Flooding after Hurricane Tomas threatens to derail efforts to contain a cholera outbreak. We’ll get the latest news on what’s being done to prevent the spread of that disease and learn more about access to clean drinking water in Haiti.


  • Carleene Dei USAID Country Director for Haiti
  • Wesley Laine Program Manager, International Action
  • Julie Sell Spokesperson, American Red Cross in Haiti
  • Laura Cabahug Shock Trauma Nurse, University of Maryland
  • Wilfrid Cadet, MD Deputy Chief of Party for Health, Catholic Relief Services in Haiti

Haiti’s Health Care Professionals

Dr. Wilfred Cadet, MD, the Deputy Chief of Party for Health for Catholic Relief Services in Haiti, talks about how life – and medical care – changed forever in the country in the 35 seconds it took for the January 2010 earthquake to devastate Port-au-Prince:

University of Maryland shock/trauma nurse Laura Cabahug talks about traveling to Haiti in the immediate aftermath of the Jan. 12, 2010 earthquake to help treat victims. Cabahug talks about the work she and others have been doing to ensure sustainability of organized, safe care in the country as it rebuilds:


  • 13:06:42

    MR. KOJO NNAMDIFrom WAMU 88.5 at American University and broadcasting live from the studios of Radio Metropole in Port au Prince, Haiti, welcome to "The Kojo Nnamdi Show," connecting your neighborhood with the world. Later in the broadcast, a look at the U.S. role in Haiti, but first, we arrived in Port au Prince yesterday and spent the day getting to know the city. One thing you can say about the Haitian capital is that it is intense. Everything about life here from the traffic to the public markets to the camps where people have been living since the earthquake is an intense experience for an outsider.

  • 13:07:26

    MR. KOJO NNAMDIAnd for Haitians, the last few weeks have added a new level of intensity. There are fears over cholera, especially now that the first case, that of a three-year-old boy who did not travel to any other parts of the country, has been confirmed in Port au Prince. And the hurricane that just passed through here showed that this city is ill-prepared for a major storm. Our reporter, Sabri Ben-Achour, visited a camp yesterday to see what life was like there. Here is his report.

  • 13:07:54

    MR. SABRI BEN-ACHOUROn a barren, rocky outcropping overlooking Port au Prince, it's time to celebrate.

  • 13:08:03

    MR. SABRI BEN-ACHOURBaptiste Roosevelt is in this hangar-size tent for church in this camp of 450 families. Roosevelt translates some of the hymns.

  • 13:08:18

    MR. BAPTISTE ROOSEVELTOkay, over the gate, no more sad so over the gate we have no pain, no stress.

  • 13:08:24

    BEN-ACHOURThis church is part of the rhythm that's taken hold here in the settlement despite calls by the Haitian government and aid agencies to resettle these camps outside of the over-populated capital they are very much still here.

  • 13:08:39

    BEN-ACHOURMarkets have sprung up here and there between boulders and of course there are all the tents, although they're actually more like shacks now, with frames made out of branches, all wrapped up in tarps donated by World Vision. Possibly the most exposed shack of all sits atop an overlook. It's where Bernadette Jeudi lives with her family. She's putting a frilly but dingy white shirt on her one-year-old while her three-year-old sleeps on the family mattress. The mattress was rescued from the rubble of their old home and it shows.

  • 13:09:12

    MS. BERNADETTE JEUDIWe used to have a mattress, too, but it blew.

  • 13:09:12

    TRANSLATORThe first thing she does in the morning is try to find some water.

  • 13:09:13

    BEN-ACHOURThe water's not far away. It's supplied by another NGO. After that, she says there's just not a lot to do.

  • 13:09:23

    JEUDI(speaks foreign language)

  • 13:09:25

    TRANSLATORShe's not working so she has nothing to do all day, just get water in the house, give shower, a bath to the kids and then just sit around, walk around, do nothing.

  • 13:09:40

    BEN-ACHOURThat's the sound of what used to be Jeudi's husband, Pierre Arinet, who used to be a baker. He still has a pizza cutter and an assortment of icing texturizers.

