Institute for Justice and Democracy in Haiti

INTERVIEW-Safer shelter needed to avert Haiti disease outbreaks

Written by: Anastasia Moloney

Dr Pape in his office.<br> GHESKIO
Dr Pape in his office.

BOGOTA (AlertNet) – A Haitian doctor who runs the country’s leading AIDS treatment centre has warned of typhoid and tuberculosis outbreaks if the government does not move homeless quake survivors from tents into better housing ahead of the looming hurricane season. Jean William Pape, the founder of the Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), also told AlertNet rape has increased amid the insecure conditions in the capital’s camps, with his staff now seeing 50 cases a month, up from 16 before January’s disaster. Pape said the main priority should be safer accommodation for the 1.5 million Haitians who remain camped out on the streets and in tent cities, vulnerable to landslides and severe flooding during the storm season due to start next month. “I am pleading that some emergency funds can be released now for the government to relocate people quickly and organise semi-permanent and permanent housing,” he told AlertNet in a telephone interview from Port-au-Prince. This is essential to avoid a typhoid plague many fear could be the next crisis, said the doctor, whose organisation treats more than half of Haiti’s AIDS patients – around 14,000 people – plus 2,000 people with tuberculosis. “Typhoid is a major concern,” said Pape. “The tent situation is an ideal way to transmit diseases, including tuberculosis. The threat of outbreaks remains high unless the government is very quickly able to move people into better housing conditions and where there is no risk of flooding.” Pape and his staff are keeping a close watch on the potential spread of disease. Every day his volunteers scour tent cities for suspected cases of sickness including measles, diphtheria and meningitis. Those showing possible symptoms, like coughs or fevers, are immediately tested and isolated if necessary. “We are prepared, and we are controlling and monitoring any infectious diseases in our camps. But more rigorous surveillance is needed in other camps,” Pape said.

PREPARED FOR DISASTER The doctor said the large numbers of people moving from place to place, especially single men and women, also “potentially increases” the risk of infectious and sexually transmitted diseases. In response, public awareness campaigns are being conducted in camps, and condoms are available. Pape said there is no indication that HIV rates have risen since the quake. Neither have many patients been forced to go without treatment, thanks to the contingency plans made by GHESKIO – one of the world’s first HIV/AIDS clinics – which allowed it to restart operations immediately after the January 12 catastrophe wrecked much of the capital. “We have learned from past hurricanes, political problems and strikes to be always prepared for any disaster and any event,” said Pape. “While neither we, nor anyone else, were prepared for the magnitude of the quake, it helped having an emergency plan in place,” he added. Before the quake struck, GHESKIO had already stockpiled key medicines, given every HIV and tuberculosis patient an extra two-week supply of medication, and located drug distribution points in easy-to-reach areas in and around the capital. Despite losing four staff and suffering extensive damage to its facilities in the disaster, GHESKIO was treating thousands of survivors in a trauma centre and makeshift field hospital set up on its grounds within a day. Field workers carrying extra drugs went out on the streets to track patients, while radio adverts let patients know they could obtain medication from 28 facilities set up before the disaster. Two laboratories with tuberculosis-testing equipment were shipped in to replace those destroyed by the earthquake. Three weeks on, GHESKIO had tracked down nearly all its patients and was able to continue giving them life-saving antiretroviral therapy.

AWARD-WINNING CLINIC GHESKIO’s resilience in the wake of natural disasters, its grassroots approach and success in lowering Haiti’s high HIV rates since opening its doors in 1982 have not gone unnoticed on the international stage. The clinic has become a leading centre for research, counselling, rapid testing for sexually transmitted diseases, treatment of children with AIDS and prevention of mother-to-child HIV transmission. Earlier this week, the organisation won the prestigious $1 million Gates Award for Global Health, sponsored by the Bill and Melinda Gates Foundation, which recognises achievements in improving health. “We haven’t yet decided what the money will be spent on,” said Pape, adding that some will go towards repairing the $10 million quake damage to the clinic’s buildings and laboratories. Despite significant progress, Haiti still has the highest HIV prevalence outside sub-Saharan Africa. And while the quake has brought new health challenges, GHESKIO remains focused on its goals of HIV prevention and HIV-related diseases, and improving the diagnosis and treatment of tuberculosis. Central to Pape’s recipe for success is staying out of local politics. “Don’t get involved…and make sure the focus of your politics is to help poor people,” he said.

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