tagged w/ waterborne diseases
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The swollen Mississippi River rolled south Wednesday, swamping emptied-out towns and businesses and threatening untold damage to areas still recovering from a series of natural disasters.
Authorities and residents braced for the days ahead in Mississippi, Louisiana and Arkansas.
"I went through (Hurricane) Katrina," said Lynn Magnuson of New Orleans. "I would not wish flooding on anyone, and this city is the last place on Earth that needs any more high water."
The river crested Tuesday at Memphis, just short of a record set in 1937.
The Mississippi in Memphis measured 47.8 feet Tuesday night, according to the National Weather Service.
In Natchez, Mississippi, the river surpassed its record early Wednesday, exceeding 58 feet. Forecasts predict the river will crest in Natchez on May 21 at an overwhelming 64 feet.
Mississippi already has had to close some casinos at Tunica, a key economic driver in that part of the state, as floodwaters seeped in.
About 600 people in the Tunica community of Cutoff have been driven from their homes, said Larry Liddell, a county spokesman.
"We're just watching and waiting," he said.
Louisiana Gov. Bobby Jindal said flooding could affect as many as 3 million acres in his state. Some 500 National Guard members have been mobilized so far, and 21 parishes have issued emergency declarations.
The river's crest is expected to begin arriving in Louisiana next week. The flooding would be a major setback in the southern part of the state.
"After hurricanes Katrina, Rita, Gustav and Ike -- as well as the oil spill -- Louisiana can ill afford another large-scale disaster," said Sen. Mary Landrieu, a Louisiana Democrat. "Billions of dollars in property is at stake, not to mention the threat to human life."
The U.S. Army Corps of Engineers said it was closing a major lock that allows for the transfer of barge traffic between the Mississippi and the Red River Basin.
On Tuesday, the Corps opened 44 more gates to the Bonnet Carré Spillway in Norco, Louisiana, north of New Orleans, sending millions of gallons of water rushing into Lake Pontchartrain and, eventually, the Gulf of Mexico.
In addition to 28 gates opened Monday, it may consider opening an additional 38 Wednesday, according to John Young, the Jefferson Parish president.
Mississippi mayor: 'It's very painful'
Neighborhoods swallowed by rising river
Flood victim: 'It smells like sewage'
As the swollen waters inch closer, anxious Louisiana residents are demanding answers.
In postings on Facebook pages operated by the Corps, some have demanded answers about when certain spillways will be opened and what other areas are facing flooding.
In Arkansas, the Farm Bureau estimated damage to the state agriculture could top $500 million as more than 1 million acres of cropland are under water.
In Helena, Arkansas, the river was above 56 feet Wednesday. Flood level in Helena is 44 feet.
cont.The swollen Mississippi River rolled south Wednesday, swamping emptied-out towns and... more
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http://www/circleofblue.org/waternews/2010/world/hold-cholera-in-haiti-the-climate-connection
After lying dormant in Haiti for half a century, a three-week-old cholera outbreak has killed more than 700 people and is advancing across the country. On Tuesday, the epidemic reached Port-au-Prince, Haiti’s capital and largest city, where more than a million people are still squatting in over-crowded tent camps and sharing scant latrines. Hurricane Tomás, meanwhile, struck Haiti’s shores on Friday, flooding vulnerable tent camps. Reported infections have climbed close to 10,000 cases — nearly doubling in the last week.
“I don’t think we are going to see the end of it any time soon,” Emmanuelle Schneider of the United Nations Office for the Coordination of Humanitarian Affairs told Circle of Blue. “It’s very contagious and it can spread fast.”
Cholera, a water-borne disease, can spread rampantly when clean water and proper sanitation are not available, as had been the case in Haiti long before the January earthquake that killed 250,000 and displaced 1.6 million. But the damage from the earthquake, which hit hardest in Port-au-Prince, could be the compounding factor that allowed cholera to rise from the rubble.
Researchers, health officials and the media are all seeking answers to the same question: where did the cholera bacteria come from?
