The Haitian Cholera Epidemic 'The Fight Is Not Hopeless'

More than 1,400 people have died of cholera in Haiti, and every day that number grows. Nurse Anja Wolz is working with Doctors Without Borders in the country to help save lives. In an interview, she talks about the epidemic's spread and why Sunday's elections are a huge concern for her organization.

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SPIEGEL ONLINE: Ms. Wolz, you already helped provide emergency aid after the earthquake in Haiti in January. Now cholera has brought you back to the country. How is this double catastrophe affecting the people?

Anja Wolz: Many patients are traumatized and they ask: Why us? What is going to happen next? Especially in Port-au-Prince and Leogane, where almost everything was destroyed. Here in the north, in Cap-Haitien, the people were among those most spared by the earthquake, but even they have realized how much suffering there is in their country and are in despair.

SPIEGEL ONLINE: How have the two catastrophes been different for the aid workers there?

Wolz: The earthquake hit the country hard. From one moment to the next, hundreds of thousands of Haitians were left homeless. We had to treat many people, but over time the numbers of patients have dropped. With cholera it has been different. It is spreading rapidly, and we are registering more cases every day. We started with 30 cases of infection in our treatment center in Cap-Haitien; at the moment we have 450.

SPIEGEL ONLINE: What are you doing about this rapid increase?

Wolz: Here in the north we are currently setting up two more treatment centers with 250 beds. Doctors Without Borders is working nationwide in 27 treatment centers with a total of 2,500 beds. But our capacity is far from sufficient. And, unfortunately, we are still only seeing the tip of the iceberg.

SPIEGEL ONLINE: How long are you on duty each day?

Wolz: We are working between 16 and 18 hours every day and we save many lives. Two weeks ago, we had a mortality rate of 15 percent here in Cap-Haitien. In the meantime, it has fallen to 1.6 percent. The fight is not hopeless, it's just a lot of work.

SPIEGEL ONLINE: What gives you hope?

Wolz: Cholera is certainly a dangerous illness, but if the sick come to us in time then we can help them. Last week some parents brought us a child. It was limp in its mother's arms, with sunken eyes and hardly any pulse. In fact, the child was almost dead. But we actually revived it. I saw it again a few days ago: It smiled at me and waved. Moments like that give me strength. But there are also children who arrive without parents, because they have already succumbed to cholera.

SPIEGEL ONLINE: What is the biggest problem there?

Wolz: Now, as before, it is insufficient hygiene. In the slums people are living in sludge, there is waste everywhere. One of our most important tasks is to explain to the people how they can improve sanitation by washing hands thoroughly, only drinking treated water and getting rid of rubbish.

SPIEGEL ONLINE: How do you get that message through?

Wolz: We have trained people who inform the populace about the disease. Teams that go from health center to health center and tell the people what cholera is, how it is treated and, most importantly, that they must pay attention to hygiene. There is still too much misinformation.

SPIEGEL ONLINE: In Port-au-Prince the corpses are being buried in mass graves. What is the situation in Cap-Haitien?

Wolz: The burial of the cholera victims is the government's duty. We do not know how they are buried. In order to prevent the epidemic from spreading further we must disinfect the dead before we give them to officials in body bags. We spray them with chlorine solution and close all orifices with chlorine soaked compresses. The relatives are strictly not allowed to take the dead back home. The danger of infection is too high.

SPIEGEL ONLINE: It must be hard for those left behind to deal with the loss then.

Wolz: That's right. But we really don't have any time to provide psychological assistance. We put all our efforts into treating, and healing, people. Naturally we try and explain as much as possible. We talk a lot to patients and their relatives so that they know how to look after themselves when they are allowed to go home.

SPIEGEL ONLINE: There have been multiple incidents of violence against the United Nations soldiers because of a rumor that the contingent from Nepal had introduced the cholera. What is the security situation currently like there?

Wolz: It caused massive security problems. Barricades were erected in the streets. It led to people fortifying themselves in their houses and being too afraid to go out. This was a big problem for us because it meant the infected did not come to our treatment centers soon enough. Those who found their way to us late were already half dead.

SPIEGEL ONLINE: Elections are scheduled for this weekend and riots could break out again.

Wolz: Yes, at the moment that is our biggest concern. If the city is blocked by these disputes, then more people will die in their homes. Children are most at risk. They are already weak, anyway, and can die within an hour if they are not treated quickly. With cholera, it can be a matter of minutes. We really hope that these elections go peacefully.

Interview conducted by Julia Stanek

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