  • 13:09:52

    MR. PIERRE ARINET(speaks foreign language)

  • 13:09:54

    TRANSLATORThe bakery where I was working before the earthquake was cracked then the owner is repairing the bakery, but it's still not yet working.

  • 13:10:00

    BEN-ACHOURLike many Haitians right after the quake, Arinet moved his family out to the countryside to live with surviving relatives, but there was nothing to keep them there so they followed the money. They came back to Port au Prince. Arinet tried to work for some of the NGOs employing people to clear rubble, but the positions filled up fast so he and his family are still entirely dependent upon relatives and friends for food.

  • 13:10:26

    ARINET(Foreign language)

  • 13:10:26

    BEN-ACHOURDuring the hurricane, it was pretty bad, he says.

  • 13:10:30

    ARINET(Foreign language)

  • 13:10:30

    TRANSLATORWhen they said that the storm was coming, they didn't have any money and they didn't have any food for the kids and (word?) . It was, he says, unbelievable so -- and then the water...

  • 13:10:41

    BEN-ACHOURWater flowed up under their shack. Everyone's clothes got wet.

  • 13:10:45

    TRANSLATORAnd it's scary. At the same time the storm were coming. It was a worry about cholera so they had to take care of the water they were drinking.

  • 13:10:52

    BEN-ACHOURSo they were worried about cholera, which they knew came from water, and all this water was coming up under the walls. And the camp's toilets, not in good shape.

  • 13:11:09

    ARINET(speaks foreign language)

  • 13:11:09

    TRANSLATORThey have, like, 12 bathrooms for both camps here and he says that it is so bad now if you pass by, you may even see some worms.

  • 13:11:19


  • 13:11:20

    TRANSLATORWorms, yeah.

  • 13:11:20

    BEN-ACHOURLike intestinal worms.

  • 13:11:24

    TRANSLATORYou can see some of them in the bathrooms.

  • 13:11:25

    BEN-ACHOURThis is a lot like what things were like ten months ago. There are more tarps, a few more jobs funded by aid groups, but people are concerned about the same sorts of things says Barthazar Jacques, who is sort of like a councilmember for this section of the camp.

  • 13:11:39

    MR. BARTHAZAR JACQUES(speaks foreign language)

  • 13:11:39

    TRANSLATORThere are three important things that people keep asking here. They ask for food, since they are very hungry. And then, they ask for drinkable water and then they ask for toilets because they have very big, big problem with toilets here.

  • 13:11:54

    BEN-ACHOURAnd even as people and their concerns become semi-permanent here, there is something looming on the horizon. This land is not theirs.

  • 13:11:59

    JACQUES(speaks foreign language)

  • 13:12:01

    TRANSLATORBut the owner of this land, Acra, give them the deadline until October, 2011, then they have to move.

  • 13:12:17

    BEN-ACHOURAnd as for where they'll go after that?

  • 13:12:22

    JACQUES(speaks foreign language)

  • 13:12:22

    TRANSLATORThey don't know yet. They don't know what the government will be doing for them.

  • 13:12:26

    BEN-ACHOURThat is one of the major obstacles to moving the camps. It's hard to find free land to put them on. And it's still too early to see exactly how that's going to get resolved, but for now, this tarp shack is all Arinet and his family and a lot of others have.

  • 13:12:44

    ARINET(speaks foreign language)

  • 13:12:44

    TRANSLATORHe says that the house he had before the earthquake wasn't a dream house, like a castle but he liked it compared to always living here now. It's not a position people should live in but he have nowhere else to go. He has nothing else to do so he's obliged to live here.

  • 13:13:05

    BEN-ACHOURI'm Sabri Ben-Achour.

  • 13:13:08

    NNAMDIAnd you can see photos taken by Kojo Show producer, Michael Martinez, of the camp that he and Sabri Ben-Achour visited yesterday. You can find that at our Facebook page, facebook.com/kojoshow We wanted to learn more about some of the daily challenges that many Haitians face, including a very basic problem, access to safe drinking water. Joining me now in the studio here at Radio Metropole to do that is Dr. Carleene Dei, USAID mission director of Haiti, Carleene Dei. Thank you for joining us.