The Centers for Disease Control and Prevention (CDC) reported that the strain of cholera that is spreading in Haiti originated in Southeastern Asia. That finding prompted news organizations to focus on humanitarian workers as the source of infection, an assertion that medical specialists quickly discounted. A handful of activists, in addition, blame the outbreak on Haiti’s substandard housing since the quake.
snip
“They have been fortunate in Haiti that for 50 years the conditions have been such that they haven’t had an intense increase in cholera bacterial populations,” said Rita Colwell, professor at the University of Maryland and former director of the National Science Foundation. “But they’ve had an earthquake, they’ve had destruction, they’ve had a hurricane. So the conditions would lead to a very high probability of an outbreak.”
She added: “I think it’s very unfortunate to look for a scapegoat. It is an environmental phenomenon that is involved. The reason we don’t know [the catalyst] is because the medical community is not receptive to climactic causation or correlation.”
The Climate Connection
Cholera is an intestinal bacterial infection spread by eating food or drinking water that has been contaminated.
Although rural areas experienced less damage from the earthquake, they were the first epicenter of the epidemic. The small communities along the Artibonite River, located 60 miles north of Port-au-Prince, have been using the river as a source of drinking and bathing water — until reports came that the river is the likely source of the outbreak.
“Cholera was originally in the Artibonite River,” Schneider said. “But people are very mobile, so they are moving from place to place, which is a trigger for the cholera epidemic.”
In the last few decades, great strides have been made in unlocking the riddles associated with cholera and seasonal climate patterns. Dr. Colwell was among the first to find that cholera epidemics flare up during the wet spring and fall seasons, when excess precipitation creates favorable environmental conditions such as increased salinity and warmer temperatures in areas already suffering from poor sanitation and lack of clean water access.
Colwell and her colleagues are studying 75 years of cycles in India and hope to have definitive parameters in the next few months. Additionally, using weather data from 1991-1992 and 1997-1998, they have shown that there is a correlation between cholera outbreaks in Latin America and El Niño climate patterns.
The intent of her research is to predict cholera outbreaks using the link between weather patterns, water surface temperatures and plankton blooms — all of which could be detected using remote sensing satellites. An early warning system for coastal dwellers would have been valuable for Haiti.
Afsar Ali, an associate professor of environmental and global health at the University of Florida, agrees with the environmental climate conclusion. He told the Tampa Bay News that the cholera outbreak is happening now, rather than immediately following the earthquake in January, because the water temperature is warmer. And since the first cases of cholera were reported in a coastal city, Ali believes that residents had longtime immunity, whereas the estimated 300,000 refugees who moved to the Artibonite region after the earthquake did not.
Even before the earthquake, there were risk factors for water-borne disease. More than 40 percent of Haiti’s total population did not have a source of reliable drinking water, according to a study by the United Nations. And nearly half of rural Haitians were defecating in the open, according to a joint study by the World Health Organization and UNICEF.
snip
Colwell, who this year was awarded the Stockholm Water Prize, has studied the link between cholera and climate for the last 30 years. Her research has disproven the long-held belief that cholera could only enter the environment due to a release of sewage, and has proven that there is a link between changes in the natural environment and the spread of disease.
conthttp://www/circleofblue.org/waternews/2010/world/hold-cholera-in-haiti-the-climate-conn... more
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A cholera epidemic spread in central Haiti on Friday as aid groups rushed doctors and supplies to fight the country's worst health crisis since January's earthquake. Nearly 200 deaths had been confirmed and more than 2,000 people were ill.
The first two cases of the disease outside the rural Artibonite region were confirmed in Arcahaie, a town that is closer to the quake-devastated capital, Port-au-Prince.
Officials are concerned the outbreak could reach the squalid tarp camps where hundreds of thousands of quake survivors live in the capital.
"It will be very, very dangerous," said Claude Surena, president of the Haitian Medical Association. "Port-au-Prince already has more than 2.4 million people, and the way they are living is dangerous enough already."
The Ministry of Health confirmed 194 deaths and 2,364 cases of cholera, said Imogen Wall, a spokeswoman for the U.N. Office for the Coordination of Humanitarian Affairs.
