Haiti is currently facing its first cholera outbreak in a hundred years. It’s not a surprise, exactly. It was something public health experts have been afraid of since the earthquake. But after nine months, we were starting to hope maybe it wouldn’t happen.

According to the BBC, 196 people have now died, and 2,634 have been hospitalized as the result of the cholera outbreak. It is most likely the result of drinking water from the Artibonite River. A few of the sufferers report drinking only purified water, but they may have gotten the disease from accidentally swallowing bathing water or from food prepared by an infected person.

Cholera is exactly the kind of diseases you worry about after a natural disaster. It comes from drinking water tainted with fecal matter, which is what happens when infrastructure is destroyed and people don’t have access to clean water or functioning toilets. Cholera is especially hard on children, who dehydrate and very quickly from the diarrhea caused by the disease.

The Haiti Operational Biosurveillance blog is tracking the cholera outbreak. They have confirmed that the disease has spread from the Arbonite valley, and are now researching accounts of cholera within Port au Prince. If it is indeed spreading in Port au Prince, the death and hospitalization rates will shoot up in the densely packed urban environment.

Individuals tweeting from Haiti are deeply anxious about the spread of the disease, and about quality of care. Carel Padre reports that patients have been sleeping on the floor of overcrowded hospitals. A doctor based on Port au Prince points out that investing in cholera prevention is also a long term investment, “Even if PAP makes lots of preparations for cholera that never comes, they would be good investments. Clean Water, Sanitation, ORS for kids.”

Melinda Miles, Director of Let Haiti Live, expressed her frustration to UN Dispatch today, “Considering that an outbreak of this nature was predicted nine months ago, it is absolutely stunning that so little was in place to prepare for it.”

She also fears for the future impact of the outbreak “The potential impact of cholera in the city of Port-au-Prince is a terrifying vision – in addition to the more than one million people living in official camps, many others are living in tents on side streets and in their yards, and very few have access to potable water or sanitary facilities. It is certain that many unnecessary deaths will be the result of poor planning and slow response.”

We’ll know very soon if this is an outbreak or an epidemic. Either way, it’s the result of slow earthquake response, and children are going to suffer the most.

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