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This document has been prepared to share the 10-year experience, from 2010 to 2020, that UNICEF staff and their partners have accumulated in fighting cholera in Haiti. This guidance document has the objective of providing WASH, Health, Communication for Development and Emergency sectors staff with insights and tools in dealing with a wide-scale cholera epidemic. Although the case of Haiti is particular in many respects, the implemented strategy and lessons learnt from the alert-response approach will be applicable in a number of contexts.

Reducing the risk of cholera transmission is not solely about treating the sick, disinfecting patients’ homes, ensuring that water and sanitation services are safe, or even promoting safe hygienic habits, it is all those at the same time, and in the most integrated and time-efficient manner possible. Time here is really of the essence; responding to every potential cholera case as fast as possible and implementing the alert-response approach has been instrumental in terms of reducing the transmission. Reactivity to all suspected cases was indeed essential, as a single undetected case has the potential to reignite the epidemic.

Today, Haiti has not seen a confirmed case of cholera for a year and a half (last positive case was in February 2019), there is cautious optimism that Haiti may have won this war against cholera. However, continued surveillance remains essential to ensure not a single case slips through the cracks.

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