Haiti Storm Calmer Than Feared, But Disease Still Spreading

A river in Haiti that has been a source of a cholera epidemic is expected to overflow following heavy rains from Hurricane Tomas. Cholera, the diarrhea and fever-causing illness, has killed some 500 people and hospitalized thousands since appearing last month. Its origin has not yet been confirmed. Host Michel Martin speaks with Jonathan Katz, the Associated Press' Haiti correspondent, and Matt Marek of the Red Cross.

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MICHEL MARTIN, host:

And now we got to Haiti to check in on the aftermath of Hurricane Tomas. Specifically government officials say the river said to be the source of the recent cholera outbreak is likely to overflow. Tomas was the first hurricane to hit Haiti since the country's devastating January 12th earthquake. And with an estimated 1.3 million Haitians still living under tents in Port-au-Prince alone, there was a lot of concern about what would happen to an already vulnerable population.

Here to tell us more is Matt Marek. He is the Haiti deputy country representative for the American Red Cross. Matt was in Haiti during the hurricane, and he's just back and joining us from New York. Also with us from Port-au-Prince is Haiti correspondent for the Associated Press, Jonathan Katz. Welcome back, Jonathan. Welcome to you Matt. Thanks for joining us.

Mr. MATT MAREK (Haiti Deputy Country Representative, American Red Cross): Thanks, Michel.

Mr. JONATHAN KATZ (Haiti Correspondent, Associated Press): Thank you.

MARTIN: Jonathan, tell us just, as we understand, things were not as bad as many people had feared. But if you would just describe what it was like waiting out the hurricane.

Mr. KATZ: Well, here in Port-au-Prince, fortunately, it basically was a long drizzly day with low hanging clouds and occasional gusts of wind, but nothing too bad. Farther out on the southern peninsula, they got more of a direct hit. The storm became a category one hurricane as it was coming toward Haiti, which meant that the winds got stronger but they also pulled in a little closer to the center. So it was really only the far extreme part of the southern peninsula that bore the brunt of what would normally be called a hurricane. Out here in Port-au-Prince, it was basically like having a long rainy and somewhat miserable weather day, but nothing fatal.

MARTIN: That was going to be my next question. Were there any fatalities?

Mr. KATZ: The death toll actually has gone up as more reports are coming in. They're standing at about 20 right now. But that's still far lower than was feared. If there had been a direct hit by a hurricane here on the capital with 1.3 million people living out on the streets under tarps and tents, then that figure could've gone well into the realm of unimaginable.

MARTIN: Matt, there were reports that many people were refusing to be evacuated, so I wanted to ask, is that true? Was there a significant effort to get people to evacuate? And to go where?

Mr. MAREK: Those are very good questions. When you ask 1.5 million people or 1.3 million people to evacuate to a safer location when there aren't many safe locations in existence after the earthquake, they obviously don't know how to respond. I think the official line from the government and some of the international agencies was, try to get yourself to a safer place. And that means try to find either family or friends who do have a safe structure. So it's not unlikely that individuals, though, you know, when you look at the devastation that hit Haiti on January 12th, destroying over 200,000 some homes and buildings, would have to ask themselves, you know, where do I got that is safer?

MARTIN: So, tell me, what's the biggest concern now?

Mr. MAREK: The biggest concern is the same concerns that we've had since before Hurricane Tomas made landfall. And they are, you know, how do we get people into permanent housing? How do we get people back into neighborhoods? How do we continue to remove the rubble that's existing? How do we continue to keep the 1.3 or 1.5 million people that are living in the streets safe until all of that long-term reconstruction and development can take hold?

MARTIN: So, talk to me a bit, if you would, and maybe, Matt, you'll start and then Jonathan, you'll pick up the ball here. Tell us the scope of the concern about the cholera outbreak that has been reported in recent weeks. And are the current circumstances adding to the concern?

Mr. MAREK: Sure. No, this is an extreme concern for all of us. The conditions in Port-au-Prince, you know, prior to the earthquake, very congested urban capital - and now even more so. And this increases any likelihood of any disease to spread, especially something as deadly as cholera.

We've been fortunate that it has not hit Port-au-Prince head on just yet. If it does come to Port-au-Prince, you know, this is something that, you know, can cause enormous amount of fatalities.

MARTIN: Jonathan, could you pick up the thread there? Is there widespread awareness that there is a cholera concern?

Mr. KATZ: Yeah, well, I can tell the Haitians definitely know that cholera by name is a disease spreading around the country which is a very fast (unintelligible) effort of aid groups that were working with them and also just a testament to how quickly word spreads in Haiti about anything new that's going on. What's interesting about it is that cholera was completely unheard of in Haiti. There had never been a documented case before.

And so the fact that everybody - almost everybody that you talk to seems to be aware that it's going on and at least most of the people I've talked to have been the least exposed to advice on, you know, maintaining proper hygiene and washing your hands and how to try to prevent the epidemic from spreading is a testament to those two things.