"It's concentrated in Artibonite right now and we're doing our best to keep it that way," Wall said.
Dozens of patients lay on the floor awaiting treatment at the St. Nicholas hospital in the seaside city of St. Marc, some of them brushing away flies on mattresses stained with human feces.
One of them, 55-year-old Jille Sanatus, had been there since his son Jordany brought him Thursday night. A doctor was struggling to stick a needle into his arm.
"He's completely dehydrated, so it's difficult. It's hard to find the vein," said Dr. Roasana Casimir, who had been working nearly without rest since the outbreak began two days earlier.
Casimir finally penetrated the vein and fluid from an IV bag began to trickle in, but half an hour later the father of 10 was dead. Two hospital employees carried the body to the morgue behind the hospital and placed it on the ground for the family to reclaim for a funeral.
Sanatus' son said the family had been drinking water from a river running down from the central plateau region. Health Minister Alex Larsen said Friday that the river tested positive for cholera.
Wall said the sick patients and the contagious remains of the dead were insufficiently quarantined.
"Part of the problem has been people are moving around a lot, and there hasn't been proper isolation in place at the clinics," she said.
The sick come from across the desolate Artibonite Valley, a region that received thousands of refugees following the Jan. 12 earthquake that killed as many as 300,000 people and destroyed the capital 45 miles (70 kilometers) south of St. Marc. Most of the new arrivals have been taken in by host families.
In addition to the two cholera cases confirmed by the health ministry in Arcahaie, the International Medical Corps said it was investigating other possible cases in Croix-des-Bouquet, a suburb of the capital. Radio reports also said there were two dozen cases of diarrhea on Gonave island.
Cholera was not present in Haiti before the earthquake, but experts had warned that conditions were ripe for disease to strike in areas with limited access to clean water.
"You cannot say it is because of the earthquake, but because of the earthquake the situation here requires a high level of attention in case the epidemic extends," said Michel Thieren, a program officer for the Pan-American Health Organization.
cont.A cholera epidemic spread in central Haiti on Friday as aid groups rushed doctors and... more
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A cholera outbreak has hit the region along the Artibonite River, between the cities of Saint-Marc and Mirebalais.
Following the outbreak of acute diarrhea in the Artibonite region of Haiti, Doctors Without Borders/Médecins Sans Frontières (MSF) medical teams—including doctors, nurses, and logisticians—immediately traveled to the affected areas along the Artibonite River, between the cities of Saint-Marc and Mirebalais.
According to Haitian health authorities, at least 138 people have died and 1,500 cases of cholera have been confirmed.
In collaboration with national health authorities, MSF is providing human resources and technical and material support to health structures in Saint-Marc. Teams are involved in treating patients and implementing necessary measures to prevent the outbreak from spreading. MSF is sending additional medical materials and experienced staff to the affected areas.
MSF is not able to confirm either the cause or the exact bacterial type of the outbreak. The Artibonite region was not affected by the January 12, 2010, earthquake.
MSF Activities in Haiti
In Haiti, Doctors Without Borders/Médecins Sans Frontières (MSF) has more than 3,000 Haitian and international medical and non-medical staff providing assistance to the population. They run seven private, free of charge, secondary-level care hospitals and support two Ministry of Health structures in Port-au-Prince, accounting for nearly 1,000 hospital beds in the capital city. These facilities provide emergency, trauma, obstetrical, pediatric, maternal, and orthopedic care services. Mental health care and treatment and counseling for victims of sexual violence are also provided by MSF.
MSF is also in the process of opening a new emergency obstetrical hospital with 100 beds in the Delmas area of Port-au-Prince. Outside the capital, MSF supports Ministry of Health hospitals in the cities of Leogane and Jacmel with nearly 200 beds of patient capacity. MSF opened a private 120-bed container hospital in Leogane in October.