  • 13:13:39

    DR. CARLEENE DEIThank you for having me.

  • 13:13:40

    NNAMDIAlso with us is Julie Sell, spokesperson for the American Red Cross in Haiti. Julie, thank you for joining us.

  • 13:13:46

    MS. JULIE SELLThank you, a pleasure.

  • 13:13:49

    NNAMDIAnd joining us from the studios at WAMU 88.50 in Washington is Wesley Laine, program manager with International Action, which is an NGO that works on water issues in Haiti. Wesley, thank you for joining us.

  • 13:14:01

    MR. WESLEY LAINEThank you. It's an honor to be your guest.

  • 13:14:03

    NNAMDIIf you've got questions about everyday life in Haiti, you can call us at 800-433-8850. If you've got questions about how people get water or healthcare in Haiti, call us, 800-433-8850, or go to our website to ask your questions. That's kojoshow.org

  • 13:14:21

    NNAMDIHaiti was spared from the worst of Hurricane Tomas, but that was really just a lucky break. Tell us about the last week in each of your lives and what you did to try to help this country prepare for that storm. First you, Carleene Dei.

  • 13:14:35

    DEIWell, I should begin by saying that we began preparing for the storm many, many months ago. It's not a last-ditch effort. I mean, ever since the earthquake, we have been anticipating storms because Haiti, almost on an annual basis, has a storm with fairly catastrophic impact. In this particular instance, we have been building, clearing canals, shoring up river banks, dredging, re-profiling, sandbagging in the camps and in the cities and the country where we know there's a great deal of vulnerability, Genevieve being a good example.

  • 13:15:18

    DEIIn fact, we started working on Genevieve back in 2008 after the huge -- it was hit by a series of earthquakes during that season and the devastation, the loss of life, the loss of people's resources was enormous and so we've been working on the rivers up there, on the canals, on the banks. That's a two-year project and we think that the impact of that intervention was seen at this last earthquake. You had flooding, but not the entire city. The rivers didn't overflow.

  • 13:15:50

    NNAMDIYou mean, the last hurricane.

  • 13:15:51

    DEIThe last hurricane, sorry. The catastrophes tend to get mixed up in my head after a while.

  • 13:15:54

    NNAMDIThis is true.

  • 13:15:57

    DEIThere wasn't as much flooding. The riverbanks didn't overflow. But that's Genevieve. Here in Port au Prince, as I said, we've been doing pretty much the same thing, most of our partners. But it's not just the physical preparation. We've been working the meteorological department, which, as you know, probably lost most of its equipment and its building with the earthquake, putting that back together again.

  • 13:16:22

    DEIAnd a lot of work with the people who are responsible for the early warning systems at the national and regional level, the folks whose job it is to say hello everybody, 48 hours from now we expect Tomas to hit. Let's get going. Pack up your belongings. Put your important papers in plastic next to your body. Find a place that is either a public shelter or a friend with a house that's made of cement, concrete as opposed to wood.

  • 13:16:51

    DEIAnd I think the impact of our preparation was very clear. The government of Haiti, specifically the DPC, which is the office of civil protection, took the lead. Preposition food -- and we've been propositioning food since June in anticipation of the earthquake. Prepositioned water, mattresses, anything you can think of that you would need, hygiene kits, clean water, warm clothing, in anticipation of a hurricane.

  • 13:17:20

    NNAMDIAnd you, of course, anticipating a direct hit in Port au Prince.

  • 13:17:22

    DEIWell, usually, I'm told Port au Prince doesn't normally take a direct hit. This is my very first hurricane season and we had our fingers crossed, but Tomas looked very, very menacing for a while there. It was coming up from the south instead of going west/east, which it normally does. And so we did anticipate a direct hit. And I will tell you we were all very frightened, very frightened of the kind of devastation we could expect with such a large population living in, you know, camps.

  • 13:17:53

    NNAMDISpeaking of frightened, not to mention a radio show that actually postponed its arrival here, but that's another story. Julie Sell, what was it like for you during the last week?

