Haiti Grapples With Political Unrest, Health Crisis

Haiti's election crisis has deepened after two leading presidential candidates rejected a proposed recount of last month's disputed vote. The poll was fraught with claims of voter fraud, and has sparked public protests and violence. Meanwhile, public health officials are calling for mass vaccinations in the wake of a growing cholera epidemic that has killed two thousand people and sickened almost 100 thousand others. Host Michel Martin speaks with Associated Press Correspondent Jonathan Katz and Dr. Matthew Waldorf of the Harvard Medical School.

Copyright © 2010 NPR. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

MICHEL MARTIN, host:

I'm Michel Martin, and this is TELL ME MORE from NPR News.

Former Republican Congressman J.C. Watts is on the program. In a few minutes, it's our wisdom watch conversation. He'll talk about his days on Capitol Hill and what he hopes to see in the next Congress. You might remember, he was one of only two African-American Republicans serving in the Congress in the early 1990s and two more African-American Republicans are scheduled to join the body next month.

But first, we turn to Haiti, where political deadlock has crippled the country. Elections were held there last month, but virtually nobody seems to accept the results except for the two top vote getters. But, now - and those two top candidates have rejected a proposed recount by election officials. There's been violence in the capital of Port-au-Prince. And Haitians rushed into shops that had been closed for days to stock up on food and supplies.

Now, trying to curb the violence, the Haitian electoral council has begun a new three-day process for candidates to submit appeals before the final count is announced. And this is all happening amidst a cholera epidemic. We wanted to know more about what's going on so we're joined once again by Haiti correspondent Jonathan Katz of the Associated Press. He's with us from Port-au-Prince. Welcome back. Thanks so much for joining us again.

Mr. JONATHAN KATZ (Haiti Correspondent, Associated Press): Yeah, thanks for having me.

MARTIN: So, Jonathan, where do things stand now? As we said - as you told us, that even as the vote was going on, a number of the candidates - and there were a large number - so that they didn't accept the results because there was just too much chaos. The electoral commission announced there were two top vote getters who were supposed to meet next month in a runoff. What's happening now?

Mr. KATZ: Yeah. Well, right now, actually the competition is essentially between the three top vote getters. The idea is that the top two are going to go on to a round of - second round in January. And right now the first place and the third place, Mirlande Manigat and Michel Martelly, have rejected a proposition of a recount in which they were going to re-tally the tally sheets that they were using to come up with the preliminary results in the first place.

Then right now, basically, as you said, there's this new three-day period that was announced about 10 o'clock, 10:30 last night that candidates can use to appeal and present their cases. And the hope is going to be that at least that's going to keep a lid on things for the next couple of days. Although, you know, as everything in Haiti, that remains to be seen.

MARTIN: What has been the atmosphere there over the last couple of days?

Mr. KATZ: Well, last week it got really tense. In the middle of the week, there were barricades up, there was rock throwing, tear gas being fired by the U.N. There were gunshots. There were a couple of killings. You know, it was a real mess. And it was really a level of generalized unrest and protest that we hadn't seen here in a couple of years.

It calmed down and today business is going on basically as normal. Markets are open, children are going to school. But under that, there's an undercurrent of tension because people know that there's a lot of discontent out there and depending on how this electoral process goes in the next couple of days, things could very easily return to where they were at the worst last week.

MARTIN: What should we be looking for over the next couple of days? What are some of the key markers or events to look forward to?

Mr. KATZ: I mean I think essentially what's going to have to happen is there's going to have to be some sort of compromise made. And nobody knows quite what that compromise is going to look like. The constitution says that the top two vote getters, if nobody gets more than 50 percent, go on to a runoff, that's scheduled for January 16th. The third place candidate is alleging massive fraud and says that he should not be eliminated. And it's his followers who are the ones who are most out in the streets with the barricades last week.

And so if accommodation can't be found that makes them happy, the supposition is that they're going to go back out again. But at the same time, they also don't want to see any kind of runoff that has the government-backed candidate, Jude Celestine in it. And so, if anything in which he participates in could foment unrest as well. And presumably if he's eliminated, he has supporters and very strong backing of the government and they would be upset. And so, even that compromise would leave people unhappy.

So I think the main marker to look for is when a serious proposal is made, it looks like it has a real chance of making all of the parties either equally unhappy or equally satisfied and then seeing whether or not that comes through. But until then, we're in a real political stalemate and I think crisis is the right word.

