dimanche 7 novembre 2010

At least four dead as Hurricane Tomas hits Haiti

By Joe Mozingo

Saturday, November 6, 2010; 1:01 AM
PORT-AU-PRINCE, HAITI - At 6 a.m. Friday, Roseanna Nicolas, 50, heard screams from the road. She looked out her door to see a sheet of tea-colored water streaming down the road.
Nicolas, her husband and four teenage children ran for higher ground as the water gurgled into their newly built patchwork home.
The Rouyonne River had burst its banks and was now flowing right through the center of the town that was closest to the epicenter of a devastating January earthquake. Camps filled with refugees of one disaster were now inundated with two to three feet of water.
But by the afternoon, Nicolas was in good cheer, with a great toothy smile.
"God could have had it happen last night, and we wouldn't have escaped," she said. "Instead he had it happen during the day, so we could see it and get out."
Her original house fell to the ground with the rest of this old sugar plantation capital in the quake. The family of six barely escaped alive. They picked up what they could from the ruins and found a patch of open land under a mango tree behind an abandoned maternity hospital.
They started with tarps and sticks, and over 10 months built a little two-room house covered with dented squares of salvaged tin. Now they were hunkered down inside the hospital, grateful to have escaped.
On Friday, Hurricane Tomas passed to the west, flooding several cities and causing much anxiety but sparing a direct hit at a time when more than 1 million people remain in tent camps after the Jan. 12 earthquake. By evening it was north of the island nation.
If anything, Tomas reminded the world how vulnerable Haiti remains.
Haitian radio reported four deaths. But government officials and foreign aid groups had been warning of a much greater catastrophe, particularly in Port-au-Prince, where most of the homeless live.
- Los Angeles Times

US military flies over Haiti to view storm damage


The Associated Press
Saturday, November 6, 2010; 11:44 AM
WASHINGTON -- The U.S. military on Saturday began flights over Haiti to assess the damage caused by Hurricane Tomas.
Flights off of the amphibious assault ship USS Iwo Jima will help pinpoint the worst-hit areas and those where people most need relief, U.S. Southern Command spokesman Jose Ruiz said.
The Iwo Jima arrived off Haiti's coast Friday with eight Marine Corps helicopters and two Navy helicopters that could also be used later to help deliver relief supplies. In a telephone interview from Miami, Ruiz said that the damage assessment flights were requested by Haiti's government, and that was all that had been asked for so far.
The State Department has said it has enough blankets, plastic sheeting, hygiene kits and other relief supplies in place throughout Haiti to help as many as 125,000 storm victims. If those supplies aren't enough, there are more warehoused in Miami.
The U.N.'s World Food Program has stockpiled food around Haiti and on a barge off the coast.
The Iwo Jima had been on a humanitarian mission to eight Caribbean and Latin American nations since mid-July, when it was ordered to divert from Suriname to Haiti for the storm emergency. It has more than 500 Marines on board as well as about 1,100 uniformed and civilian workers, including engineers and doctors.

