WORLD HEALTH ORGANIZATION
Global Task Force on Cholera Control
CHOLERA COUNTRY PROFILE: HAITI
Last update: 18 May 2011
General Country Information:
The Republic of Haiti is located in the western part of
the island of Hispaniola, in the Greater Antillean
archipelago. It shares border with the Dominican
Republic located in the Eastern part of the island. Haiti
is divided in 10 departments further divided into 41
arrondissements. Port-au-Prince the capital, is the
largest city of Haiti.
The natives of Hispaniola known as Taino were
invaded by Spanish settlers after the discovery of the
island by Christopher Columbus in 1492. The French
th
established a presence in the beginning of the 17
century.
In 1697, the western part of the island (which later became Haiti) was given to the French by Spain. The French colony quickly became
wealthy due to profits from the sugar-related and coffee industries. Many African slaves were brought and significant environment
degradation occurred during that time.
Haiti gained its independence from France in 1804 after a revolt from the slaves. It was the first independent nation in Latin America.
Haiti politics have gone through a lot of turmoil in the past 200 years. The country suffered 32 coups and has a long history of
oppression by dictators. Long years of political instability left the country with huge social and economic problems. In January 2010, a
magnitude 7.0 earthquake struck Haiti with an epicentre about 15 km southwest of the capital, Port-au-Prince leading to 220 000 deaths
and the destruction of most of the infrastructure.
Before the earthquake, many Haitian households lacked running water and lived in inadequate housing and unsanitary conditions. This
situation aggravated after the earthquake. A large majority of the population are at a high risk for major infectious diseases and only a
few have access to basic health care. The chronic shortage of health care personnel, and hospitals lack of resources, became even
more so apparent after the earthquake.
Cholera history in the region:
th
The last major cholera outbreak in Latin America started in Peru in 1991when the continent was hit by the 7 pandemic . The outbreak
th
spread to many neighbouring countries. However Haiti and the Caribbean did not record any case during that phase of the current 7
pandemic.
Cholera Outbreak in 2010/2011:
The first cholera cases in Haiti started to be reported on 14 October 2010 in the department of Artibonite from where the outbreak rapidly
spread along the Artibonite river affecting several departments. Within one month, all departments reported cases (see map) with a high
case fatality rate in remote rural areas and areas with difficult access to health services. On 20 October 2010, Vibrio cholerae O1 Ogawa
was laboratory confirmed. The identified variant strain is also present in several countries in South East Asia and Africa.
As of 31 December 2010, a total of 179'379 cases including 3'990 deaths (CFR 2.2%) were reported in all 10 departments including
Port au Prince. This represents 61% of all cases reported as of 3 May 2011 and 80% of all deaths. In the beginning of November 2010
the overall case fatality rate (CFR) in hospitals was 3.8%. This high CFR reflects the lack of experience of the healthcare system to deal
with case management as well as the fact that patients reached the health facilities too late.
The rapid spread of the disease was mainly due to the lack of immunity and the very limited access of the population to safe water and
basic sanitation in a context of internal migrations after the January 2010 earthquake. A limited spread was observed in internal
displaced persons camps with access to water and sanitation. In November 2010 the first cases were detected in the neighbouring
country Dominican Republic which reported in some areas a local transmission with a total of 191 lab confirmed cases in 2010.
16000
Artibonite
weekly cholera cases
1 Nov - 1 May 2011
Port-Au-Prince
weekly cholera cases
1 Nov - 1 May 2011
6000
Port-Au-Prince
Artibonite
14000
5000
12000
4000
cases
8000
3000
6000
2000
4000
1000
2000
0
week
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week
WORLD HEALTH ORGANIZATION
Global Task Force on Cholera Control
CHOLERA COUNTRY PROFILE: HAITI
Last update: 18 May 2011
HAITI
weekly reported cholera cases
1 Nov 2010 - 1 May 2011
30000
Cases
25000
Nb of cases
20000
15000
10000
5000
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WHO Support Actions in 2010/2011 include among others:
•
•
•
•
•
As health cluster lead, ensured coordination of emergency activities and developed together with partners (Ministry of
Health and Population, Cuban Medical Brigade, Centres for Disease Control, NGOs and others, a contingency plan for
next steps (surveillance, alert & response, and departmental coordination). A plan for deployment of staff and supplies
during the early phase of the outbreak into areas that are difficult to access was also developed.
Deployment of staff (epidemiologist, field coordinator, logisticians, communication specialists)
Distribution of large amount of medicines and supplies
Distribution of cholera-related posters and pamphlets; training of health workers in cholera diagnosis, case
management and prevention at health centres
Developed training sessions with engineers from the MSPP, focusing on setting-up of CTCs and CTUs, management
of infection control and hygiene
Demographic and Socio-Economic Data:
Geography
Environment
Total surface
Capital
Provinces
Climate
Rainy season
Floods and droughts
Desertification
Demographics
Economy
Health
Indicators
Communicable
Diseases
Risk Factors
for Cholera
Natural resources
Population
Religions
Ethnic groups
Official Language
Industry
27, 750 m2 (coastline of 1'771km)
Port au Prince (population: 704'776 in 2003 )
10 departments
Tropical; semiarid in mountains
Summer, and mid-winter (February)
Lies in the middle of the hurricane belt and subject to severe storms from June to
October; occasional flooding and earthquakes ; periodic droughts
Extensive deforestation (much of the remaining forested land is being cleared for
agriculture); soil erosion; inadequate supplies of potable water
Bauxite, copper, calcium carbonate, gold, marble, hydropower
9,446,0001 (annual population growth rate: 0.787%)
Catholic 80%, Protestant 16%, none 1%, other 3%
African 95%, Mulatto and Caucasian 5%
French and Haitian Creole
Textiles, sugar refining, flour milling, cement, light assembly based on imported
parts
coffee, mangoes, sugarcane, rice, corn, sorghum; wood
96 (2006)
Farming
Per capita total
expenditure on health (int'l$)
Life expectancy birth (yrs)
Males: 59
Females: 63
Under 5 mortality (per 1000) Males: 83
Females: 77 (2006)
Access to healthcare
Hepatitis A and E, typhoid fever, diarrheal diseases, dengue fever, malaria, leptospirosis (2009)
HIV prevalence (2005): 3.37%
Population with sustainable access to improved drinking water sources
58% (2006)
Population with sustainable access to improved sanitation
19% (2006)
Prevalence of undernourishment in total population (% of population)
58% (2006)
Sources for Document: WHO, UNHCR, UNICEF, UNDP
The Cholera Task Force country profiles are not a formal publication of WHO and do not necessarily represent the decisions
or the stated policy of the Organization. The presentation of maps contained herein does not imply the expression of any
opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or areas or its authorities, or
concerning the delineation of its frontiers or boundaries.
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