
how did human factors increase disease risk?
A
- urban centres lacking water and sanitation infrastructure are especially susceptible.
- the rapid diffusion of the disease is tied to squalid conditions and insufficient health and sanitary infrastructure in earthquake ravaged Haiti.
- in areas with poor sanitation, explosive diarrhea and vomiting can accelerate the diffusion of disease.
22
Q
what strategies can be used to mitigate the disease?
A
- cholera can be prevented through careful sanitation and hygiene.
- if bottled water is unavailable, boil the water for at least one minute or treat it with chlorine/bleach
- any food, especially shellfish/seafood, should be thoroughly cooked.
- safe handwashing practices are crucial
- latrines should be located away from homes and defecation should take place at least 30 m away from a body of water.
23
Q
what environmental factors helped this disease spread?
A
- rainfall and flooding spread contaminated water
- however, this wasn’t a sig factor in Haiti’s initial outbreak since rainfall was low when earthquake hit in October 2010
- it was later on Nov 5th 2012 that Hurricane Tomas caused rapid flooding
= overflowing latrines, further spreading infected water.
24
Q
why is hurricane Tomas significant?
A
- mass flooding = disease spreads considerably
- ↑ destruction of infrastructure/houses
- camps/slums flooded
(- tropical storm, synoptic link)
25
what social/economic factors helped this disease spread?
- importance of Artibonite River within people's day to day lives was a major factor in why initial outbreak was so severe. common practice of growing rice in paddy fields and reliance on river for fishing/transportation. ↑ exposure to contaminated water
- poverty - stricken nature of Haiti = significant lack of access to safe drinking water + basic sanitation prior to EQ. only **17%** of Haitians had access to proper latrines = problem ↑ by damage to infrastructure from EQ.
- large numbers of people forced to use rivers for all their water needs, including drinking, cooking, washing and alternative latrines
- lack of general awareness + importance of sanitation techniques e.g. hand washing/disposal of human waste
- most medical facilities = poorly funded and ill equipped to sufficently treat epidemic of this scale. also lacked space/facilities to contain spread of diseas among their patients.
26
how did the Artibonite River impact the cholera outbreak negatively?
- importance of Artibonite River within people's day to day lives was a major factor in why initial outbreak was so severe.
- common practice of growing rice in paddy fields and reliance on river for fishing/transportation.
- ↑ exposure to contaminated water
27
how did poverty impact the cholera outbreak negatively?
- poverty - stricken nature of Haiti = significant lack of access to safe drinking water + basic sanitation prior to EQ.
- only **17%** of Haitians had access to proper latrines = problem ↑ by damage to infrastructure from EQ.
28
how did large numbers of people impact the cholera outbreak negatively?
- large numbers of people forced to use rivers for all their water needs, including drinking, cooking, washing and alternative latrines
29
how did lack of general awareness impact the cholera outbreak negatively?
- lack of general awareness + importance of sanitation techniques e.g. hand washing/disposal of human waste
30
how did medical facilities impact the cholera outbreak negatively?
- most medical facilities = poorly funded and ill equipped to sufficently treat epidemic of this scale.
- also lacked space/facilities to contain spread of diseas among their patients.
31
what were the IMPACTS of cholera following the natural disaster?
- EQ earlier in the year led to high levels of **internal migration** = helped to spread the disease across the country
- migrants often lived in temporary accomodation e.g. emergency camps/staying with extended family. = overcrowding in poor quality accomodation ↑ likelihood of transmission. accomodation rarely had access to clean water/latrines.
- between Oct 2010-2014 there were more than 720,000 cases of cholera in Haiti, with a total of 8,700 deaths (actual number may be higher due to difficulties in obtaining data in remote areas).
32
how did the EQ enhance the impacts of cholera?
EQ earlier in the year led to high levels of internal migration = helped to spread the disease across the country
33
how did temporary accomodation enhance the impacts of cholera?
- migrants often lived in temporary accomodation e.g. emergency camps/staying with extended family.
- = overcrowding in poor quality accomodation ↑ likelihood of transmission.
- accomodation rarely had access to clean water/latrines.
34
in numbers, what was the impact of cholera on Haiti?
- between Oct 2010-2014 there were more than 720,000 cases of cholera in Haiti, with a total of 8700 deaths
- (actual number may be higher due to difficulties in obtaining data in remote areas).
35
what strategies were used to mitigate this disease? who was involved in doing this and why?
- large scale response from the **UN, aid organisations and medical relief groups**
- direct need to save lives
- while at the same time it was of utmost importance to halt the spread of disease
- direct treatment implemented via specialised cholera treatment centres to relieve the overburdened hospitals
- these programmes found themselves overwhelmed with patients
- local hospitals and clinics recieved additional training
- reducing the spread of infection was even larger task. widespread health awareness campaign launched.
- aid groups also launched campaigns focused on the importance of boiling/chlorinating water, and supplied chlorine tablets to rural communities
- **HUGE SUCCESS!!!**
- infection rates plummeted in 2011
- mortality among cholera victims ↓ from 10% in october 2010 to less than 1% from jan 2011 onwards
36
who was involved in the strategies mitigating against cholera?
- large scale response from the **UN, aid organisations and medical relief groups**
- direct need to save lives
- while at the same time it was of utmost importance to halt the spread of disease
37
how were overburdened hospitals relieved during the cholera outbreak?
- direct treatment implemented via specialised cholera treatment centres to relieve the overburdened hospitals
- these programmes found themselves overwhelmed with patients
- local hospitals and clinics recieved additional training
38
how did organisations tackle reducing the spread of infection?
- reducing the spread of infection was even larger task. widespread health awareness campaign launched.
- aid groups also launched campaigns focused on the importance of boiling/chlorinating water, and supplied chlorine tablets to rural communities
39
were the strategies used to mitigate against cholera successful?
- **HUGE SUCCESS!!!**
- infection rates plummeted in 2011
- mortality among cholera victims ↓ from 10% in COt 2010 to less than 1% from jan 2011 onwards
40
