RENEE MONTAGNE, HOST:
It is the rainy season in Haiti. That's making it even harder for aid workers trying to contain a 4-and-a-half-year-old cholera outbreak that followed the massive earthquake in 2010. Recently, there's been a disturbing spike in new cases, from about a thousand a month to a thousand a week. To find out more, we reached Dr. Louise Ivers. She's the senior health advisor for Partners in Health. Thank you for joining us.
DR. LOUISE IVERS: You're welcome. It's nice to be here.
MONTAGNE: Cholera arrived in Haiti in October of 2010, and, at that point, aid poured in. So why is it not under control at this point in time?
IVERS: Well, I think one of the reasons why it's not in control yet is really quite fundamental. One of the things you need to control cholera is that you have to have good water systems and good sanitation systems. And although there has been some progress in that regard in Haiti over the last four and a half years, there really has not been the kind of transformative change that needs to happen. Most poor people living in the countryside or living in the urban slums, they don't have a place to go to the toilet and that just leads to cases of diarrheal disease, and especially cholera now that cholera is there in the country.
MONTAGNE: From what you say, then it seems like cholera would never be defeated.
IVERS: Well, it certainly can be defeated. Actually it's very simple. We know exactly what to do. Cholera is transmitted from contaminated water, contaminated food. And it's basically a question of keeping the poop separate from the water and the food. Unfortunately though, when you don't have good access to latrines and you don't have access to soap - and it's hard for a lot of people to understand or even believe, but so many Haitians are so poor that they're literally choosing between buying soap one day or buying food for their family or for their children.
MONTAGNE: Why didn't all the money that poured in after the earthquake of 2010 go towards building toilets?
IVERS: Yeah, I think a lot of it did go towards building toilets. And what you see is that, as is probably true in many humanitarian disasters, you see a huge influx of assistance and aid and resources in the early months, in the early weeks, and then it very quickly peters off. Some of that is just lack of attention and people in organizations become interested in the next disaster or the next emergency. And some of it is just that the amount of resources needed are quite tremendous. The Haitian government and the Dominican Republic governments worked together and put a plan for how they could eliminate cholera, and it came up to be about $2.2 billion over 10 years. So they've been seeking funds for that and have received only about 15 percent of what they need to try to really deal with the issue.
MONTAGNE: Well, there is a campaign to vaccinate against cholera in Haiti. Are you satisfied with how that is going? Is that going to make a difference?
IVERS: Well, we at Partners in Health were leaders in trying to introduce the cholera vaccine to Haiti back in 2010. We argued very strongly for that to happen. And we vaccinated 50,000 people, and our colleagues in Port-au-Prince vaccinated another 50,000, and the vaccine was definitely effective. And thankfully, after those campaigns, the government and other organizations followed our lead and began to vaccinate others. But unfortunately, you know, there's 10 million people in Haiti and only about 300,000 or 400,000 people have been vaccinated so far.
MONTAGNE: The transformation that you've said is needed hasn't happened. Hard to envision a dramatic turnaround on the part of the aid community so it will probably not happen immediately. So where to from here for those people?
IVERS: We can't really lose hope. We just have to try to deal with the issues as we're faced with them, if you understand. So we continue to advocate for resources. We continue to try to be advocates for the poor and for people suffering from cholera and deal with the patients we see and keep hope that we're going to be able to find what we need to take care of the problem in the long term.
MONTAGNE: Well, thank you for joining us.
IVERS: Thanks very much.
MONTAGNE: Dr. Louise Ivers led the response to the cholera epidemic as the senior health advisor for Partners in Health. She's also a professor at Harvard Medical School. Transcript provided by NPR, Copyright NPR.