Monday, October 25, 2010

Haiti cholera and poverty

Haiti, wrecked by a massive earthquake in January, is now struggling with an epidemic of cholera that has spread through camps of earthquake refugees and into the nation's capital of Port-au-Prince.

Cholera is, essentially, the worst food poisoning you can possibly imagine. After you ingest the cholera bacteria, it'll hang out in your gut for a few days before symptoms kick in. Once they do, though, cholera can kill you within hours. How? to be blunt: Massive, constant diarrhea that drains the body of fluids and electrolytes and leaves victims looking like glassy-eyed, hollow-cheeked corpses before they actually are.

Frustrating, because it ought to be relatively simple to treat and prevent infection. We know what to do to help a cholera victim survive. All it takes is access to clean water and the most basic medical supplies. The trouble here isn't science, it's poverty. Today, cholera is all but non-existent in developed countries. Not because we're immune. Not because we have access to a miracle drug. It's simply about money. Money, and the will to build public sanitation systems that treat the poor and the wealthy to an equal level of separation between what we drink and what we excrete.

It is all about the money. What kills you isn't so much the diarrhea, itself, but the loss of fluids and essential salts and minerals. Replace enough of those, soon enough, and people tend to survive. In fact, one of the greatest public health inventions of the 20th century—and, perhaps, the most underrated—is the pre-mixed Oral Rehydration Therapy sachet—little packets containing dried mixtures of mostly sodium and glucose. Pour a packet into clean water, and you have an instant treatment for cholera. This is pretty much all that stands between a bout of cholera meaning a really bad, gross week, and a bout of cholera meaning death. Right now, people are dying in Haiti not because we don't know how to save them, but because of a lack of access, both to clean water and to Oral Rehydration Therapy.

In other words, they are dying not because of a disease, but because of poverty.

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