Via the Council on Hemispheric Affairs, an interesting article by Jennifer Aron: Cuba Conceals Cholera Outbreak. Excerpt:
There is no doubt that the Cuban Ministry of Public Health issues a wealth of practicable information on cholera, including detailed books and training procedures. However, the Ministry has unyieldingly refused to distribute much of this material to the island’s residents, prompting a significant amount of scrutiny from the outside world, which is increasingly aware of this medical problem.
Cholera is easily treatable when diagnosed, with a low mortality rate, if the disease is promptly treated. Up to 80 percent of cholera cases are treatable simply through the use of rehydration salts, while less than one percent of all cases are fatal.
Having long dealt with cholera related issues, Cuba routinely has sent medical aid workers, as well as instructors, to teach professional medicine on a worldwide basis during natural disasters, in other countries ranging from earthquakes to hurricanes relief missions. In 2010, the Castro administration sent doctors and major supply shipments to Haiti to help deal with their ongoing cholera epidemic.
In 2011, Cuba’s Ministry of Public Health realized that aid workers returning from Haiti might have carried with them to the island the possibility of a future cholera outbreak. While Havana officials were fully aware of the potential danger to the health of the local population, low level officials were not sharing information with members of the community and failed to take necessary precautions.
Ironically, the Caribbean island has had a long history of rallying its people for grassroot efforts on health and national issues. During the National Literacy Campaign in 1961, the country achieved a literacy rate of 99.8 percent, with Cubans from all walks of life traveling throughout the country and teaching, on a person to person basis, people from all demographics to read.
The Pan American Health Organization (PAHO), a branch of the World Health Organization, has recommended that with the confirmation of cholera cases in Cuba: “In an outbreak situation the following measures are recommended:
• Intensified surveillance with the inclusion of active case finding.
• Laboratory confirmation to monitor the geographic spread and the resistance pattern.
• Weekly analysis of the number of cases and deaths by age, sex, geographical location, and hospital admission.”
PAHO also set out what actions Cuba must take to strengthen “public health education awareness with an emphasis on hand hygiene and safe food and drinkable water…while continuing to take action to ensure the supply of drinkable water as well as the strict control of food products.” In order to eradicate cholera on the island, Cuba needs to apply its past successful grassroots experience.I'm not sure that PAHO, after its feckless performance in Haiti, is in any position to give advice on cholera control. But the Cuban government's response has undercut its own hard-earned reputation as a leader in public health—and its credibility in general. Both organizations seem to consider political embarrassment a far graver threat than cholera.
