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.
Despite documented health benefits of household water treatment and storage (HWTS), achieving sustained use remains challenging. In prior evaluations of a long-term HWTS program in Haiti, multiple marketing interventions failed to increase use or had prohibitively high costs. Using mobile phones is a potentially cost-effective way to change HWTS behavior. We conducted a randomized experiment to evaluate the impact of sending short-message service (SMS) messages to promote household chlorination in this program in Haiti.
This operational guideline authored by UNICEF WASH Gregory Bulit and Monica Ramos, supports the establishment of case area targeted interventions (CATI) with dedicated community outbreak response teams (CORT) in a country affected by cholera. Annexes include tools to set-up, implement, monitor and evaluate the team responses. Inquiries: Greg Bulit and Laure Anquez.
Global Review of Water, Sanitation and Hygiene (WASH) Components in Rapid Response Mechanisms and Rapid Response Teams in Cholera Outbreak Settings
In recent outbreak settings, the use of rapid response teams (RRTs) to support the WASH sector has increased.
RRTs have been used as part of the response to cholera outbreaks in countries such as Haiti, Yemen, Somalia, South Sudan and the Democratic Republic of the Congo, with the scope of these teams varying widely. As the
presence of RRTs becomes more common in outbreak settings, it is important to better understand and document
the different types of models in use.
In the aftermath of the 2010 Haiti earthquake, Oxfam’s Public Health Promotion team used a voucher programme to provide beneficiaries with essential hygiene items through local shops. The voucher system was chosen so that beneficiaries could access hygiene items in a normal and dignified way, and in order to pilot an innovative approach to dealing with the challenges of in-kind distributions in an urban setting.
Strengthening Market Systems that Provide Water and Hygiene Items for Cholera Mitigation and Emergency Preparedness in Haiti
In the context of the cholera epidemics in Haiti, a pre-crisis market analysis (PCMA) was conducted in Artibonite to study the supply of and demand for various water- and hygiene-related items. The market analysis found that the majority of households already purchase soap from local traders, but very few have handwashing facilities in their home. A good uptake of chlorine-based disinfection products was observed, including specific products to treat water for drinking.
Introduction A cholera epidemic began in Haiti over 8 years ago, prompting numerous, largely quantitative research studies. Assessments of local ‘knowledge, attitudes and practices’ relevant for cholera control have relied primarily on cross-sectional surveys. The voices of affected Haitians have rarely been elevated in the scientific literature on the topic.
After the flood: an evaluation of in-home drinking water treatment with combined flocculent-disinfectant following Tropical Storm Jeanne — Gonaives, Haiti, 2004
Tropical Storm Jeanne struck Haiti in September 2004, causing widespread flooding which contaminated water sources, displaced thousands of families and killed approximately 2,800 people. Local leaders distributed PuR, a flocculent-disinfectant product for household water treatment, to affected populations. We evaluated knowledge, attitudes, practices, and drinking water quality among a sample of PuRw recipients. We interviewed representatives of 100 households in three rural communities who received PuR and PuR-related education.
For people affected by disaster, whether wars, earthquakes, or disease epidemics, conditions of life can change suddenly and in ways that require rapid adjustments. Often, adaptation includes taking greater care to prevent transmission of disease, in order to minimize the new threats to public health.
The Case-Area Targeted Rapid Response Strategy to Control Cholera in Haiti: a Four-year Implementation Study
Background In October 2010, Haiti was struck by a large-scale cholera epidemic. The Haitian government, UNICEF and other international partners launched an unprecedented nationwide alert-response strategy in July 2013. Coordinated NGOs recruited local rapid response mobile teams to conduct case-area targeted interventions (CATIs), including education sessions, household decontamination by chlorine spraying, and distribution of chlorine tablets.