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Investigation of diarrheal disease outbreaks post hurricane Matthew in Haiti

I was working for 8 weeks in Les Cayes, South department of Haiti, to assist the local government in the response to cholera and desyntery outbreaks which followed a disastrous Matthew hurricane in autumn 2016.

After my long sabbatical leave to travel across South America in 2015-2016, I applied to the WHO Global Outbreak Alert and Response Network (GOARN) to help in a humanitarian crisis in Haiti, which followed the disastrous hurricane Matthew. In October 2016, the hurricane destroyed most houses, health facilities, water sources, and caused inundations. This in turn led to the reemergence of cholera and other waterborne diseases. When I arrived in February 2017, the most urgent needs related to clean water supply were covered by huge international mobilisation, and the cholera outbreak was well under control. I observed that there was also increasing reports of bloody diarrhoea cases in the southern provinces. With other colleagues from international organisations, I organised two investigations in South and Grand'Anse provinces, which revealed a massive outbreak of desyntery, which developed in the same time as cholera, but because of everyone focusing on cholera, and because of poor surveillance, it was not properly handled.

Why does it matter?

In a humanitarian crisis situation, there are many needs, not only related to health. After the hurricane Matthew, people lost their houses, their crops and their access to clean water. Therefore, humanitarian organisations focused on providing temporary shelters, clean water and food. The World Health Organisation correctly idenitified cholera as an immediate threat, since it can lead to large epidemics and high mortality. My investigations showed that sometimes even a well coordinated response can hide important health problems, when everyone's attention is focused on one disease.

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