From: "Jim Wilson, MD" <iceaxe5@gmail.com>
Sent: Nov 28, 2010 8:09 PM
To: Haiti Epidemic Advisory System <haiti-epidemic-advisory-system@googlegroups.com>
Subject: A Note of Serious Concern From a Senior HEAS Member
Dear HEAS,
I share the below commentary from Dr. [REDACTED], an esteemed colleague here in the HEAS community with years of experience working for the World Health Organization and having lived in Haiti for many years as well. His thoughts are a treasure to many of us, and he was initially reluctant to share the below commentary with the group. I told him I believed many of us in the HEAS have these same thoughts. While we have made substantive efforts to remove political commentary from the HEAS in order to emphasize operational communication, it is nevertheless important to recognize a perception things may not be going so well...
One month after the cholera outbreak started, it's my feeling, as an epidemiologist, that there is something terribly lacking in the actions of the health community, both national and international.
In large-scale catastrophies, the pressure, at the same time human, humanitarian, political and mediatic, on the deciders to show determination and visible action is overwhelming. And in the absence of quick results, they know they will be blamed anyway.
In the case of the cholera epidemic in Haiti, the overwhelming pressure is to do everything possible to treat the sick and prevent deaths. Unfortunately, the context is daunting: impossible logistics, with scattered, isolated habitats all over the country; poor roads and few transport facilities, an uninformed populace; an insufficiency of health resources, both human and material. As a result, the best curative efforts, costing millions, are only a rearguard action, while the endemic spreads.
This is frustrating, as cholera is an easily preventable disease, provided the correct information and the cheap means of prevention are supplied to the individuals. This would be feasible in Haiti through a well-conceived mass information campaign, based on focused, simple messages, with a wide distribution of inexpensive water purification tablets. It should not deter the current curative efforts, the main ingredient being leadership, more than money.
Unfortunately, this is not even started. The public is largely left to itself, trusting desperately ineffectual preventive cure-alls... Barring a mass information campaign, expect the epidemic to go on, with its trail of suffering and deaths, and to establish itself endemically.
Personally, I could not agree more with Dr. Dresse's sentiments and welcome the community's thoughts.
Cheers,
Jim
James M. Wilson V, MD
Haiti Epidemic Advisory System (HEAS)
Executive Director
Praecipio International
Washington-Houston-Port au Prince
Praecipio International is a charitable non-profit organization devoted to the promotion of operational biosurveillance worldwide.
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