From January 12 to September 30, MSF has treated more than 339,000 people, performed more than 15,700 surgeries; and delivered over 9,900 babies. MSF also provides primary medical care and relief supplies to displaced persons living in various camps in Port-au-Prince through mobile and fixed clinics, and is carrying out water-and-sanitation services to displaced persons in the Cite de Soleil slum.A cholera outbreak has hit the region along the Artibonite River, between the cities... more
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When the 47-member Human Rights Council (HRC) affirmed last week that the right to water and sanitation was a basic human right, the consensus resolution was described as a "historic first" for the U.N.’s premier human rights body based in Geneva.
"This landmark decision has the potential to change the lives of billions of human beings who still lack access to water and sanitation," claimed Catarina de Albuquerque, a U.N. independent expert on human rights obligations.
What this means, Albuquerque explained, is that the right to water and sanitation is equal to all other human rights - and is therefore legally binding and enforceable in existing human rights treaties.
The consensus resolution was a logical follow-up to a key General Assembly resolution adopted last July which also - for the first time - recognised water and sanitation as basic human rights.
But in reality water and sanitation have remained two of the most neglected sub-texts of the eight Millennium Development Goals (MDGs) which came under scrutiny at the MDG summit here last month.
At this much-ballyhooed summit, world leaders adopted a plan of action - officially called the ‘outcome document’ - which recognised the obstacles thwarting the MDGs and offered pledges and commitments to reach the defined goals by the targeted date: 2015.
The primary goals and sub-goals include a reduction by 50 percent the proportion of people living in extreme poverty and hunger, the reversal of the spread of HIV/AIDS, the elimination of gender inequality, and the reduction by half the proportion of people without access to water and sanitation.
Currently, over 800-900 million people have no access to safe drinking water and over 2.6 billion people are living without adequate sanitation.
While most developing nations have made limited progress in providing clean water, the targets for sanitation remain virtually unreachable.
"If current trends continue unchanged, the international community will miss the 2015 sanitation MDG target by almost one billion people," warns U.N. Deputy Secretary-General Asha-Rose Migiro.
In an interview with IPS, Jon Lane, executive director of the Geneva-based Water Supply and Sanitation Collaborative Council (WSSCC), said he sees visible signs of progress since 1.3 billion people have gained access to improved sanitation since 1990.
Still, he says, "the pace is too slow to allow the world to meet the MDG target on sanitation."
"There are many reasons for this slow pace," Lane said, "but the main one is that political leaders in developed and developing countries have not grasped the fundamental role that good sanitation plays for people’s health, dignity, economic well-being and local environment."
Success with sanitation would bring a huge swag of benefits, plus it would support the achievement of other MDG targets on child and maternal mortality, education, and poverty reduction, among others, he added.
Jamie Bartram, director of the Water Institute at the Gillings School of Global Public Health at the University of North Carolina, told IPS the MDG targets for water and sanitation are "wildly under-ambitious".
The idea that anything less than water and sanitation in every home is a serious target in today’s world is astonishing and binds millions in poverty, he pointed out.
"Today’s MDG targets focus on water and sanitation for households. But these essential needs are required elsewhere too - in schools, workplaces and markets for example," said Bartram.
The idea that it is possible to deliver effective health care services without reliable and safe water and sanitation makes no sense, but yet it is the reality of many health facilities.
"It is often said that sanitation lags water. Yet, if we use as simple benchmarks their availability at home, then we see that water lags sanitation and both are available for only around half of humankind," Bartram noted.
He also said that water and sanitation offer rare opportunities to make progress across the MDG agenda, yet have not attracted the attention they deserve.
Asked if the outcome document adopted by the U.N. summit last week offers any hope, Lane, of the WSSCC, told IPS the document makes note of sanitation 17 times. "This is good, and an improvement over the past." Remember, sanitation was not originally an MDG target, he said.
However, it remains to be seen whether the outcome document as a whole is concrete enough to accelerate progress so that the target is reached.
What’s missing, Lane pointed out, is a reference to hygiene practices: hand washing with soap can save one million lives per year - mostly children in developing countries.
Fortunately, there is momentum in the sector and sanitation’s profile is rising, thanks in part to new initiatives like the Global Sanitation Fund operated by WSSCC and the new Sanitation and Water for All initiative, a multi-stakeholder network reaching out directly to finance ministers, among others.
