Washington, D.C., 6 October 2016 (PAHO/WHO) - With damage assessments from Hurricane Matthew still underway in the Caribbean, the Pan American Health Organization/World Health Organization (PAHO/WHO) deployed field teams even before the storm affected areas in Haiti, the Bahamas, Cuba, and Jamaica, and is preparing for a possible cholera upsurge in Haiti, where more than 28,500 cases have already been reported so far in 2016.

In Haiti, nine of the country's 15 main hospitals remain operational, five are unreachable by phone or radio, and one, Les Cayes Hospital in Sud Department, was evacuated to a functioning hospital, according to PAHO's Health Emergencies Department. At least 23 persons are dead, over 10,000 are in shelters, and bridge collapses have made access to three departments very difficult.

PAHO's regional response is supporting technical activities in four countries, including Haiti, Jamaica, Cuba, and Bahamas. The organization has deployed 11 Regional Response Team experts to these countries.

PAHO's office in Haiti activated its 35 staff members to respond to Hurricane Matthew and the cholera epidemic. Additional experts in health coordination, Emergency Medical Teams, logistics and supply management and four field teams were deployed and are coordinating the response with national officials and the Ministry of Health.

First meeting of PAHO's response team with the Ministry of Health of Haiti.

Due to massive flooding and its impact on water and sanitation infrastructure, cholera cases are expected to surge after Hurricane Matthew and through the normal rainy season until the start of 2017, so PAHO is already supporting the Ministry of Health in enhancing surveillance and identifying areas at high risk of cholera outbreaks. In these areas, usually with poor access to water and sanitation, where there are high attack rates and high case fatality rates, PAHO will implement targeted interventions to minimize the surge in cases of cholera. 

Starting this week, PAHO is deploying field epidemiologists with cholera experience to track and control the outbreaks. The next step will be to strengthen the cholera alert and response networks that were active since 2010 until recently, with epidemiologists and field coordinators in priority areas integrated into PAHO response teams.

Since October 2010, Haiti has reported more than 790,000 cases of cholera and more than 9,300 deaths. This year, cholera red alerts have been activated by the Ministry of Health for 12 municipalities in 4 departments for multiple localized outbreaks. 

PAHO's Emergency Operations Center and the National Emergency Operations Center and centers in the departments have been activated, and a Shelter Team and Evacuation Coordination Unit are on standby to respond.

In Cuba, 900,000 people were evacuated and 30 national emergency medical teams were deployed. In Jamaica, 112 shelters were opened with 1,378 occupants. In the Bahamas, PAHO deployed three experts in water and sanitation and health coordination and is completing a readiness assessment of clinics, and experts were identified to support Turks and Caicos for post-hurricane rapid assessment. 

Response teams have been placed on alert in other countries and territories including Turks and Caicos, as well as Eastern Caribbean islands including Barbados, Dominica, St. Vincent and the Grenadines, and Saint Lucia, which are assessing damages from the storm.

In the Dominican Republic, over 14,600 people were evacuated and provinces bordering Haiti were placed on alert. In Colombia, where 73,000 people were affected, damage assessment and needs analysis are continuing, alerts remain for the risk of floods and landslides in some areas, and emergency humanitarian assistance was provided for affected families in the Magdalena Department.

PAHO is coordinating with partners including the Red Cross, OCHA, the World Food Program, the USAID Office of Foreign Disaster Assistance, ECHO, Global Affairs Canada, and the DFID agency of the United Kingdom.