  • 13:18:02

    SELLWell, it's been an incredible week for everyone at the American Red Cross here in Haiti. As you alluded to, we're dealing with not one, not two, but really three simultaneous emergencies, the ongoing response to the earthquake, which has left hundreds of thousands of people under tarps and tents, then this cholera outbreak, which initially surfaced a few weeks ago and appears to be building. And then, we had the threat of Tomas. So, you know, this time last week the American Red Cross and everyone in the Red Cross network here in Haiti was very much focused on cholera, which at the time, you know, thankfully, had been contained largely to an area north of Port au Prince.

  • 13:18:50

    SELLAnd so we were in the process of sending much-needed supplies, chlorine for clean drinking water. We flew in cots from one of our U.S. warehouses to expand the capacity of hospitals. We were sending out, through the Red Cross network, SMS text messages to about 380,000 people with cell phones around Haiti warning them about cholera and what they can do. So there were a variety of things going on.

  • 13:19:25

    SELLHere in Port au Prince in the camps, we have teams of what we call health promoters, who, for months, have been going literally tent by tent talking to people about health and good hygiene. And as soon as the extent of the cholera threat became clear, we directed them to target specifically cholera prevention messages. So all that was going on and, suddenly, up popped Tomas and needless to say, there was a little bit of scrambling. But the good news is that we have known for many months that hurricane season was coming and we knew this was a very vulnerable population so plans were in place. We got out to the camps. We've been working with people, again, for months on hurricane preparedness.

  • 13:20:07

    SELLEverything from emergency first aid training to early warning systems in the camps, some similar things to what USAID was doing with sandbagging and drainage systems. So it, you know, it was a plan that was in place that we could sort of activate and fortunately, you know, we dodged the worst of Tomas. That the sad news, of course, is that now the cholera threat appears to be increasing.

  • 13:20:34

    NNAMDIJulie Sell is a spokesperson with the American Red Cross in Haiti. She joins us in studios in Port-au-Prince along with Dr. Carleene Dei, USAID mission director for Haiti. Wesley Laine, you might be in Washington D.C., but you were, in fact, born and raised in Petionville where we are staying here in Haiti. You are program manager with International Action. What was your last week like?

  • 13:20:57

    LAINEYes, indeed, I am Haitian, for the record, and also I'm actually just returned from Haiti. I was in Haiti two weeks ago. We were assisting the folks in the Artibonite Region. We spent a week there because we felt that those folks really needed our help. So we spent a week installing chlorinators and water tanks in that region. And for those folks who did not have water tanks in the communities, we're making chlorine solution and teaching them how to use that to treat their water buckets at home, also distributing an Albendazole deworming pills in that region as well.

  • 13:21:32

    LAINEAnd upon returning to Washington, as we all know, the threat of Hurricane Tomas, that our workload has substantially increased. We know that every time it rains in -- heavy rainfall falls in Haiti that, you know, there's a risk for more waterborne illnesses. And we know that also it must be said that prior to the cholera outbreak, there's always been a clean water crisis in Haiti. Having been born and raised there myself, there are times where I've gotten sick from drinking water that was not properly treated.

  • 13:22:04

    LAINEInternational Action has really been actively on the ground just mobilizing our staff to stay in that region, that Saint-Marc region. The tenepa (sp?) which is the government water agency, is actually asked us to install 20 chlorinators a week in that region. So right now we are focused on assisting those folks in the Artibonite Region, Grand'Anse, Saint-Marc. We were working with different partners to really reach more folks in that region, while not forgetting those folks in Port-au-Prince as well. So as you can imagine, the workload has increased a lot.

  • 13:22:42

    NNAMDICarleene Dei, you pointed out many people living in the camps were advised to go stay with family and friends who have more stable shelter, but it's clear that wasn't an option for a lot of other people. What lessons do you take away from this experience in terms of preparing for the inevitable next storm?

  • 13:23:00

    MS. CARLEENE DEIWe need more public shelters. Remember that the earthquake destroyed innumerable number of buildings. We've just finished assessing over a quarter of a million buildings to see whether they can be repaired or if they have to be demolished totally. Over 4,500 schools were lost. And schools are your best source of shelters. They're large. They're usually solid and they can accommodate a lot of people. Churches were destroyed, 28 out of 29 of the government ministries were destroyed. So there really has been a loss of public spaces.

