H5N1

Haiti: 8,105 (or more) cholera deaths as of May 5

MSPP has published another week's worth of cholera statistics on its Documentation. I confess I've been thinking of just giving up on this front, because the numbers are so obviously bogus, and no one seems to give a damn—not PAHO, not the Haitian and foreign media, not the NGOs, and certainly not the Haitian government itself.

Consider the most recent date covered in this batch, May 5. It lists total of 655,300 cholera cases seen, 326,636 cases hospitalized, and 8,105 deaths—all in the two and a half years since the outbreak began in October 2010.

But the May 5 numbers do not include any reports from Grande Anse, Nippes, Nord Est, Ouest, Port-au-Prince, or Sud Est—6 out of Haiti's 11 reporting departments. Some departments like Grande Anse seem not to have reported in weeks or months.

When MSPP releases a batch of "daily" reports, often two weeks late, the first day's numbers usually include a sharp increase in cumulative cases over the previous day's cases. This increase is unexplained; I would like to think it includes the delayed reports from laggard departments, but who knows?

Haiti has become the madwoman in the humanitarian attic, kept out of sight and never mentioned in polite company. When the screams do reach downstairs, everyone clatters their teacups and makes louder small talk...about anything but the source of the screams.

So I guess I'll keep posting those phony numbers, if only to remind myself of how the rest of the world has failed a small black nation.

Cholera cases down but disease still deadly in Haiti

Via The Miami Herald, a report by Jacqueline Charles: Cholera cases down but disease still deadly in Haiti. Excerpt:

Five months after U.N. Secretary General Ban Ki-moon promised to “use every opportunity” to push for funding to eliminate cholera from Haiti and the neighboring Dominican Republic, government officials in both nations are still waiting on donors to open their wallets. 

The feet-dragging comes as the rainy season begins and a new French study says the disease could quickly be eliminated from Haiti if investments are made to restrain transmissions. 

“Cholera is only shrinking and has not yet disappeared. But it can disappear if the fight is correctly managed,” said Dr. Renaud Piarroux, who has studied the deadly waterborne disease in Haiti since it first appeared in October 2010. 

Piarroux’s study first came to light last week when Prime Minister Laurent Lamothe was asked at Columbia University about the government’s plan to combat cholera. But he mischaracterized the report’s findings when he stated that “cholera right now is disappearing” from Haiti and the country is seeing less than three cases a day. 

Lamothe’s Ministry of Health statistics show an average of 150 cholera cases a day so far this year. Lamothe’s comments triggered a debate in Haiti about whether the government was underplaying the seriousness of the epidemic. He later backed off the statement when asked by The Miami Herald for clarification. 

“This isn’t a sign of cholera’s disappearance, but rather its persistence and the reasons are simple — funding for the cholera response has greatly declined, and the response capacity has therefore diminished,” said Jake Johnston, international research associate and lead blogger on Haiti’s relief and reconstruction for the Center for Economic and Policy Research. 

“This is now the third year that funding for cholera has diminished prior to the rainy season when cases will predictably spike leading to more easily preventable and unnecessary deaths,” Johnston added. 

Johnston said he isn’t surprised by the U.N.’s inability to mobilize funding to eradicate cholera in Haiti, where more than 654,000 have been sickened and more than 8,100 have already died. 

More than three years after the international community pledged $5.4 billion to help Haiti rebuild after its devastating Jan. 12, 2010 earthquake, more than $2 billion remains outstanding. Meanwhile, emergency cholera funds in Haiti are quickly drying up.

I try not to get too bitter and twisted about Haiti. Then again, no matter how bitter and twisted you get about Haiti, it's not enough. 

From its own government on up through the UN and the United States (which calls the shots), Haiti is run by incompetents, deadbeats, and well-tailored scoundrels. Having introduced cholera through incompetence, this sorry coalition has turned the disease into just another revenue stream.

