A Year On The Front Lines In Haiti

David Walton, deputy chief of mission to Haiti for the group Partners In Health, has spent much of the past year on the front lines in Haiti treating earthquake victims and working to stem the cholera epidemic. He's now involved in the building of a new hospital. He talks to NPR's Michele Norris about his work.

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MICHELE NORRIS, Host:

Now to a doctor who spent much of last year dealing with the aftermath of the earthquake. David Walton is with the group Partners in Health. He's worked in Haiti for 15 years. Welcome to the program, Dr. Walton.

DAVID WALTON: Thanks so much for having me.

NORRIS: You know, I'd like to get a sense from you of what the last year has been like. Immediately after the earthquake you were treating victims in the general hospital in Port-au-Prince and then later you had to deal with the cholera outbreak and people who were still trying to find a stable place to live. As you reflect back, what's your predominant feeling on this anniversary?

WALTON: You know, it's really one of frustration, to be honest. The moment after the earthquake, the days after the earthquake, even the months after the earthquake were just so challenging in a number of ways. But we expected to be working in this difficult environment.

But as I reflect on the year and I look around, you know, not much has changed. There are some places in Port-au-Prince that you would think the earthquake happened two weeks ago, three weeks ago. There's been a lot of talk about the aid that's come through and a lot of talk about everything that has been done. But overall I think we haven't been as successful as we could be. You know, this is the latest chapter in the tragedy that is Haiti.

MARTIN: I want to ask you about the cholera outbreak there. Immediately after the earthquake, you started to hear the concerns and the worries about cholera. It was described almost like this big dark cloud that was, you know, looming above the country and there was hopes that maybe it would pass over and we wouldn't see a mass outbreak. And now, unfortunately, we have.

How do you control something like that? What is the hope there? How do you bring that kind of thing under control?

WALTON: We are now in the epidemic phase of this outbreak, where hundreds of thousands of people are contracting this disease. I think most experts would agree that this epidemic phase will then transition into an endemic phase, where cholera is now part of the microbes, one of the microbes that one sees in the country.

The problem, however, is it's almost impossible to control unless you get to the root causes of this epidemic. If cholera was introduced to the United States tomorrow, it wouldn't take root because we have great sanitation, we have potable water. If you look at a place like Haiti that is one of the most water insecure nations in the world and one of the nations that has some of the worst metrics in terms of sanitation, this is the perfect setup for cholera to both spread like wildfire and set up shop for years to come.

So unless we deal with the underlying issues that allowed cholera to spread so rapidly, it will almost be impossible to control.

NORRIS: I know that there aren't any simple answers, but is there something that's somewhat simple that could be done almost immediately to help bring this under control?

WALTON: Well, I think those things are under way. First of all, we need more cholera treatment centers. One of the problems with Haiti for so many years is that care, basic medical care, is so inaccessible to so many people in the population. And so, you know, we really need to make oral rehydration therapy, say, the mainstay of treatment for cholera available on every corner, behind every mountain here in this country.

Also, I think there has to be massive investments in creating new systems for potable water, distributing chlorine tabs to the population. You know, people here have been suffering for a long time from a variety of maladies, from really horrendous living conditions, et cetera. And because things are so bad, you know, to incrementally improve the situation isn't as hard as it would seem.

NORRIS: How long will you stay in Haiti?

WALTON: I'm here for the long term. I have the privilege of being able to work here, splitting my time between here and Boston. And, you know, this is my life's calling. And so, I expect to die here an old man.

NORRIS: Well, Dr. Walton, I hope that we'll have other opportunities to talk to you in the future. Thank you very much for your time.

WALTON: Thanks so much for having me.

NORRIS: Dr. David Walton is the deputy chief of mission to Haiti for Partners in Health. He's in Mirebalais, that's 40 miles north of Port-au-Prince.

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