Team 20
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Eliminating Cholera from Haiti by 2024
Presentation prepared for the U.N. Haiti Cholera Settlement Fund
International Developoment Group’s Emergency Task ForceAbi Olvera, Akarsh Sharma, Katherine Rich, Theresa Bailey and
Sohini Sircar
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• Cholera Outbreak in Haiti:
• Following 2010 earthquake, UN affiliated forces stationed in nation let untreated sewage from their camp leak into a tributary and pollute surrounding water sources
• Cholera has spread to other countries including Haiti, the United States, the Dominican Republic and Cuba
Background
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Problem
Cholera in Haiti
People have died
People are sick & dying
People will
continue to get sick
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Problem ComponentsPeople have died due to
cholera•UN image in the international community
•Families have lost income earners
People are sick and dying
•Highly infectious
•6% of people in Haiti have had cholera
•1.2% case-fatality•Lack of knowledge, resources, and infrastructure fuel this process
People will continue to get
sick•Scarce clean water sources for drinking water, sanitation, and hygiene
•Cholera spreads with each new case
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Mission: We seek to eliminate cholera as a cause of death in Haiti and prevent the possibility of the reoccurrence of an outbreak within 10 years.
ObjectivePeople have died due to
cholera
People are sick and dying
People will continue to get
sick
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Strategic Approach
People have died
•UN Settlement Fund Claims Committee
•UN Peacekeeping Operation health protocols
People are dying
•Clean water•ORS•IV•Antibiotics
People will continue to get
sick•Education•Supplies•Infrastructure•Regional incentives
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StrategyPeople have
died
Claims committee
UN Peacekeeping protocols
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$40 million allotted
Formula Driven:
Proof of Death + Number of Dependents + Age + Economic Loss
Ex. Father of five, aged 28: $3,000 - $4,000
8,000 have died so far
Claims Committee
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Health screening and immunization of peacekeepers prior to deployment by troop-contributing country
After deployment, chief administration office responsible for exams
Cross check by setting up an internal committee to investigate the UN officials
Determine waste disposal protocol on a country-by-country basis
UN Peacekeeping Health Protocols
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People are sick and
dying
ORS Clean water IV antibiotics
reduce case–fatality rates to <1%
Treatment strategies
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Clean WaterFilteredBoiled
Salt & sugar solutionsIV fluids and kits
Low-tech, Low-cost Solutions
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Strategy
People will continue to
get sick
Education Supplies Infrastructure
Regional Incentives
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Curriculum:Cholera: Signs & SymptomsWater purificationWaste treatmentHygiene: hand washing & food preparationORS administration
Education
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FuelClean water containersSoapFiltersORS packetsVaccines
Supplies
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Public campaignsCommunity health workersCommunity-based education programsSchoolsDoor-to-door
Method of Distribution
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Waste TreatmentUrban
UNEP: Collective disposal through small sewer systems including a primary treatment plant Sanitary sewer system by gravity or under pressure optimal.
UNEP: Private disposal system through individual holding tanks, cesspools, and septic tanks.
SOIL Toilets in slumsRural
Partners in Health $250,000 wastewater treatment systems installed in clusters of rural populations, scaled to size
SOIL toilets for dispersed clusters
Infrastructure
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Healthcare systemCholera Treatment CentresIncrease access
Infrastructure
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Pilot programs for optimal usage and PRUrbanRural
Randomized testing:Up-front cost of toilet on sliding scaleMonthly maintenance fee, reimbursement
SOIL Toilets
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Partner Countries
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Distribution of Budget
Infrastructure: 65% ($1.95 Billion)
Treatment and Education: 25%($750 Million)
Settlement Fund: 5% ($150 Million)Regional Incentives: 5% ($150 Million)
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Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Timeline
Infrastructure: 65% ($1.95 Billion)
Treatment and Education: 25%($750 Million)
Settlement Fund: 5% ($150 Million)Regional Incentives: 5% ($150 Million)
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Rollout Plan
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People have died Animosity towards the UN may not be absolved by settling personal claims Relations with other nations may still be permanently affected by this incident
People are dying Plan does not include diagnostics Haiti’s health care infrastructure may prevent patients from obtaining treatment
People will continue to die: More countries affected then we can sustainably support Haiti may not be able to consistently generate enough electrical energy to
adequately maintain all sewage treatment facilities
Limitations
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Sewage treatment plan is self-sustainingThe infrastructure of Haiti will undergo rapid expansion
The current proposal simultaneously improves the state of neighboring nations like the Dominican Republic
Engages the community in the solution Relatively low-cost, low technology solutions
Advantages
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Our goal is to elminate cholera from Haiti through treatment, prevention and
development of long-term infrastructure.
Summary Slide
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Additional slides
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Problem8,300 have died due to
choleraCholera
outbreak in Haiti: people
are gettig sickInadequate water and
waste treatment & hygiene
Inadequate waste treatment by PKO
Haiti lacks infrastructure
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• Haitians with cholera and at risk for cholera
• Haitian Government
• UN
• UN PKO
• WHO
• Partners in Health
• SOIL
• HAS
• DINEPA
Stakeholders
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8,300 Haitians who died as a result of the cholera epidemic as well as some 650,000 more survivors of the illness.
$2,220,000 ORS (.11cents per packet, 20 packets per person, 1,000,000 ppl)
$10,000,000 vaccine/yr (1.85 per vaccine, vaccines for 1,000,000)
$9,600 (.04per 200mg tablet)
$920,000 (7 per IV Ringer Lactate solution kit) *really 840,000 but a bit
more added just in case
[120,000 hospitalization per year]
$1,222,300,800 Full sanitation system (cost of treatment system for all of the domestic water
$250,000 (300,000liters per day)
Hôpital Universitaire de Mirebalais (HUM) Mirebalais
Solutions
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As of 30 November, 40 cholera treatment centres (CTCs) were operational (100 to 200 beds each) and 61 cholera treatment units (CTUs) were functional. Few oral rehydration centres (ORCs) have been established so far due to difficulties in implementing the response.
Cholera Treatment Centres
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Deputy director of PAHO, and arm of UN thinks that vaccines for all newborns could be useful (60-70% effective and lasts 2 years)
So we would need about 3 vaccines per kid to get them out of the danger zone
Densely populated urban areas and rural places since little access to health care because vaccine is in short supply
Need about 46% vaccination coverage and Zindoga Mukandavire, David L. Smith & J. Glenn Morris Jr think it’s a good idea
Vaccine Distribution
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Treatment
Education
Infrastructure
Investment in Haiti’s neighbor
Strategic Approach