As Haiti suffers, the world dozes

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Saturday, November 6, 2010; 6:50 PM
LEVELED BY AN EARTHQUAKE, staggered by a cholera outbreak and, now, lashed by a hurricane, Haiti remains a country in dire need of critical care and sustained aid. Instead, it has been shoved once again onto the backburner of international neglect and left to its own misery.
Rebuilding Haiti after the cataclysm of last January's earthquake was never going to be easy or quick. The Haitian government, already feeble, was decimated; 28 of the 29 ministry buildings in Port-au-Prince were destroyed. At least a third of the nation's civil servants, and an even higher percentage of senior officials, died in their offices when the afternoon quake struck. The finance minister reported for work the next day despite the fact that his school-aged son had been killed.
A muscular international relief effort, supplementing and in most cases supplanting the government, managed to save lives and furnish enough food, water, shelter and medicine to preserve a minimum living standard for perhaps 2 million homeless immediately after the quake. With the help of battalions of nonprofit relief organizations and a surge of aid from wealthy nations - including more than $1 billion in emergency aid from the United States - Haiti was stabilized to a degree and left to the grim business of combing through the rubble for its dead.
Then, in the spring, the TV crews disappeared, and so did the momentum of international spending and relief. Ironically, this took place shortly after a U.N. conference in New York where nearly 60 donor nations and multilateral organizations pledged billions of dollars to rebuild the country.
The precise dollar figure was always squishy; $5.3 billion was first promised and later adjusted to $6 billion. But even by the inexact standards of such pledges, the contrast between the self-congratulatory conference and the subsequent absence of urgency in rebuilding the Western Hemisphere's poorest, unluckiest nation is inexcusable.
Of the billions pledged at the United Nations to rebuild Haiti, barely a fifth of the total, around $1.3 billion, has been approved or dispersed by donors. In some cases - including, scandalously, in the United States - all or part of the funds has been held up by lawmakers or bureaucrats. Of the $1.15 billion Washington promised for long-term reconstruction projects, only a trickle has been received so far in Haiti.
The main problem with American reconstruction funding is that the administration and Congress have treated it as business as usual. The bill containing the funds was signed into law by President Obama on July 29; after that, it took almost two months for the State Department to devise a spending plan. Since mid-September, the staffs of at least four congressional committees and the State Department have been engaged in back-and-forth negotiations regarding the particulars of the funding - mechanisms to promote sound strategy, accounting, transparency and so on. On Thursday, State Department spokesman P.J. Crowley said that the U.S. funds would have to wait a bit longer until Congress and State could satisfy themselves that the money wouldn't be stolen or misused once it arrives in Haiti.
That's a reasonable concern given the country's lurid history of graft and President Ren Prval's own dismissive remarks, on a visit to Washington this year, about the risks of corruption. But the fact is that American officials and lawmakers have had since March to contemplate this question. Why is it being addressed only now?
The heart of the problem, in Washington and in other donor countires, is that rebuilding Haiti has been treated as a routine development task, akin to improving an irrigation system or extending rural electrification. This makes no sense given the extent of ruination, the scale of needed reconstruction and the ongoing humanitarian suffering in Haiti.
In and around Port-au-Prince, more than a million people still live in tent cities, scratching out a meager living. Throughout the capital and surrounding areas, huge piles of rubble remain unmoved, awaiting bulldozers. In addition to at least 230,000 people killed in the quake, hundreds of thousands were injured and maimed; many remain in need of medical care.
In Haiti itself, elections are planned at month's end, but that is unlikely to provide quick relief. The government's weakness remains a stumbling block for reconstruction. Lacking clear rules and records governing land ownership, the government has struggled to determine where to build new housing and where to dump mountains of debris. The Interim Haiti Recovery Commisssion, chaired by former president Bill Clinton and Haitian Prime Minister Jean-Max Bellerive, whose job is to set spending priorities and review reconstruction projects, is severely understaffed and lacks expertise. Even if the international aid flow were much quicker than it has been, Haiti would face enormous problems.
Foot-dragging by international donors, however, only complicates the picture. In Haiti, it is impossible to draft reconstruction plans without knowing how much funding is likely to be available. Contractors who stand ready to clear debris and rebuild infrastructure and neighborhoods have been kept waiting for weeks and months as desultory donors shuffle paper or squabble.
Now is the time for Mr. Clinton, whose vigor was apparent on the campaign trail for Democrats in the midterm elections, to play a critical role for Haiti. He should set his sights on wealthy nations whose pledges to Haiti remain unfulfilled, and he should cajole them to meet their obligations. He should prompt the Haitian authorities, too, urging them to tackle the problems of land ownership, NIMBYism and strategic paralysis that have beset clearance and reconstruction efforts in Port-au-Prince.
It's worth bearing in mind that, bad as things are in Haiti, they could get worse. Despair and disillusionment may ossify. Political violence, particularly in the context of the approaching elections, is an ever-present concern. So far, there has been no rioting in the tent camps. But in the absence of jobs and tangible improvements to their devastated surroundings, how long will Haitians accept the unacceptable?

Experts: Did UN troops infect Haiti?