And if the deadbeats don't cough up what they promised, too bad. Enough will still come in to keep people flying in and out of Port-au-Prince for stays in air-conditioned hotels where they will hold meetings about what needs to be done for Poor Haiti.

Haiti is not a country; it's a career opportunity for non-Haitians.

Haiti: 8,099 cholera deaths as of April 21

MSPP has posted another week of cholera statistics on its Documentation page, covering April 15 to 21. As usual, the first day of numbers after a long pause brings some unexplained extra deaths: On April 14, the death total was 8,066, but on the 15th, when only one death was reported, the cumulative total rose to 8,094. By April 21 it reached 8,099. Grande Anse, Nippes and Nord Est filed no reports during this week.

I no longer take these numbers very seriously; no one else seems to, except for fund-raising appeals, and even those are few and far between these days.

Whatever the true number of cases and deaths, neither the UN, nor its agencies, nor its individual member states care much about Haiti any more. If they ever did.

China: IFRC Earthquake Information Bulletin n° 1

Via ReliefWeb, a report from the International Federation of Red Cross and Red Crescent Societies: China: Earthquake Information Bulletin n° 1. Click through to download the complete PDF. The summary:

This bulletin is being issued for information only, and reflects the current situation and details available at this time. The Red Cross Society of China (RCSC) is in discussion the International Federation of Red Cross and Red Crescent Societies (IFRC) to determine if external assistance is needed. 

A 7.0-magnitude earthquake hit Lushan county of Ya'an city in south China's Sichuan province at 8:02 a.m. Beijing time on 20 April. The earthquake’s epicentre was monitored near Lushan county (30.3 degrees north latitude and 103.0 degrees east longitude) at a depth of 13 kms. 

Up to 29 aftershocks have been reported, with the biggest one at magnitude 5.3. As of the reporting time, at least 100 people were killed and more than 2,000 injured. Around 120,000 people are reported to be evacuated and relocated in Lushan county. 

Teams from the Red Cross Society of China (RCSC) headquarters and Sichuan Red Cross provincial branch and Ya’an Red Cross branch staff are on the way to the affected areas to conduct a needs assessment and initial relief distribution. RCSC headquarters has sent 500 tents from its Chengdu disaster response and preparedness warehouse. 

A volunteer emergency team of RCSC Sichuan branch has also departed to the affected areas with food, medicine, drinking water and other relief supplies. 

The International Federation of Red Cross and Red Crescent Societies’ (IFRC) East Asia regional delegation and Asia Pacific zone office are closely tracking the situation and ready to provide any international assistance

Cholera in Haiti takes a turn for the worse: The Lancet

Via The Lancet: Cholera in Haiti takes a turn for the worse. Excerpt:

Nearly 2·5 years after it began, Haiti's cholera epidemic is getting worse, not better, and efforts to treat the sick are desperately short of funds, say aid groups on the ground. 

Since the first reported cases in October, 2010, cholera has killed 8000 people and sickened some 649 000 more, wreaking havoc in a country bereft of effective water and sanitation systems and among a population with no natural immunity to the disease. 

Now, with the rainy season fast approaching, some fear a surge in new cases could overwhelm Haiti's ill-equipped cholera treatment centres, many of which have struggled to retain staff and replenish supplies in the face of donor fatigue and errors of perception about the state of the epidemic. 

“For those of us who are providing care to patients with cholera, the emergency phase is still ongoing”, says Louise C Ivers, a senior policy and health adviser at Partners in Health (PIH), the largest non-governmental health-care provider in Haiti. 

“It's not as dramatic as it was in 2010, but we've seen in our clinics double the number of cases early this year compared to last.” 

Ivers says that uptick observed in PIH clinics may be explained in part by the fact that many smaller non-governmental organisations (NGOs) have since pulled out, leaving more patients to those providers that remain. But it's probably also a reflection of the overall increase in cholera cases nationally. 

According to the UN Office for the Coordination of Humanitarian Affairs, 11 220 cholera cases were registered in Haiti in December, 2012—an increase of more than 3000 over the same period the previous year. 

