“Conquering Cholera in Haiti and the Dominican Republic” – Panel Discussion

By Nic Johnson, Undergraduate Research Assistant

On October 24, 2013, Representative Barbara Lee (CA) and the Global Health Caucus hosted “Conquering Cholera in Haiti and the Dominican Republic: The Untold Story of Progress” at the Rayburn House Office Building in Washington, D.C. The briefing featured representatives of public health organizations and advocacy groups to discuss new policy initiatives and partnerships for the elimination of cholera in Hispaniola.

Karen Goraleski, Executive Director of the American Society of Tropical Medicine and Hygiene, introduced the background of the event, a “call to action” in January 2012 that began a partnership between Haiti, the Dominican Republic, and a group of more than 20 international organizations to eliminate cholera on the island of Hispaniola by 2022. This international coalition led to the creation of the 2013 National Plan for the Elimination of Cholera in Haiti.

One of the lead organizations of the partnership is the Pan American Health Organization, represented by Director Dr. Carissa Etienne who gave the keynote address. In her address, Dr. Etienne stressed the development of Cholera as not only an illness in Haiti, but a risk for pandemic infection throughout Hispaniola and surrounding countries in Latin America. Although she did not address the source of the outbreak, Dr. Etienne traced its devastating spread to “decades of under-investment [in water and sanitation systems] in the most underserved country in the Western hemisphere.” Dr. Etienne cited that only 59% of Haitians have access to improved drinking water and current studies found “50% of improved (treated) water sources are still infected in the Artibonite valley region.” Her recommendation, following the National Plan, was to expand national water and sanitation capacity through state run programs funded presumably by international donors.

After Dr. Etienne’s remarks, Dr. Rick Gelting of the Centers for Disease Control and Prevention, began the panel discussion by stressing that the reach of cholera in Hispaniola was due to the “lowest rates of water sanitation in the Western Hemisphere.” Dr. Gelting promoted the National Plan and its implementation by the National Water and Sanitation Directorate (DINEPA), a coordinating organization directed by the national Ministry of Public Works and funded chiefly by international donors. Dr. Gelting characterized DINEPA as “arguably the best” model of rural water sanitation management.

The panel continued with Dr. Katherine Bliss of the Center for Strategic & International Studies. Dr. Bliss focused on long-term national sustainability as the most important goal of cholera alleviation and promoted international funding and cooperation with the DINEPA organization to achieve it.

Bringing in the United States legislative prospects, Elynn Walter of the WASH Advocates group was next. Walter encouraged the expansion of the United States involvement and funding of water and sanitation projects through the “Water for the World Act” to integrate the programs that already exist in US development projects into one cooperative institution.

The most interesting component of the event was the inclusion of Dr. Ralph Ternier, a Haitian physician affiliated with Partners in Health. Dr. Ternier thanked the organizations that invited him to speak, but said that he “would prefer to be in Haiti” to continue treating patients. Dr. Ternier’s comments were thankful for international involvement, but stressed the immediate priority of vaccines and education programs that allowed Haitian doctors to finally recognize and treat Cholera over long term planning. Dr. Ternier was optimistic about progress, but stated the “battle against the disease is not even close to being finished.”