En 2010, si vous travaillez dans le milieu hospitalier des grandes nations de l’Europe, vous risquez de tomber sur des bases de données ou des instruments de collections de données concernant le sida ou Haïti et Haïtien continuent à être considérés comme facteurs épidémiologiques de la maladie. Personne jusqu’à présent n’a mené une campagne pour nous enlever cette étiquette.

Aujourd’hui, nous nous trouvons devant une catastrophe de santé publique et j’ai l’impression qu’il y a une volonté manifeste de minimiser les choses. 23 décès par jour se lit comme une banalité. Des pratiques douteuses sur la prise en charge de déchets ne sont pas questionnées. Des gens venant de l’extérieur nous dit ce qui est important de ce qui ne semble pas l’être. On ne nous infantilise plus sinon on nous prend carrément pour des cons.
Des instances pointées du doigt s’érigent en juge et partis. On n’entend qu’un seul son de cloche. Le leur…Et nous nous sommes obligés de dire …chef !...oui… chef !
Ce sujet est passionnant, il ne manque qu’un passionné pour s’en occuper. Mais comment peut-on devenir passionné d’Haïti si ce n’est que pour se prouver qu’on est mieux et meilleur que l’autre en affichant sans pudeur son intimité miséreuse à la lumière de la convoitise des voyeuristes pervers ?

The Associated Press
Wednesday, November 3, 2010; 5:40 PM
PORT-AU-PRINCE, Haiti -- Researchers should determine whether United Nations peacekeepers were the source of a deadly outbreak of cholera in Haiti, two public health experts, including a U.N. official, said Wednesday.
The U.S. Centers for Disease Control and Prevention found that the strain of cholera that has killed at least 442 people the past three weeks matches strains found in South Asia. The CDC, World Health Organization and United Nations say it's not possible to pinpoint the source and investigating further would distract from efforts to fight the disease.
But leading experts on cholera and medicine consulted by The Associated Press challenged that position, saying it is both possible and necessary to track the source to prevent future deaths.
"That sounds like politics to me, not science," Dr. Paul Farmer, a U.N. deputy special envoy to Haiti and a noted expert on poverty and medicine, said of the reluctance to delve further into what caused the outbreak. "Knowing where the point source is - or source, or sources - would seem to be a good enterprise in terms of public health."
The suspicion that a Nepalese U.N. peacekeeping base on a tributary to the infected Artibonite River could have been a source of the infection fueled a protest last week during which hundreds of Haitians denounced the peacekeepers.
John Mekalanos, a cholera expert and chairman of Harvard University's microbiology department, said it is important to know exactly where and how the disease emerged because it is a novel, virulent strain previously unknown in the Western Hemisphere - and public health officials need to know how it spreads.
Interviewed by phone from Cambridge, Massachusetts, Mekalanos said evidence suggests Nepalese soldiers carried the disease when they arrived in early October following outbreaks in their homeland.
"The organism that is causing the disease is very uncharacteristic of (Haiti and the Caribbean), and is quite characteristic of the region from where the soldiers in the base came," said Mekalanos, a colleague of Farmer. "I don't see there is any way to avoid the conclusion that an unfortunate and presumably accidental introduction of the organism occurred."
Cholera, which had never before been documented in Haiti, has killed at least 442 people and hospitalized more than 6,742 with fever, diarrhea and vomiting since late October. It is now present in at least half of Haiti's political regions, called departments.
Death occurs when patients go into shock from extreme dehydration. The epidemic has diverted resources needed for the expected strike of a hurricane this week, and could spread further if there is flooding.
Suspicions that the Nepalese base could have been a source of the infection intensified Monday after the CDC revealed the strain in Haiti matches those found in South Asia, including Nepal.
But nothing has been proven conclusively, and in the meantime the case remains politically charged and diplomatically sensitive. The United Nations has a 12,000-strong force in Haiti that has provided badly needed security in the country since 2004. But their presence is not universally welcomed, and some Haitian politicians have seized upon the cholera accusations, calling for a full-scale investigation and fomenting demonstrations.
Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, said it is clear that the disease was imported to Haiti but that it is still not clear by whom or how. She said the epidemic will contain lessons for humanitarian relief work and disaster relief around the world.
"It has to be either peacekeepers or humanitarian relief workers, that's the bottom line," she said.
Mekalanos said researchers might be more aggressive in finding the source of the infection if the case was less sensitive.
"I think that it is an attempt to maybe do the politically right thing and leave some agencies a way out of this embarrassment. But they should understand that ... there is a bigger picture here," he said. "It's a threat to the whole region."
He also cast doubt on U.N. military tests released this week that showed no sign of cholera. The tests were taken from leaking water and an underground waste container at the base a week after the epidemic was first noted and processed at a lab in the neighboring Dominican Republic, U.N. spokesman Vincenzo Pugliese said.
Mekalanos said that it is extremely difficult to accurately isolate cholera in environmental samples and that false negatives are common.
The Nepalese troops were not tested for cholera before their deployment if they did not present symptoms. But health officials say 75 percent of people infected with cholera bacteria do not show symptoms and can still pass on the disease for weeks.
(Dans un communiqué de l’ONU, l’organisation internationale affirme le contraire! Pourquoi cette nuance et cette volonté de se justifier ?)
A spokesman for the World Health Organization said finding the cause of the outbreak is "not important right now."
"Right now, there is no active investigation. I can't say one way or another (if there will be). It is not something we are thinking about at the moment. What we are thinking about is the public health response in Haiti," said spokesman Gregory Hartl.
The Harvard experts said more conclusive evidence would be available following closer examinations of the genetic material in the strain.
CDC spokeswoman Kathryn Harben said in an e-mail that the center will make the full genomic DNA sequence available when it is confirmed.
"At some point in the future, when many different analyses of the strain are complete, it may be possible to identify the origin of the strain causing the outbreak in Haiti," she said.
Farmer, who co-founded the medical organization Partners in Health that is a leading responder in the epidemic, said there is no reason to wait.
"The idea that we'd never know is not very likely," he said. "There's got to be a way to know the truth without pointing fingers."
Associated Press reporter Colleen Barry in Geneva contributed to this article.