  • 13:23:39

    MS. CARLEENE DEIThe government did assess and did identify the spaces that were still available and these were distributed within the neighborhoods. But the reality is, we could not have set up and organized ourselves to shelter 1.3 million people. You have no -- just think of the dimension of the problem. So what we had to do was to break it down into manageable pieces. Work camp by camp. Haitian's in the past, when there's an earth -- a disaster, a hurricane, they go to a friend.

  • 13:24:14

    DEIThey go to a relative's house. I mean, in DR next door, 12,000 people moved. 11,000 of them went into the homes of families and friends. That's in the United States. You usually move some place. But Haiti was just in an unfortunate situation where our ability to move these people in terms of transport, in terms of identifying the site was such that we had to say, look for a friend. For those of you who are really in extremis, like, women and children out in (word?) you move them into an empty hospital.

  • 13:24:47

    DEIWe move them to an empty church. I shouldn't say we because this was actually a government action. The same DPC that I referred to before. We're just going to have to do better next year, but it's going to take a massive effort between now and the next season.

  • 13:25:02

    NNAMDIGot to take a short break. When we come back, we will continue this conversation on Hurricane Tomas, cholera and health concerns in Haiti. If you have already called, stay on the line. We'll try to get to your call. If the lines are busy, go to our website, kojoshow.org, join the conversation there or send us a tweet at kojoshow. I’m Kojo Nnamdi.

  • 13:27:08

    NNAMDIWe're discussing health concerns in Haiti in the wake of the earthquake, a cholera outbreak and more recently, Hurricane Tomas. We're talking with Julie Sell, spokesperson with the American Red Cross in Haiti. Dr. Carleene Dei is the USAID mission director for Haiti. And joining us from the studios at WAMU 88.5 in Washington is Wesley Laine, program manager with International Action, which is an NGO that works on water issues in Haiti. Let's go directly to the telephones and talk with Odua. Odua, you are on the air. Go ahead, please.

  • 13:27:41

    ODUAYes, good afternoon, Kojo. And thanks very much. I'm enjoying the program. I'm a long time listener. I have so many questions I want to ask, man. I don't...

  • 13:27:48

    NNAMDINo, ask.

  • 13:27:49

    ODUA...even know where to start. Look (unintelligible) ...

  • 13:27:49

    NNAMDIAsk them one at a time, please.

  • 13:27:52

    ODUAYes. The main one I want to ask is, did someone mention that these people have to be leaving the land within a year or something like that? And I am wondering, isn't there an imminent domain where the government can take this land from these people so people can live in it? I don't understand. What's going on there?

  • 13:28:08

    NNAMDIWesley Laine, can you take this question? Keeping in mind that we don't have that much time left in the broadcast, but -- 'cause this is a fairly complex issue.

  • 13:28:16

    LAINECan you repeat the question? I could not hear.

  • 13:28:18

    NNAMDIIt has...

  • 13:28:19

    ODUAYes. Is there...

  • 13:28:19

    NNAMDI...the question has to do with land ownership in Haiti and whether or not the people who are living wherever they happen to be living now can't simply claim imminent domain.

  • 13:28:29

    LAINEWell, it's hard for them to claim domain 'cause these lands are already owned by individuals. And so it's also hard to, as individuals, also just give up their land. Well, I think, that's when the government -- that's a governments rule to assist those folks and make sure that the government also owns a lot of land in Haiti. So...

  • 13:28:48


  • 13:28:48

    LAINE...maybe this will step up and offer those folks a place to go.

  • 13:28:53

    ODUAAll right. One other question, Kojo. I have donated to the different charities and I heard someone said that, like, $10 for the cost of an efficient stove. If I wanted to adopt 10 families and buy them 10 stoves, how can I go about doing something like that?

  • 13:29:09

    NNAMDIDr. Dei?