“What's clear is that it hasn't burned itself out”, she says. “Cholera in Haiti won't just go away.” 

Nor will it stop killing people in parts of the country where treatment programmes have been crippled by a lack of funding. As Médecins Sans Frontières reported in March, the mortality rate in some treatment centres has reached an alarming 4%, the result of sharp declines in the quality of care brought on by worn-out equipment, staff shortages, poor waste-management, and a dearth of essential supplies, including everything from cots to the chlorine used to disinfect shoes. 

“Cholera is not difficult to treat if it's done promptly”, says Joan Arnan, MSF head of mission in Haiti. “But sometimes there are only two nurses to manage 50 patients. That's not nearly enough to ensure quality care.”

Haiti: 8,060 cholera deaths as of March 31 (it says here)

After a long pause, MSPP has posted another week's worth of cholera statistics on its Documentation page. I'm not sure I believe a digit of it.

Apart from the routine unexplained jump in numbers, which usually happens in the first day after a long pause, at least three departments failed to report at all during this week—Grande Anse, Nippes, and Nord Est. A couple of others went AWOL now and then.

According to MSPP, on March 31 a total of 652,730 cholera cases had been reported since the outbreak began in October 2010. Total deaths are now 8,060, with 4 of them in the last week of March (not counting 3 extra deaths slipped in on March 25). 

Back on March 1, the death tally was 8,055. It rose to 8,057 on March 4, no tally was reported for March 5, and on March 6 the deaths miraculously fell to 8,048. Since then only 6 more have been recorded in the daily count, yet Haiti ended the month with 12 more since March 6.

It really looks as if Haiti's ministry of health, in dealing with the worst cholera outbreak in the world, is pulling numbers out of the air–with the silent acquiescence of the Pan American Health Organization, countless NGOs, the media, and the various governments that fund and staff MINUSTAH, the UN babysitters who brought cholera to Haiti in the first place.

I would be abjectly grateful to be refuted, rebutted, and put in my place by anyone with knowledge of the facts. But until that happens, I'll go on thinking that Haiti and its masters have been telling us all a very implausible story.

Dr. Carroll in Haiti: "Hope keeps us alive"

John Carroll

I'm very happy to pass along Dr. John Carroll's latest blog post at the Peoria Journal Star: Hope Keeps Us Alive. It's a follow-up to his posts here, here, and here, about Marie Claude, a Haitian patient with grave heart problems:

I will spare you the gory details. At least most of them. 

Marie was granted her visa today to travel to the United States for heart surgery! She just has to hang on for a few more days. She is very very ill and we need to get home quickly. 

This week Marie was miraculously accepted by a fine medical center and a skilled heart surgeon who surrounds himself with an excellent operating and perfusion team. She will be in excellent hands and that is all we can ask. 

By the grace of God and an intense amount of dreadful work here in Port-au-Prince by a handful of driven people, things worked out. 

Thanks to the hundreds of you who have been praying that Marie would be accepted and granted a visa. (I kind of despise social media, but I probably need to get over it.) Thank you for all the very critical e mails that were urgently sent during the last six hours and for all the leg work in the dangerous streets of Port. 

Haitians say “lespwa fe viv” which means “hope keeps us alive”. Marie never lost her hope and she has even more hope today.

Haiti: 8,053 cholera deaths as of March 24

On the evening of Good Friday, no less, MSPP has posted 11 days' worth of cholera statistics on its Documentation page, taking us from March 14 to 24. As usual, the numbers are highly doubtful.

On March 13, the cumulative total of cholera cases was 650,218. On March 24 the total was 651,339, an increase of 1,121 or just about 100 cases a day for the latest period. But the daily total was 819, with no day's cases higher than March 14 (110) and most in the 60s or 70s.

