HAITI — Hospitals in Haiti’s capital, Port-au-Prince, face closure if fuel for diesel generators and critical medical supplies is not made available soon, according to Médecins Sans Frontières (MSF), Health Policy Watch has reported.

“We will not be able to operate our medical facilities for more than a few weeks if we do not have access to fuel,” said Mumuza Muhindo, MSF’s head of activities in Haiti.

“In addition, medical equipment, which we also need to continue to treat cholera cases and provide care to the population, is currently blocked at the port.”

The ongoing gang blockade of a key fuel terminal in the country has exacerbated shortages. According to documents seen by Reuters, this has prompted its neighbor, the Dominican Republic, to approve a request to export 20,500 gallons of diesel to Haiti for use primarily in hospitals.

As long-term outages continue to plague Haiti’s power grid, hospitals must rely on fuel to ensure consistent power. The healthcare system in Haiti’s capital is already on the verge of collapse.

Hospitals in Port-au-Prince have been forced to reduce their services in recent days due to a fuel shortage as the country teeters on the brink of foreign intervention and revolution

Unsafe water is one of the main causes of the spread of cholera, and with no functioning government, escalating violence, and no clear path to a resolution of its political crisis, the resurgence of the disease in Haiti could be disastrous, warned Auguste Ngantsélé, MSF’s Haiti Medical coordinator.

“Without drinkable water, treatment, and good waste management, the risk of a spike in the number of cases is very high and needs to be addressed urgently.”

Additional reports emerged last week of an outbreak in an overcrowded prison where dozens of people were infected, triggering fears that transmission may grow out of control. 

Amid the chaos, the re-emergence of cholera, officially confirmed on October 2, poses a growing threat. As of 8 October, there were 224 cases officially confirmed, according to WHO. 

Haiti has a long history of cholera. Its most recent outbreak occurred in 2010, following a devastating earthquake, and it was the worst in recent global history, resulting in approximately 10,000 deaths and 820,000 cases.

Current cholera outbreaks and vaccine rationing

According to the World Health Organization, 29 countries have reported cholera cases this year, a significant increase from the previous five-year average of fewer than 20 countries with outbreaks.

Furthermore, the fatality rate has nearly tripled from about 1% to around 3%, raising concerns.

In Haiti, which had not reported a cholera case in over three years, Doctors Without Borders teams in Port-au-Prince report treating an estimated 100 patients per day.

Yemen experienced the worst cholera outbreak in recorded history, with over 2.5 million cases and approximately 4,000 deaths.

The outbreak started in Yemen in 2016 and has only recently begun to subside, especially as the long-running conflict has ended and humanitarian workers have been able to resume cholera vaccination campaigns.

Meanwhile, natural disasters affecting clean water supply are becoming more common as a result of climate change. Floods, for example, pollute water, and droughts deplete safe drinking water supplies.

And now there are problems with vaccine supply. Due to a scarcity of vaccines, the International Coordinating Group (ICG), which includes representatives from the WHO, Doctors Without Borders, UNICEF, and the Red Cross, has temporarily suspended the two-dose cholera vaccination strategy in favor of a single-dose.

The director general of WHO, Tedros Adhanom Ghebreyesus, said, “The one-dose strategy has proven effective in previous outbreaks. Though evidence on how long protection lasts is limited.”

A single dose of the cholera vaccine does not provide immunity for as long as a two-dose regimen and is less effective in providing immunity to children.

The change in vaccination strategy, on the other hand, is intended to allow more people to be vaccinated during the current outbreak and at a time when cholera vaccine supplies are extremely limited.

So far this year, 24 million doses of cholera vaccine have been shipped, with an additional 8 million doses approved for emergency use in four countries affected by the outbreak.

According to WHO, this change in vaccination strategy is only a temporary solution and that immediate action is required to increase global vaccine production.

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