Haïti: le choléra a fait plus de 500 morts

Publié le 06 novembre 2010
Agence France-Presse, Port-au-Prince
L'épidémie de choléra qui frappe Haïti a fait plus de 500 morts, selon le site internet du ministère haïtien de la Santé.
L'épidémie de choléra, qui frappe Haïti depuis le 20 octobre,
a fait chaque jour 32 décès et 404 hospitalisations, selon les
statistiques officielles. Photo: AFP
Un précédent bilan rendu public le 3 novembre avait fait état de 442 morts et de 6742 personnes hospitalisées.
Le nouveau bilan, établi jusqu'au 4 novembre, publié sur le site internet du ministère haïtien de la Santé publique et de la Population, dénombre 501 morts et 7359 hospitalisations.
L'épidémie de choléra, qui frappe Haïti depuis le 20 octobre, a fait chaque jour 32 décès et 404 hospitalisations, selon les statistiques officielles.
L'épidémie de choléra sévit dans le pays depuis mi-octobre. Des analyses de laboratoires publics américains, rendues publiques récemment par les autorités haïtiennes, ont révélé que la bactérie responsable de l'épidémie était similaire à des souches trouvées en Asie.
Les autorités haïtiennes redoutent une nouvelle flambée du choléra à cause des inondations provoquées par le passage de l'ouragan Tomas, qui a frappé Haïti vendredi.
«Nous sommes préoccupés à cause des conditions sanitaires dans lesquelles vivent des centaines de milliers de victimes du séisme du 12 janvier», déclarait récemment une responsable du ministère haïtien de la Santé.
Selon des chiffres communiqués par les ONG, depuis le séisme meurtrier de janvier, 1,3 million d'Haïtiens sur une population totale de 10 millions vivent dans des camps de réfugiés abrités dans des tentes.
Le choléra est une maladie hautement contagieuse dont la propagation est favorisée par les défaillances des réseaux sanitaires et l'absence d'hygiène.