Haiti has received its first shipment of cholera vaccines since an outbreak was declared more than two months ago.
The first of the 1.1m doses, delivered last week, will be distributed in the capital, Port-au-Prince, and surrounding areas in the hope of stemming the spread of the disease, which has been aided by political instability and lawlessness.
“The arrival of oral vaccines in Haiti is a step in the right direction,” said the director general of Haiti’s health ministry, Lauré Adrien.
The vaccine campaign is expected to begin in the coming days and will target children and adults over the age of one in Ouest, where Port-au-Prince is situated, and Mirebalais regions, where most cases have been reported.
According to the latest health ministry data, the Ouest region saw the highest number of suspected cases last week. The vaccines have come late and will be slow to deliver.
The supplies, sent from the International Coordinating Group on Vaccine Provision, a partner of the World Health Organization that manages global vaccine stockpiles, were held up by the brutal violence engulfing Haiti, which has prevented medical supplies from reaching the Caribbean country.
NGOs say it will be impossible to send vaccines to much of the countryside as gangs control the roads out of the capital. Vaccine hesitancy is also expected to be high.
Cholera is having a global resurgence, a result of numerous humanitarian crises and global heating. “The map is under threat (from cholera) everywhere,” said Dr. Philippe Barboza, of the World Health Organization, last week as the UN said there were cases of infection in around 30 countries, whereas in the previous five years, fewer than 20 countries reported infections.
Since an outbreak was declared in Haiti in October, 13,000 people have been hospitalised and more than 300 – many of them children – have died.
Haiti’s rural hospitals are also fragile. Many facilities were forced to shut in October due to fuel shortages and at least three babies have died in hospitals in the capital due to national oxygen shortages, said Magda Cheron, from the non-profit FHI 360, who directs a USAid-funded programme to supply oxygen to public hospitals. One of the hospitals on the outskirts of the city couldn’t get oxygen because gangs blocked the road.
The latest concern is the dwindling supplies of IV fluids, which are key to rehydrating cholera sufferers.
The Sacre Coeur hospital, a private facility in Milot, northern Haiti, has managed to stay one step ahead of the disease, said its director, Harold Prévil. The slow spread across the country bought them enough time to replenish basic medical supplies from the neighbouring Dominican Republic.
“Maybe God is on our side, because we are lacking the essentials to handle a big surge,” said Prévil.
But public hospitals are not so well equipped and staff fear that fragile facilities could collapse if they are hit by a sudden increase in cases.
There is little hope supplies would be restocked quickly, said Blaise Hamidou, a water and sanitation manager at Mercy Corps.
“We have had supplies in Port-au-Prince before early September but we cannot shift those supplies to the south of Haiti, even after the reopening of the petrol port last month,” Hamidou said.
Airlink, an American non-profit that delivers medical supplies, has 56 tonnes of aid in European warehouses. It has been unable to ship them because of a lack of air cargo space, and because it’s too unsafe to be collected on the other side.
The end of the rainy season – and therefore less flooding – offers some hope in reducing infections. But the Christmas holidays and February’s carnival could lead to another rise. Rumours are also circulating that fuel prices will rise, which could bring more protests.
“It’s just one crisis to the next,” said Cappellini. “The country is dying, and we’ve no reason to think it will get better tomorrow.”