As to what the strategy is for dealing with it, you know, it was unexpected that cholera was going to break out here and so I think it's going to be very hard to predict exactly what it's going to do in the future. I know that a lot of people are working very hard about it all over the country to try to keep it from spreading out of control, but at this point we're just sort of sitting back and waiting to see where it goes.

And as Matt said, the major concern right now is if or when it's going to hit the capital and then when it does, exactly what kind of impact it's going to have here.

MARTIN: And, Matt, a final question to you and I understand that the Red Cross's main mission is generally immediate relief as opposed to sort of long term rebuilding efforts. But do you - have given your time on the ground - have a perspective about why there still are 1.3 million people living in tents?

Mr. MAREK: Yeah. That's a great question, Michel. And there's a lot to be said about that and why the situation is what it is. But I want to respond to what Jonathan had said too, regarding the cholera outbreak. You know, the information and the response that needs to be done in order to address the cholera outbreak is something that we've actually been doing since February, and that is hygiene promotion.

There is not much difference, okay, in going out and informing people and giving people the means and the resources to clean water to drink, to clean water to bathe in, the soap, the Aquatabs, the chlorinated tabs, in order for people to protect themselves. And we've been fortunate, I guess, in the situation to only have now just reached, you know, a point where there is an outbreak of some disease.

And it's still not sure, you know, why that has come about, okay. And it doesn't seem to be pointing in the direction of, you know, the living conditions of the Haitian people who have been, you know, extremely resilient in how they, you know, address their hygiene in these very poor conditions and overcrowded conditions. So in order to, you know, continue to address the outbreak, we have to continue to do what we're doing around education and hygiene promotion.

How do we address the other question that you asked, the 1.3, 1.5 million people still living in the streets? To some people it certainly seems like a very long period of time, 10 months since the earthquake. But I can assure you that if anyone who's visited Port-au-Prince, you know, can take and just eyeball the congestion of this urban capital, and start to conceive how long it actually has taken for this capital to become this way, in order to reconstruct it with such poor infrastructure, roads, electricity, water system, drainage, everything that makes up a plan for an urban area, has been nonexistent in Port-au-Prince even before the earthquake.

So to reconstruct that within 10 months for 1.5 million people is an enormous feat. And we've been saying from the beginning that this is going to take years. And it's a sad reality. It is not deserving of any of the individuals that are living in these conditions. But it is the truth. It is something that, you know, we're trying to move as quickly as we can on. A number of agencies, a number of international governments, and the challenges are, you know, they're going to remain there until, you know, we get people back into a better situation than they were before.

MARTIN: And, Jonathan, final - the same question to you - a final thought from you, why are 1.3 or five million people still living in tents?

Mr. KATZ: Oh, as Matt said, it's an extremely difficult situation. There were a lot of problems that had to be fixed. The thing is, from the perspective of the people who are living in the camps, you know, 10 months living in a camp is a lot longer than 10 months looking at a camp or trying to address the problems in a camp. And there's no doubt that I don't think there was any expectation even on the part of the people here that all the problems that existed in Haiti before the earthquake were going to get solved very quickly.

There was a lot of hope. There was a lot of optimism, especially around the March 31st donor's conference at the United Nations. There were a number of speeches made, including by Secretary of State Hillary Clinton, about the speed with which, you know, the problems we're going need to be addressed. And how the patterns of the past where things take a long time and get caught up bureaucracy and, you know, issues that are internal to various donor countries that are working here we're going to have to get resolved quickly or else the problems here are going to metastasize and could become regional as well.

And in a lot of cases, we really haven't seen that. With regard, for instance, to the United States. There's the $1.15 billion pledge that was made at that conference for reconstruction money. It was promised that it was going to be delivered in fiscal 2010, fiscal 2010 is now over. It ended at the end of September, beginning of October. And essentially the reason why that money has been caught up is bureaucracy in Washington.

People who are involved in the process will tell you that this is about as fast as you can expect it to go. But like I said, when you're actually in the camps and this is your daily life, that is a very, very long period of time. So even though it may be acceptable to people in Washington, I don't think it's acceptable to people here.

You know, there are limits to what that money can do and it's not, like, just pouring money into the situation is the only thing that's going to make it better or that even pouring it in all at once would solve all the problems within the time frame that we're in now. But I think there are things that we're told could have been done in this time that haven't been done. And, you know, reconstruction is going to be a very long process. But in order to do that process you have to start. And right now from what we're seeing from a journalistic perspective just watching here on the ground is a lot of things that should have started by now still haven't.

MARTIN: Jonathan Katz is Haiti correspondent for the Associated Press. He's been with us from time to time to give us updates on the situation there. And he joined us once again from Port-au-Prince. Also with us, Matt Marek. He's the deputy representative for Haiti at the American Red Cross. He's just back from Haiti and he joined us from our studios in New York.

Gentlemen, thank you both so much for speaking with us.

Mr. KATZ: Thanks, Michel.

Mr. MAREK: Thank you.

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