海地霍亂可能蔓延到美國 1.64億美元控制計劃已定案

The United Nations and its partners have finalized a $164 million plan to support the government of Haiti's response to the current cholera epidemic. To date, more than 12,000 Haitians have been hospitalized, and over 800 people have died, the UN reports.

The Cholera Inter-Sector Response Strategy for Haiti includes projects from 42 nongovernmental organizations, five United Nations agencies, and the International Organization for Migration, in support of the Ministry of Public Health and Population, which is leading the response.

The cholera epidemic is Haiti's first in 50 years. First confirmed on October 22 in Artibonite province, north of the capital Port-au-Prince, it has spread rapidly.

On Tuesday, Haiti's Ministry of Health said 73 cases had been reported in Port-au-Prince, a city of three million people. Displaced by the January earthquake,1.3 million people live in makeshift camps spread across 1,300 sites.

Ezra Barzilay, an epidemiologist with the U.S. Centres for Disease Control and Prevention, told colleagues at a medical conference in Biloxi, Mississippi by phone from Haiti Thursday that U.S. health officials worry cholera could spread from Haiti to the United States, which is only two hours away by plane.

Barzilay is working in Haiti to set up a nationwide database that will help Haitian health officials to track cholera cases.

The Florida Department of Health issued a warning to doctors on November 2, saying, "An ongoing epidemic of cholera in Haiti may result in introduction of cholera cases to Florida."

The department said, "Travel to and from Haiti has increased since the Haitian earthquake; this includes local Haitian residents visiting family in Haiti and relief workers who travel to and from Haiti via Florida. As a result, we can expect that some travelers returning from Haiti may become symptomatic with cholera en route to, or shortly after arrival in Florida."

If Haiti's cholera epidemic follows a pattern similar to the last cholera epidemic in the Americas, it could produce tens of thousands of additional cases over the next several years, said Dr. Jon Andrus, deputy director of the Pan American Health Organization, a regional division of the World Health Organization.

The last cholera epidemic in the Western Hemisphere began in Peru in 1991 and spread to 16 other countries, from Argentina to north to Canada. Florida had 25 cases from 1991 through 1997, said the Department of Health.

In Peru alone, the epidemic produced more than 650,000 cases over six years.

Dr. Andrus said a similar pattern would produce upwards of 270,000 cases in Haiti.

While Hurricane Tomas just nicked Haiti as a Category 1 storm on November 5 instead of striking the island country a solid blow as many had feared, the storm still caused major flooding, and that has increased the risk of cholera, which is a waterborne disease.

"While the impact of Hurricane Tomas was not as immediate or severe as many had feared, Dr. Andrus said on Tuesday. "We have every reason to expect that the widespread flooding has increased the risk of cholera spreading."

The effects of this could become apparent through a spike in cases in the coming days but Dr. Andrus warns that this cholera epidemic could last for years.

"We have to think about and plan for the long term," he said. "The bacteria have a foothold in the rivers and the water system, so it will be there for a number of years."

Even before the earthquake last January, Port-au-Prince had inadequate water and sanitation infrastructure and crowded living conditions in many areas. Now, says Dr. Andrus, conditions in the city are "very ripe for rapid spread of cholera."

This week, Haitian health authorities declared the epidemic "a national security problem."

As cholera spreads through Haiti, protestors marched in Port-au-Prince Wednesday to denounce the UN peacekeeping mission in Haiti, MINUSTAH.

It has been discovered that the Nepalese battalion of MINUSTAH allowed their latrines to overflow into a river in Haiti's Central Plateau. Although no tests have proven definitively that the cholera in Haiti came from these soldiers, the Nepalese arrived in October, only weeks after an outbreak in Nepal, and the strain of cholera in Haiti has been defined as coming from South Asia, according to alternative media project Bri Kouri Nouvel Gaye.

Until speculation is replaced with confirmed facts, the frustration and anger among the population grows.

The UN's new strategy anticipates that up to 200,000 people will show symptoms of cholera ranging from cases of mild diarrhea to the most severe dehydration. This number was calculated based on other countries' experiences, and calculations by the Pan-American Health Organization/World Health Organization and the United States Centers for Disease Control.

Epidemiologists anticipate that the disease will continue to spread throughout the country and resources will need to be mobilized for at least six months.

The new strategy includes public communications outreach, rapid operational response, access to health services for those affected, disease surveillance, supporting and strengthening the national response, ensuring clean water, and providing safe sanitation and waste management for high risk areas.

The largest financial component of the strategy is $89 million for water, sanitation and hygiene, followed by $43 million for health services and $19 million for camp coordination and camp management.