MARTIN: Jonathan Katz of the Associated Press is based in Port-au-Prince. He was with us on the line from there. Jonathan, thanks so much for joining us once again.

Mr. KATZ: Yeah, thanks again.

MARTIN: Now we want to turn to the health crisis in Haiti - cholera has spread through the country and is now appearing in neighboring Dominican Republic. More than 91,000 people have become ill and at least 2,000 people have died. Public health officials are now calling for a mass vaccination program to control an even more lethal strain of cholera.

We wanted to know more about all that, so we've called Dr. Matthew Waldor. He's a professor of medicine at Harvard Medical School and an infectious disease specialist who studied cholera for almost 20 years. Thanks so much for joining us.

Dr. MATTHEW WALDOR (Professor of Medicine, Harvard Medical School): Thanks for the opportunity to speak with you.

MARTIN: First of all, Dr. Waldor, what is cholera?

Dr. WALDOR: So, cholera is a very, very severe diarrheal disease. So, patients get sick with cholera if they ingest the bacteria called Vibrio cholerae. This organism then can multiply in our gastrointestinal tract and lead to such severe diarrhea that by the time people show up with symptoms, they can become so dehydrated within four or five hours, that they can actually die within four or five hours of getting diarrhea.

The diarrhea fluid from a patient with severe cholera can be up to 20 quarts of diarrhea fluid per day. Each teaspoon of that diarrheal fluid can have upwards of 100 million of this bacteria in each teaspoon. So you can imagine once a patient gets cholera, how the water supply, especially in a situation where there's very poor sanitation, can spread. Cholera is traditionally spread -sorry - cholera

MARTIN: I understand what you're saying. I think we need to get to the whole question of the vaccine, though. I think a lot of people may not have been aware that there is a vaccine and how effective is it?

Dr. WALDOR: So, vaccines have been developed for cholera, at least over the past 30 years. In the past 20 or so years, there's been development of a fairly simple and relatively effective vaccine. There's currently two similar vaccines that are now available and licensed on the planet. Those vaccines both consist of killed, whole Vibrio cholerae. So, to make those vaccines, company would just grow a very large batch of Vibrio cholerae and then the organism is killed And then those killed organisms are given as an oral vaccine much like, for instance, the polio vaccine used to be an oral vaccine is now.

MARTIN: Is this vaccine hard to come by? I think the question would be then, since cholera has been feared for quite some time, given that the terrible condition that a lot of the infrastructure is and given that a lot of people still in tents. Was vaccination a possibility before now? And why wasn't a vaccination program introduced sooner?

Dr. WALDOR: All very good questions. So, currently, there is on the planet only something on the order of 400,000 doses of the two different cholera, oral cholera vaccines. So, however, since the Haiti epidemic has spread so rapidly and has been so devastating, the companies that make this, at least one of those companies, a company based in India called - that makes a vaccine called Shanchol, has come forward to say that they have one to two million additional doses of vaccine that have not yet been packaged, but could in principle be rapidly packaged and delivered to Haiti.

MARTIN: I see. OK, one final issue that I think many people are afraid of is whether that this epidemic will spread, particularly through the Dominican Republic and then of course to other countries in the region, how big of a concern is this?

Dr. WALDOR: As you mentioned in your lead material, the cholera has already spread from Haiti to the Dominican Republic, where there's already been reported several hundred cases. Furthermore, there have been one or two imported cases into the U.S. from travelers who've returned from Haiti. I think the U.S. has a very, very low risk - almost no risk of cholera becoming endemic in this country since we have such an excellent sanitation system and water supply.

However, there's a very real risk that cholera will spread from the island of Hispaniola into other Caribbean nations, as well as into Latin America. And one worrisome aspect of the spread of this strain from Haiti to other regions in Latin America is that this strain appears to be more virulent and more hearty. So the possibility exists that this strain would replace strains that are currently circulating in Latin America.

MARTIN: OK, something to watch for. Dr. Matthew Waldor is a professor of medicine at Harvard Medical School and he was kind enough to join us from Boston. Dr. Waldor, thank you so much for joining us.

Dr. WALDOR: Thanks for having me.

Copyright © 2010 NPR. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to NPR. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR's prior permission. Visit our permissions page for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Support comes from: