Cholera in post-earthquake Haiti: how an outbreak became an epidemic
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Cholera in Haiti has persisted since its introduction after the 2010 earthquake. The outbreak demonstrates how a combination of socioeconomic factors, mainly a lack of infrastructure, can cause an outbreak to become a much more serious epidemic and the current enduring endemic. Because cholera came to a previously unexposed nation through United Nations peacekeepers, the outbreak in Haiti offers a unique perspective on the impact of globalization on public health. In addition, it provides a deeper look into the disproportionate impact of diarrheal diseases on low-income countries. Several biological and socioeconomic factors have facilitated the outbreak. Biological risk factors include immunologically naïve populations, low gastric acidity, and blood type. In addition, socioeconomic factors include a lack of clean drinking water and sanitation as well as a fragile and over-taxed healthcare system. The persisting struggle surrounding water and sanitation combined with a lack of knowledge on cholera prevention have precipitated the outbreak into an epidemic and further into its current endemic status. Current efforts to battle cholera include water and sanitation improvements, a national vaccination campaign, as well as the mobilization of community health workers. However, without the construction of sustainable water and sanitation infrastructure, it is unlikely that cholera in Haiti can be eliminated.