Pointing out existing deficiencies, Bartram told IPS there is still far too much focus on building new systems, sources and supplies, and too little on keeping them working.
"The allure of opening a new facility far outweighs the prosaic task of keeping them working, but we see a large proportion of all hand pumps [for example] out of action at any one time, and investing in sustaining systems offers more bang for the buck."
He said maintaining and extending effective water supply is challenged by other demands for water for agriculture, and by other threats, such as climate change.
"It is imperative that after 2015, water and sanitation are part of the international development agenda not as part of environmental protection but as key motors for health and development in their own right," said Bartram.When the 47-member Human Rights Council (HRC) affirmed last week that the right to... more
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UN: Flooding has displaced 1 million more in Pakistan
By the CNN Wire Staff
August 27, 2010 9:41 p.m. EDT
Levee break displaces thousands
STORY HIGHLIGHTS
* NEW: U.N. is increasingly worried about flood-driven malnutrition among children
* U.N. official says a "colossal disaster is getting worse"
* About 1 million additional people have been displaced in Sindh province, the U.N. says
* Authorities have ordered evacuations in the Indus River delta
Islamabad, Pakistan (CNN) -- Flooding has displaced an additional 1 million people in Pakistan's Sindh province in the past two days, according to new U.N. estimates released Friday.
"We have more people on the move, to whom we need to provide relief. An already colossal disaster is getting worse and requiring an even more colossal response," said Maurizio Giuliano, a spokesman for the U.N.'s Office for the Coordination of Humanitarian Affairs.
Giuliano said rains have forced the evacuation of an estimated 1 million people in southern Sindh in the past 48 hours or so.
"The magnitude of this crisis is reaching levels that are even beyond our initial fears, which were already leaning towards what we thought would be the worst. The number of those affected and those in need of assistance from us are bound to keep rising. The floods seem determined to outrun our response," he said.
The U.N. also said Friday that it is increasingly concerned about flood-driven malnutrition among children.
"The flooding has surrounded millions of children with contaminated water," said Karen Allen, deputy representative of the United Nations Children's Fund (UNICEF) in Pakistan. "Most have nothing else to drink. We fear the deadly synergy of waterborne diseases, including diarrhea, dehydration and malnutrition."
Acute malnutrition was high in much of Pakistan even before the floods. For instance, 27 percent of children under 5 in Baluchistan province were malnourished, as were 17 percent of children in Punjab, according to the U.N.
A hospital in Sindh is overrun with people suffering from waterborne illness; two children share each bed and more are on the floor. A doctor at the hospital said there are "not enough resources because of huge population ... coming to this hospital."
Remat Chacher, a farmer in Sindh, escaped the floodwaters with his wife and two children earlier this month.
But then his 3-month-old daughter Benazir got sick. "She started to get fever and couldn't keep anything down ... lots of belly pain," said Ulla, the infant's mom.
A few days later, the same symptoms struck the Chachers' son, 2-year-old Wazira. Both children died on the way to the hospital, with Wazira weighing just 8 pounds and Benazir weighing 2 pounds.
Floodwaters have started to recede across Pakistan, but in the Indus delta, the potential for more flooding remained high, especially given high tides in the Arabian Sea, where the Indus spills out.
Already, more than 17 million Pakistanis -- from the Chinese border in the north to the mouth of the Indus in the south -- have been affected by the monsoon floods that began a month ago.
To date, Pakistan's unfolding tragedy has claimed 1,600 lives, according to the National Disaster Management Authority. That number is likely to rise as more drowned bodies are discovered in receding waters.
Many refugees have sought shelter at relief camps, where food and drinking water are now available. But every day, there are new camp arrivals -- people who were already poor, who now have nothing.
Along the flooded Swat River in northeastern Pakistan, six local aid workers have spent two weeks braving the torrents on rafts they built from used tire tubes, bamboo and gaffers' tape after motorized boats failed to arrive.
The workers are ferrying tents, blankets and other supplies to hundreds of thousands of people stranded across the river and cut off from normal supply routes.
