Sunday, October 24, 2010

Love in the time of Haiti

Ahh, Cholera, what an interesting history you have. Such a small bacterium can definitely grouped in with the most historically significant pathogens in the history of humans. And, although we've figured you out, you still never cease to infect us.

If you aren't hip to reading news, or science/health news specifically, then you probably aren't aware of the fact that Cholera is ripping through Haiti's rural towns and has made it to the capital. This is important, for historical reasons...and because Cholera kills 100,000 to 120,000 people every year.

Lets take a little trip through the pathogenic history of Vibrio cholerae.

1816 - 1826: The first recorded outbreak and epidemic of Cholera struck Bengal and spread through China, Indonesia and the Caspian Sea with British troops. It is estimated that 15 million people died during the ten year tour of Cholera.

1829 - 1851: Russia, Hungary, London and Paris are all affected. Scientists scrambled to figure out the method of transmission of Cholera, while mass hysteria hit the major cities. The media coined the term "King Cholera" (which is of the same caliber as calling H1N1 "Swine Flu", in my opinion). 

This was a specifically crucial time in the development of Epidemiology. Many scientists were throwing out disease theories in hopes that one would stick. William Farr proposed the Miasmatic Theory of Disease, suspecting that Cholera was spread through "bad air" or "poisonous air".

Sorry, William Farr, you were wrong. But, many grim, black metal-esque illustrations were created to emphasize the false truth of this theory.

 Remember, at this time in history, faith-based disease theory and healing were still alive and widely believed. If it wasn't the deadly diarrhea that scared you, then the giant Cholera spirit surely would.

I shouldn't admit that I was tempted to make an AC/DC reference as the caption for that photo...

Anyway, John Snow, a British physician, took the cake with his theory on the spread of Cholera in 1854. Snow discovered that Cholera was being spread through use of contaminated water pumps that were being sourced from a well that was only 3 feet away from a cesspit. He discovered this by going door to door and surveying the people about their symptoms, and the source of their water. People actually told him that the pump that was, unknowingly, contaminating everyone was the source of the best water in town. 

...maybe it was the added benefit of a gram negative bacterium.

 Following the UK and Europe's Cholera outbreak, the bacterium spread throughout Asia, Africa and South America. There have been outbreaks in North America, but nowhere as severe and widespread as those in Africa and South America. 

So this brings us back to Haiti. Ten months ago, Haiti endured a 7.0 magnitude earthquake that left 1,000,000 people homeless. Most of these people have used any resources available to create a "tent cities" (Haitian hooverville?) throughout Haiti, yet mostly centered near Port-au-Prince. Earthquakes, obviously, affect sewage and sanitation, so it was really only a matter of time before we heard about an outbreak of Giardiasis or Cholera. On top of that, 230,000 people died during the earthquake and subsequent aftershocks. Now, Haitians must live amongst ruined sanitation efforts and mass graves.

Over 200 people have died from Cholera in Haiti in this latest outbreak. Cholera can kill its victims pretty quickly if not treated adequately. There is typically a period of 2-15 days between infection and symptoms. Most people that are infected with Vibrio cholerae experience terrible fits of diarrhea, fever, sometimes vomiting, and extreme dehydration.

Approximately 80% of illnesses in developing countries can be attributed to their poor sanitation and lack of adequate water sources. There are non-profit organizations that are working to address this issue. Many organizations have attempted to give aid and develop programs to bring clean, safe water to communities in need, but have failed to realize that they need to focus on the sustainability of the project, as well. How feasible is it for these communities to maintain the project after relief and aid efforts have left the area? Where is the money going, exactly? What are the needs for upkeep and use of the project?

If you are thinking about donating to an organization that addresses water issues, make sure you read up on the sustainability of their program. The Water Project has emphasized the sustainability of their program, and it seems like a reasonable effort.  You can check out their completed projects here.