Since an outbreak of cholera was first detected in the Artibonite region of Haiti on October 21, 2010, more than 3,000 people have died and the outbreak is far from over. The current Haitian population, having never been exposed to cholera, lacks any immunity to the disease.
Cholera is an infection of the intestinal tract caused by a small bacterium, Vibrio cholerae. The bacterium can be found in untreated water that has been contaminated with human feces. Individuals become infected by drinking contaminated water or eating food that has been rinsed in it. Cholera causes severe acute diarrhea by increasing the motility of the intestines, causing them to shed water and other important nutrients. Death can occur within just three hours due to severe dehydration .
It is the waterborne nature of cholera and other diarrheal diseases that causes so much misery worldwide. Outbreaks of waterborne diseases often occur in times of crisis, when natural disasters, civil wars and mass refugee movements create concentrations of people. In these circumstances, individuals often live in poor conditions with limited access to clean water, proper latrines and medical care. Close quarters and contamination of available water, through runoff from sewage and latrines, creates a perfect storm for a severe and rapid outbreak. Last year’s earthquake in Haiti, a country already lacking in clean water and basic sanitation, created just such a situation.
While those in developed nations may consider diarrhea an inconvenience or source of embarrassment, it is the second leading cause of death in children worldwide, killing more than 1.5 million children every year. In total, it causes four per cent of all deaths worldwide, which is more than AIDS and malaria combined. Adding to the tragedy is the relative ease at which it can be treated if only the proper infrastructure and access to medical supplies existed. Organizations like UNICEF and the WHO are promoting the use of Oral Rehydration Therapy, a simple mixture of salts and sugars with clean water. During a severe infection, the body simply cannot absorb enough water to stay hydrated, but the salts and sugars in rehydration mixtures help the body absorb much needed water and nutrients. Worldwide, the use of rehydration therapy has brought the number of deaths due to diarrhea from 4.6 million in the 1980’s to 1.5 million today.
The occurrence of waterborne disease outbreaks touches on so many complex political issues: access to clean water, sanitation, access to medical care and proper nutrition. But increasing awareness of the factors that contribute to these outbreaks and educating individuals about simple treatment solutions has contributed much to the control of devastating waterborne illnesses.