  • 13:29:11

    DEIWe always ask people to send money. Whether it's to USAID -- well, actually we don't accept donations but we have lots and lots of grantees who do. We always ask people to identify the correct grantee and contact them. Most of them are online and you look for one who's working with energy efficient stoves and that would be the person to send it to. Please don't send the stoves. You have no idea..

  • 13:29:35

    ODUABut, no, I understand that.

  • 13:29:35


  • 13:29:36

    ODUAI understand.

  • 13:29:36

    DEI...how complicated it...

  • 13:29:37

    ODUAAll right.

  • 13:29:38

    DEI...is to get the transported into the person who needs it.

  • 13:29:41

    SELLIf I could just jump in on the land question for a moment. I think it's really critical because at the same time we are dealing with meeting the basic needs of this population and these spontaneous camps, as long as people are living under tarps and tents, we're going to be grappling with serious health issues, water and sanitation, those sorts of things. You know, the real longer term solution here is land and getting people into more stable housing. You know, we at the Red Cross and other agencies have been pressing for months, you know, hoping the government can assist us with that.

  • 13:30:18

    SELLBecause until land is made available -- and particularly inside Port-au-Prince because there is land available outside, families are either going to be asked to pick up and move a long distance from jobs and schools and markets or they may be continuing to live in these camps for quite a while.

  • 13:30:41

    DEII can add something to that, too. The government actually has made land available, but as it's just been pointed out, most of it is on the outskirts of town. And it's far away from employment opportunities and from the social safety nets that most people have within neighborhoods. So for most individuals, strangely enough, the preference is to return to the neighborhood that they come from. The problem, though, is that if your house has been destroyed, there is nothing to go back to. And for us to go in and put up a transitional shelter or a new house, you have the enormous issue of rubble. There are 25 million cubic meters of it produced by the earthquake.

  • 13:31:24

    DEII heard some figure, enough to fill the Hoover Dam multiple times. And I think we've moved a couple of million, but that's just the beginning. There's much more to go. And until you move that, in many instances, you can't get to the lot that you need. We also have an alternative. We can repair the houses that are not badly repaired and make an arrangement with the owner of the house to move back in with a tenant. And this is one way of doing it. But it's not particularly fast and there are about 10 major issues that have to be looked at. Land -- who is the beneficiary? What are you going to do to help them?

  • 13:32:01

    DEIHow do you insure that the person you put into the house isn't immediately thrown out and somebody else put in? I mean, the list is endless. It's not undoable. It can be done. And enormous steps have been taken towards trying to come up with a system that everybody can agree on and that everybody can operate on. And I think we're almost there. But it -- I wish it were just so simple. You take the person, you put them back home. It isn't.

  • 13:32:30

    NNAMDIWesley Laine, we got a comment on our website. Really, a question.

  • 13:32:34


  • 13:32:35

    NNAMDIFrom somebody who says, "pardon my ignorance, but I didn't realize Haitians spoke Creole. I thought they spoke French. I associate Creole with New Orleans, which also has a French heritage. What are the origins of Creole anyway?" Wesley?

  • 13:32:49

    LAINEWell, muy parle Creole, je parle Francais, and I speak English. So the original Creole is from the Africans who were brought to Haiti from -- with the French during the slave trade. However, the Creole itself is not just broken down French. It's a lot of languages, a lot of mixed cultures, African cultures and those folks who came from Africa who mixed their different dialects and languages together and formed a -- its own language with French in it as well. So that's the origin of Creole. But...

  • 13:33:28

    NNAMDIOkay, thank...

  • 13:33:28


  • 13:33:29

    NNAMDI...thank you for your brevity on that -- on that occasion.

  • 13:33:33


  • 13:33:33

    NNAMDIThe other big concern right now, as you know, is cholera. We've heard some people say that the international community is exaggerating the problem, while others say the problem is being under reported. What is your take on the gravity of this, Carleene Dei?

  • 13:33:48

    DEIMy goodness. I don't think we've exaggerated the problem at all. And I don't think we've under reported. We're trying to be as honest as we possibly can with what is happening with the disease. But I think you need to understand that there's a cycle that's at work here. When the disease first hit, people didn't know what it was. Haiti hadn't seen cholera in 50 or 60 years. So there was some difficulty in diagnosing it. And a lot of people died because they didn't know what they had, how sick they were.