Last year, bombs and bullets from the army's offensive against the Taliban destroyed many homes and lives in the region. Residents had barely begun to recover when the rains came.
"We are fed up," said Shahravan, a 65-year old man who lost his house in the floods. "You don't ask a dead man why he's in his grave. It's not his choice."
Fayas Muhammad, another local, said he lost his leg when his house was mistakenly bombed in last year's fighting. The same blast took his wife and son. "We are very sad for all that Swat has been through," he said.
The damage from Pakistan's worst humanitarian catastrophe is sure to hurtle the impoverished nation back in terms of development. This week, America's top aid official saw firsthand the dire needs in Pakistan.
Dr. Rajiv Shah, administrator for the U.S. Agency for International Development, said he was deeply moved by his visit to Sukkur and that aid agencies were "scaling up their response efforts as quickly as they possibly can."
Shah announced the United States would be diverting another $50 million for flood relief from the Kerry-Lugar Act, which allocated $7.5 billion in nonmilitary assistance to Pakistan over five years.
CNN's Sanjay Gupta, Reza Sayah, Samson Desta, Sara Sidner, Moni Basu and journalist Nasir Habib contributed to this report.UN: Flooding has displaced 1 million more in Pakistan
By the CNN Wire Staff
August... more
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Port-au-Prince, Haiti's densely populated capital, is home to more than 2 million people, each of whom, under normal circumstances, needs to drink about a gallon of clean water every day, just to survive. Basic needs such as washing and cooking add another three gallons or so per person each day.
Those numbers illustrate the stark crisis looming as international relief agencies race to blunt the next phase of the disaster in Haiti -- a shortage of clean water that threatens survivors with potentially fatal dehydration and massive outbreaks of water-borne diseases.
"Once water supply is disrupted or contaminated, this could complicate the situation," said Jon K. Andrus, deputy director of the Pan American Health Organization, an arm of the World Health Organization that is helping orchestrate the response. "Water is top on our list."
The agency has established a makeshift headquarters near the airport and opened a field office in the Dominican Republic, about 90 minutes from Port-au-Prince, to "serve as a bridge for the management of supplies and medical relief teams," Andrus said.
But clean water is perhaps the highest priority because water is more important than food for human survival.
"The human body lives a lot longer without food than without water," said Thomas Kirsch, co-director of the Center for Refugee and Disaster Response at the Johns Hopkins Bloomberg School of Public Health in Baltimore. "Without food, we have fat stores we can cannibalize. But there is no water store."
Four gallons a day usually suffice if temperatures are moderate and there is no unusual stress. In less favorable conditions, an individual's need can be greater.
"Water is one of the basic necessities for drinking and cooking and sanitation to maintain appropriate hygiene in situations where you can have rampant infectious disease," said Kellogg J. Schwab, director of the Hopkins Center of Water and Health.
In addition to causing death from dehydration, a lack of clean water can trigger outbreaks of dysentery, cholera, typhoid fever and other illnesses.
"Diarrheal outbreaks could pose a huge problem," Andrus said.
The water purification and sanitation systems of an impoverished nation such as Haiti are typically old, poorly maintained and reliant on aging pipes and trucks for distribution. After the earthquake, the fragile system that existed was probably devastated as pipes broke, bathrooms were destroyed, pumps lost power and existing water supplies were contaminated.
"They don't have a good system in place. It has a lot of problems in the normal situation," said Luiz Galvao, PAHO's manager of sustainable development and environmental health. "Now it will be worse -- much worse."Port-au-Prince, Haiti's densely populated capital, is home to more than 2 million... more
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Approximately 2.5 billion people in this world do not have adequate access to sanitation, with waterborne diseases being the number one killer of children in the developing world. This was a project performed to test the effects of solar disinfection of water to reduce childhood diarrhoea in rural Bolivia. It is studies like this that hopefully will bring better health to developing rural communities where sanitation and access to potable safe water is a daily life and death struggle.Approximately 2.5 billion people in this world do not have adequate access to... more
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