Cholera Update - Konbit Sante

Appearing in Portland Press Herald

January 16, 2010

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Cholera dictating aid needs for Haiti

The country is desperate for proper care as well as better sanitation, says a Portland aid group's chief.

By Edward D. Murphy
Staff Writer

A year after a devastating earthquake, the immediacy of the need for aid to Haiti has passed, but the country remains desperate for long-term help, the head of a Portland-based aid group said Saturday.

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Nathan M. Nickerson, executive director, Konbit Sante

Sunday Telegram file

One Year After Haiti's Earthquake: Remembrance and Reflection

Letter from Cap-Haitien, Haiti

January 12, 2011

Dear Friends,

Today in Haiti people are solemnly observing the anniversary of the earthquake that rocked the country one year ago. It is a sad day of remembrance and reflection. There will be much said and written today about the enormity of the calamity. There will be words of acknowledgement and congratulations about all that has been done by so many heroes, Haitian and foreign. And, there will be words of rebuke and blame about all that has not been accomplished in light of the great remaining need. In this year there have been times of guarded optimism for a new Haiti that is "rebuilt right," and there have been times of anger and despair over the missed opportunities, misguided efforts, and unfulfilled promises. In many ways everything has changed since that day, and many of us who are close to Haiti have been irrevocably changed by this past year. In other ways, things are very much the same as they were before the earthquake. The basic public health infrastructure remains so poor and insubstantial, for example, that cholera has been able to spread like wildfire throughout the entire country, sparing no remote corner. It is an epidemic that could have started and spread the same way before the earthquake.

Thousands march in January 2010 to honor those who died in the earthquake.

Thousands march along the waterfront boulevard in Cap-Haitien in January 2010 to honor those who died in the earthquake

It is really not possible to capture what It is too complicated and it means too many different things to too many different people.this year has meant in a sound bite. It is too complicated and it means too many different things to too many different people. However, as I sit in Haiti today and reflect about the meaning of this day, there is one thing that stands out for me.  There is a Haitian proverb that says, "Se le ou nan malè ou konnen si ou gen bon zanmi," which translates something like, "It is when you are in trouble that you know if you have good friends."  This year Haiti was in particular trouble, and we had the opportunity and privilege to deepen and expand our friendships by standing sidebyside with the people in our sister city, to address the huge challenges they faced.  We are not big, and our resources are not greatcompared to the need, but the generosity that has been shown to us by our home community and the support that we have been able to extend here have enriched us all.

Konbit Sante is an organization, true, but the ideal of konbit sante- a group of people working together toward the common purpose of improving health- is bigger than we are, and is an ideal that we want to promote. The konbit sante that deepened over this past year includes all who made their personal or organizational agendas second to that common goal and put their shoulders to the wheel and resources on the table together. In this past year I have seen people rise to the occasion in extraordinary ways. I have been extremely proud of our staff here in Haiti for stepping up and working beyond their full capacity. I have seen rapid and effective outreach and engagement in the  communities. Volunteers have contributed in extraordinary ways. I have heard a lot about NGOs being very competitive and insular in Haiti, but in the North I have seen an increasing willingness to collaborate and share and keep focused on the common mission. I have seen the health authorities and the international groups grow in respect for each other and what each contributes for the common good.

Things are clearly not rosy here, and there is much that remains to be done, but the proverb is true; in this tragedy we have learned that we have good friends, for which we are deeply grateful, and we have learned that we can be good friends, and there is hardly a greater privilege or calling than that.


Nathan M. Nickerson, RN, Dr PH

Executive Director

Nathan M. Nickerson, executive director of Konbit Sante, who is in Cap Haitien, said those injured in the quake near the capital of Port-au-Prince who streamed north to get help have been treated, and the rate of increase in the number of cholera cases has slowed, although that disease "is now part of the landscape."

He said the spread of cholera, "which has reached every corner and village of country," highlights the need for improved sanitation and better health care in the impoverished country. Cholera is caused by drinking fecal bacteria-contaminated water, and many of the people who have died from the disease did so because they were unable to get proper care.

Konbit Sante has been working in Cap Haitien, about 50 miles north of last January's earthquake, for about a decade. The organization has hired community health workers to get care to the area's neighborhoods and also works with the Justinian Hospital, a 250-bed facility, in the city.

Nickerson noted that the earthquake sent streams of injured people from Port-au-Prince to Cap Haitien. After the injured were treated, he said, cholera began spreading because more people were drinking water from contaminated sources.

Ironically, sanitation is better in some of the tent camps for those displaced by the earthquake, and cholera has not spread as widely there as it has in other parts of the country, he said.

The outpouring of international aid in the wake of the earthquake helped lift hopes in the country, Nickerson said, "but that optimism was hampered by the lack of progress (on the country's problems), and then cholera put a hold on the sense that better days were ahead."

Nickerson said Konbit Sante has set up a treatment center for cholera patients and has also set up rehydration sites, where people can get clean water. Cholera causes severe diarrhea and vomiting, he said, and patients can become dehydrated very quickly.

Konbit Sante also hired a nurse who specializes in wound care, and more community health workers, he said. It is continuing its efforts to provide better training to doctors and nurses and helping Justinian Hospital purchase supplies.

Nickerson said the earthquake showed the world how poorly Haiti was functioning day to day.

"When everything collapsed, the pipeline (from the capital) got shut off," he said.

"The earthquake exposed how fragile things are. The earthquake, as devastating a calamity as it was, was one more thing here. The cholera was one more thing.

"The amount of destruction each of them wrought was because of the fragility of the system and the poverty that's here."

That situation can make it discouraging for aid workers, he added.

"It's a challenging place to work and see progress, and you work hard to see a little progress," he said. "There are a lot of things that are broken here. But there are some amazing Haitian people here who are really the hope for tomorrow."

Staff Writer Edward D. Murphy can be contacted at 791-6465 or at:


Founded in 2000, the Portland-based partnership works to improve health care in northern Haiti. It works with the Haitian Ministry of Health, which operates the Justinian Hospital, a 250-bed teaching facility, and a public medical clinic in Cap Haitien, Haiti’s second-largest city with a population of 180,000, about 100 miles north of Port-au-Prince.




MAINE VOLUNTEERS who traveled to Haiti last year: 31

CONTAINERS FILLED with medical supplies shipped from Portland: 11

DONATIONS AND GRANTS in 2009: $400,933


CONTACT INFORMATION: P.O. Box 11281, Portland ME 04104; 347-6733;

TO DONATE to the Konbit Sante Earthquake Reponse Fund: Visit or make checks payable to Konbit Sante, and note Earthquake Response Fund in the memo field.