During this period, MSPP reported just 2 deaths, on March 22 and 24. But on March 14, when it reported 0 daily deaths, it reported the cumulative deaths as 8,051—3 more than the 8,048 reported on March 13. 

Aggravating matters, the department of Grande Anse reported not a single time during these 11 days. Nippes department fell silent on March 21, and Nord Est department dropped out on March 22. So we have a substantial part of the country simply failing to report cases. 

In Cuba, the government clamps down on the malcontents trying to get the news out about cholera; in Haiti, no one cares. Nor, it seems, does anyone in the Haitian or foreign media. The NGOs mention cholera numbers only when they're trying to raise money from their doubtless fatigued donors. The UN and WHO maintain dead silence about the sheer unreliability of Haiti's cholera statistics.

And on Good Friday. If the crucifixion of Christ had received similar coverage, today's Christians would all be Zoroastrians or Mithrans or Druids.

Well, as the late, great Kurt Vonnegut observed in the face of irremediable harm: So it goes.

Good Friday in Haiti

Via his blog on the Peoria Journal Star, Dr. John Carroll writes: Good Friday.

It is very early Good Friday morning. 

Marie just texted me: “Dr mwn pa kapab respire bien ni donmi” (“Doctor I cannot breathe well or sleep.”) 

Jesus' actual cause of death as He hung on His cross was suffocation. Marie is having fluid from her heart backing up into her lungs, which floods her alveoli and impairs oxygen transfer. Marie is suffocating on her cross like our Lord did on His. 

Jesus had to die. Marie doesn’t. 

Jesus could text no one. Marie can. 

But our response hasn’t changed in two thousand years. 

John A. Carroll, MD 

www.haitianhearts.org

Violence, vaccine fears keep polio from disappearing

Via Dawn.com, an AFP report: Violence, vaccine fears keep polio from disappearing. Excerpt:

Sixty years after the first successful polio vaccine trial, the disease has been wiped out in much of the world, but violence, conspiracy theories and lack of cash keep it from disappearing. 

“The world is closer than ever to eradicating polio,” said Oliver Rosenbauer, spokesman for the World Health Organisation’s Global Polio Eradication Initiative. 

In 2012, there were just 223 infections worldwide, compared to 360,000 in 1988, when the United Nations launched a campaign to eliminate the highly contagious illness that causes paralysis and sometimes death, particularly in young children. 

All but six of last year’s cases were in three countries: Nigeria (122), Pakistan (58) and Afghanistan (37), according to the WHO. 

The success seen in India, which has had no new cases in two years, shows that eradicating polio is “technically feasible,” Rosenbauer told AFP. 

“So now the question is, does the world want to do this? Does it have enough political will to do this?” If the virus is not eliminated, the number of cases could return to a level of 200,000 new infections annually within 10 years, he warned. 

But efforts to end the disease face mounting risks brought on by violence against vaccine workers in the disease’s last bastions. 

In Nigeria and Pakistan, some religious figures say the vaccine contains pork, which Muslims are forbidden from consuming, or that it renders people infertile as part of an alleged Western plot to sterilise Muslims. 

Dozens of health workers have been killed in attacks on vaccination stations in recent months, particularly in remote areas – with at least 10 killed in northern Nigeria and 20 in Pakistan since December. 

In Pakistan, some believe the CIA used polio vaccines as a cover for a campaign to obtain DNA samples from people in order to root out al Qaeda chief Osama bin Laden, who was killed in a US raid in 2011. 

“There is no question that these groups fighting the polio vaccination effort are a challenge to polio eradication,” said Carol Pandak, who heads an anti-polio program at the charitable organization Rotary International. 

In order to break down hostilities, international polio workers have held meetings with local religious leaders and the governments of the countries concerned. 

The goal is to communicate on a local level “so they can learn more about the benefits of immunisation and we can hear their concerns,” said Pandak. 

But money remains a problem. Pandak said the global anti-polio campaign is short 660 million dollars in 2013, or more than half the annual budget of a billion dollars that experts say is necessary.