Summary OCR A-level Geography cholera after the 2010 Haiti earthquake case study (Disease Dilemmas)
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Disease Dilemmas (H481)
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OCR
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OCR A Level Geography Second Edition
Highly detailed case study overview of the causes and impacts of cholera in Haiti in the long- and short-term after the earthquake in 2010, and the relative success of efforts used to address the outbreak, as well as factors influencing the vulnerability of Haiti to the outbreak
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Geography of EQ & Cholera: Impacts of cholera on the resident population:
7 magnitude Almost 660,000 cholera cases & 8,111 deaths by June 2013
Port-au-Prince = capital = large numbers affected in high density Spread across to Dominican Republic
Only 10km = shallow = more severe shaking Fatality rate of 1.2% = largest epidemic every recorded in a single country
Cholera = bacterial water-borne infection causing potentially fatal diarrhoea (10- National & international efforts = 90% reduction in number of cases
20litres per day) due to dehydration & shock (‘blue death’) Government aim to eliminate cholera transmission by 2022
Rice farmers refusing to work in paddy fields as afraid of infection = short-term food
Spread from sewage system in army barracks from untested UN Nepalese aid
shortages
troops & travelled down Artibonite river = now endemic in the country Meat prices have tripled as people are too afraid to eat fish from river in Artibonite
Poor sanitation, hygiene & malnourishment in children = Haiti was especially at Slowed development and increased poverty = long-term recovery may be impossible
risk
10 months between end of EQ and start of epidemic National Strategies to minimise impacts of cholera
Environmental factors influencing disease spread: o Treatment with oral rehydration solution
o Strengthen network of multipurpose community health agents to reach 1 agent/500-
1. Climate: hot, humid, tropical = optimal conditions for disease spread, especially in 1000 at risk people
that year as air temps were above average; exasperated during hurricane season o Coordinate & supervise hygiene & health messages
o Train all health professionals in fundamentals of combating cholera
(Eg: Hurricane Sandy) = annual cholera spikes; likely to worsen due to climate
o Establish network of community health clubs to reduce workload of health agents
change
o Vaccinate people in at-risk/still-vulnerable areas = 600,000 people
2. Sanitation & water supply: 17% could access improved sanitation facilities in 2010,
o National Plan for the Elimination of Cholera 2013-2022 = long-term:
disparity in water source access of 34% between rural and urban areas = few - 85% with access to potable water, 90% with access to improved excreta disposal
barriers to disease spread - Increase capacity of solid waste management so that 90% of household rubbish
3. Food: cholera can spread through food washed in contaminated water can be disposed of following established sanitary standards
- 80% with access to primary healthcare by strengthening capacity of Ministry of
Human factors influencing disease spread: Key Idea 1c – Case Study of a
Public Health
country linked to natural hazards
- Strengthen epidemiological surveillance using new International Sanitary Code
1. Poverty: poorest country in the Caribbean, 80% below poverty line, only 40% with & disease – Haiti EQ 2010 and National Directorate of Epidemiological and Research Laboratories
access to basic healthcare, loss of all 3 MSF aid centres = could not deal with - 75% will understand importance of washing hands before eating/after bathroom
epidemic of this scale
2. Population density: increased over time with 362.8/km2 & relatively high pop. International Strategies to minimise impacts of cholera:
densities around Artibonite valley Donations: Eg US$15mil from World Bank
3. Migration (SYNOPTIC): internal migration away from Artibonite & overcrowding in NGOs (Oxfam): set up bladder tanks supplied 70% by tanker but was only used by
poor-quality accomodation with limited sanitation facilities = faster disease spread locals for washing and cooking, not drinking, as they were suspicious of it
into remote rural areas NGOs (UNICEF 2016): 1.2mil reached with hygiene awareness messaging but number
4. Access to clean water: 83% of population had no access to facilities for waste of NGO teams reduced to 30 due to funding shortages = only 60% of reported cases
disposal at start of epidemic, damage to water infrastructure forced people to rely were responded to
Vaccinations: if funding is mobilised 750,000 people should be vaccinated and have
on contaminated rivers = further spread
access to clean water at home (PAHO, WHO, other partners); US$10mil required to
5. No natural immunity/immunisation as never existed in pop. before = more
sustain vaccination programmes until 2020
vulnerable Water & Sanitation: long-term solution, $8 return for every $1 invested in providing
How successful have mitigation strategies been? this, 5,500 toilets built/in progress by UNICEF as part of National Sanitation
Campaign, also reached 18 schools and finalising rural water system
Treatment and awareness campaigns generally great
success as mortality decreased from 10% (October
2010) to <1% (January 2011 onwards)
HOWEVER cholera still lingers in rural areas and re-
emerges each rainy season so widespread access to
clean water has not yet been achieved AND progress
towards this will be very slow due to poverty, debt
and other long-term effects of the EQ
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