  • 13:34:18

    DEIAnd that the disease can kill you in a couple of hours. So you need instant treatment. Once we figured that out, people keep getting sick, but by the time they get to the hospital for treatment, they're not that sick 'cause they know they need to get help immediately. And we have set up systems for handling it. Right now, there are cholera treatment units with beds where you can lie and -- while you're getting a transfusion or other infusions. And their oral rehydration salts -- I mean, there is a way of dealing with it. The disease does not have to be fatal if you get it early and you treat it promptly and aggressively.

  • 13:34:54

    DEISo I think there was a reference to the disease being contained in the area where it began, in the Artibonite. I don't want to overstate it, but definitely people know what they're doing. But the scary part is it's going to spread. You can't put a wall around the Artibonite in the center. People travel and when they travel, they take the disease with them. And so we're trying to prepare the people of Port-au-Prince for what we think is the inevitable arrival here. And it will come.

  • 13:35:23

    DEIThe question is, can we set in motion the systems, the education campaigns, the clean water, the easy availability to treatment that we need to prevent it from becoming, you know, something of biblical proportions. Can we manage it? That's what we're working on to do. (unintelligible) .

  • 13:35:43

    NNAMDILet's talk about -- let's talk about Haiti's healthcare infrastructure. We spoke last month with Dr. Wilfred Cadet, deputy chief of party for health with Catholic release services in Haiti. He was standing in the rubble of a hospital and reflected on how that 35 second earthquake overwhelmed an already over taxed healthcare system.

  • 13:36:02

    DR. WILFRED CADETWe're standing now on top of everything, ward of Saint-Francois De Sales, downtown Port-au-Prince. I've known this hospital for, I would say, 30 years. I'm kind of old now, but I used to come here to bring relatives and friends when they were really sick. So it was a very nice decent hospital. And then the -- of course, at the beginning of the 1990s, some big migration in Port-au-Prince so the capacity of the hospital was overwhelmed. So January 12th was a big turnaround for this hospital and for the whole country as well.

  • 13:36:39

    DR. WILFRED CADETIn a place where the healthcare was deficient, almost nonexistent in terms of serving the population -- so basically over 35 seconds, we were overwhelmed with a number of patients and trauma people. Again, just up and over 35 seconds. To me, I still cannot imagine the difference that 35 seconds have made in my life, in the life of this hospital and this whole country.

  • 13:37:16

    NNAMDIDr. Wilfred Cadet, deputy chief of party for health with Catholic relief services in Haiti. Julie Sell, if a major cholera outbreak hits Port-au-Prince, how equipped is the healthcare system to respond?

  • 13:37:29

    SELLWell, as your previous guest made clear, this was a health system that was already very over-stretched and has now been seriously damaged. There is no question that if the cholera outbreak spreads to Port-au-Prince, that it's going to be very difficult to handle at all. I would point to the fact that, you know, the Red Cross is investing and supporting a number of major institutions here. Everything from the Red Cross field hospital in Carrefour, to the Bernard Mev's (sp?) hospital, which is the only critical care and trauma hospital here in Port-au-Prince.

  • 13:38:08

    SELLWe're also investing in cholera treatment centers. But the point that was made earlier, which I think is so critical, is that, you know, cholera is easily prevented. It's about washing your hands. It's about boiling the water you drink. I was out in one of the camps just this morning with one of our teams of health promoters and they're literally going tent to tent instructing people how to properly wash their hands. Giving them a bar of soap and watching them do it. You know, between every finger.

  • 13:38:37

    SELLIt seems like such a simple thing, but for people who don't have access to electricity, who have very little access to water -- you know, if the choice is do you have water to drink or are you going to wash your hands several times a day, you know, most people are probably going to choose to drink that water. So it's a tough situation and we can only hope that the prevention efforts will contain it as much as possible.

  • 13:39:03

    DEIAnd I want to add that the prevention efforts are aggressive, really. Radio messages -- the cell phone companies have jumped in and said, go ahead, use our networks to do free SMSs. We have partners going camp to camp, house to house. We've distributed water, soap, chlorine, wash basins, cholera beds, containers, bleach, made sure that just the nepa (sp?) has, you know, doubled the amount of chlorine in all the public water points in the city.

  • 13:39:36

    DEIAnd the cholera units we've set up -- the government wants to set up four teams, we've already done 200 -- sorry, seven of them. And they are large units which do nothing but treat cholera. They're not regular hospitals. So they are not full yet. They're empty, but we expect them to be full.

  • 13:39:58

    NNAMDIWesley Laine, tell us a little bit about how people in Port-au-Prince got water before the earthquake. We've seen stores that sell water and my understanding is that there are also trucks that come to neighborhoods.

  • 13:40:08

    LAINERight. Water trucking is major in Haiti so most people get their water from water truck. And those trucks, they go to different reservoirs and the owners of the reservoirs sell that water at retail price. Either that or you go to the public water fountains that are all over Port-au-Prince. I'm sure you've seen some of them with long lines. And the truth is, most of the time, that water is not treated so most people are buying water that's untreated.

  • 13:40:36

    LAINESo going back to the -- to your last question as well about the public health sector in Haiti, I think this process reveals the depth of the inadequacies and shortcomings of the public health sector in Haiti. I think it presents an opportunity for us who look unblinkingly at the situation and say, let's make a long-term health partnership with the communities that we're serving and let's establish clean water systems in Port-au-Prince and also in all the surrounding areas Port-au-Prince.

  • 13:41:08

    NNAMDII was about to ask you, Wesley, how does the access to water in other parts of Haiti differ or is similar to what we see in the capital Port-au-Prince?

  • 13:41:18

    LAINEI think what I saw when I was in Haiti last week was that water access is one issue and water quality is another issue. These are two different issues. I was in a town in a (word?) region while we were installing a chlorinator and people were actually in the same river that was killing them, taking water from there and drinking it and bathing in it. And we had to -- in my Creole language, I had to explain to them exactly what we were doing and why they should not be bathing and drinking and using that water.

  • 13:41:49

    LAINEUntil then, they had no idea. So in those regions, most people, they're in the river, the same river that's killing them, they're there. They're drinking it and they're bathing in it and using it for cooking purposes as well. So it's a crisis, Kojo, to be honest with you.

  • 13:42:05

    SELLAs crowded as the camps are in Port-au-Prince, they do have a system in place now for distribution. The Red Cross network is providing about 660,000 gallons of water every single day to the camps of Port-au-Prince and has been doing that for months. You know, when you get out into the rural areas, you have all sorts of issues with distribution and, you know, messaging to people in terms of how clean the containers need to be, that sort of thing. So I suppose if there's a bright spot here, it is that, you know, a system has been developed in Port-au-Prince to get clean water to people. The question is, you know, how long does that carry on before you transition?

  • 13:42:46

    NNAMDIAnd Julie Sell, we're running out of time pretty quickly in this segment. But what do you think is the time frame that we are looking at in terms of combating this cholera outbreak, maybe epidemic?

  • 13:42:58

    SELLWell, the health experts are talking in terms of months, many months. This is not going to go away this week or in the next few weeks.

  • 13:43:09

    NNAMDIJulie Sell is spokesperson with the American Red Cross in Haiti. Thank you so much for joining us.

  • 13:43:13

    SELLThank you.

  • 13:43:14

    NNAMDIWesley Laine is program manager with International Action, an NGO that works on water issues in Haiti. Wesley, thank you for joining us.

  • 13:43:21

    LAINEYes. Thank you and please visit us at haitiwater.org to see how we, you know, we are chlorinating water in Haiti, and that's -- we're working on national chlorination technology for Haiti.

  • 13:43:33

    NNAMDIWe'll put up a link to that website. We're going to take a short break. When we come back, Carleene Dei is still with us. We'll continue the conversation about what USAID is doing in Washington and take your calls, 800-433-8850, or your questions and comments at our website, kojoshow.org. We're broadcasting live from Radio Metropole in Port-au-Prince, Haiti. I'm Kojo Nnamdi.

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