Haiti Gears Up For Elections

With less than a week to go before presidential elections in Haiti, aid agencies are struggling to contain a growing cholera epidemic on the island. At least 1,250 Haitians have now died of cholera and thousands more are infected with the disease, which is spreading through the capital Port-au-Prince and other parts of the country. Host Allison Keyes speaks with Associated Press reporter Jonathan Katz and the executive director of Doctors without Borders USA, Sophie Delaunay, about the epidemic and its impact on Sunday’s polls.

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ALLISON KEYES, host:

I'm Allison Keyes. And this is TELL ME MORE from NPR News.

Coming up, the story of a Maryland secretary who found out she'd been named the first female king of a tribe in Ghana.

But first, to the troubled country of Haiti. Presidential elections are less than a week away there and Haitians wonder if anyone can lead one of the world's most troubled nations out of its despair.

Cholera is the latest crisis. An outbreak of the fast-moving disease has claimed an estimated 1,250 lives. Twenty-one thousand are said to be infected. The numbers have increased dramatically in the last week.

Last week, unrest broke out in the country's north. Crowds attacked U.N. peacekeeping troops from Nepal, who they claim are responsible for the cholera outbreak.

For the latest on the situation, we're joined by Sophie Delaunay, executive director of the aid group Doctors without Borders USA, and Associated Press reporter Jonathan Katz, who's in Miami on his way back to Port-au-Prince. Welcome to both of you to TELL ME MORE.

Ms. SOPHIE DELAUNAY (Executive Director, Doctors without Borders USA): Thanks for having me, Allison.

KEYES: Jonathan, let me start with you. I mean, the streets are still full of rubble from the earthquake 10 months ago. There are more than a million people living in tents and now there's supposed to be an election. What's it like there?

Mr. JONATHAN KATZ (Reporter, Associated Press): It's extremely difficult, which is pretty much a constant state of being in Haiti. Right now, until the last couple of days it wasn't even 100 percent sure that the elections were going to go ahead. But at this point, it looks like it's full steam ahead for Sunday. And essentially, it's just a very difficult situation on political and health care and every other level in Haiti.

KEYES: Is there actual campaigning going on in the midst of all this?

Mr. KATZ: Oh, yeah, very much so. Candidates are holding big rallies and going down the streets in neighborhoods and towns and going out to the countryside and rallying. There's a lot of posters going up. If you go anywhere in Port-au-Prince, you see big billboards with candidates' faces smiling back to you and posters covering the walls. So it's very much election time down there.

KEYES: Sophie, I've read that some of the candidates have been concerned that they and perhaps that people attending their rallies could be in danger because of the cholera outbreak. Is that a possibility?

Mr. KATZ: Well, I'm not sure that it's actually true that people would be in danger. Although, I've heard some of the aid groups how having mass gatherings of people is a possible way of spreading the disease if sanitation is bad and people are coming into contact with one another.

But from my understanding, it's very hard to spread cholera, really, from person to person or casual contact. But it is true that the candidates, a number of them have been concerned about that.

And that sort of reflects how new cholera is in Haiti and a lot of the - I don't want to say ignorance - but confusion that surrounds the disease. People don't exactly know how to manage it. And so, a lot of the candidates are wondering if they need to be campaigning differently in order to keep this from spreading.

KEYES: Sophie, do people there understand what's happening with this disease? And should they be worried about gathering in large crowds?

Ms. DELAUNAY: Well, I think that, you know, cholera is a disease that always carries a lot of anxieties and stigma. So there is definitely a need in Haiti these days for more public communication. Reassuring the population that is frightened by the disease and explaining what the risks are of transmission. But also what are the benefits of a proper response.

KEYES: I know Doctors without Borders had said over the weekend that the other aid groups needed to step up their response there. What do you mean by that?

Ms. DELAUNAY: Well, what we mean is that, you know, since the first cases were declared mid-October, the response has come, you know, too late, too slow and much too small from what we've experienced. In our 21 cholera treatment centers, you know, we are stretched to capacity. Out of the 21,000, I think, the last figures you reported, Allison, we've treated more than 18,000 cases so far.

So treatment is one crucial and key aspect of addressing cholera. But there are a lot of different pillars, especially in the prevention side that needs to be covered, you know, therefore, the treatment to be efficient and for not sending people back to contaminated areas.

KEYES: If you're just joining us, this is TELL ME MORE from NPR News. I'm Allison Keyes and we're speaking about Haiti's elections and how they are dealing with that recent outbreak of cholera. I'm joined by Sophie Delaunay of Doctors without Borders USA and Jonathan Katz, Port-au-Prince reporter for the Associated Press.

Sophie, have aid organizations there been able to resume operations? I know they were suspended for a bit this weekend after the demonstrations.

Ms. DELAUNAY: There are some operations going on. We have been able to continue our operations on the treatment side. But the operations need to be scaled up definitely.

There's a need for us as we see more public communication. There is a need for provisional safe chlorinated water, particularly in highly concentrated areas. There's a need for latrines to be built for better waste removal system. You know, I understand and we also face a lot of constraints on the grounds, but there is definitely a need for more response.

KEYES: Jonathan, the demonstrations were mostly against those Nepalese peacekeepers from the U.N. because there's circumstantial evidence that that is the source of the cholera. Is that right?

Mr. KATZ: That was a major factor in the demonstrations. Yeah, there's a lot of anger surrounding those rumors.

KEYES: How much science is backing up the concerns that people have that this disease was brought in from the peacekeepers?

Mr. KATZ: Well, it's kind of a difficult question to answer. And part of the reason for that is that there hasn't really been a thorough, sort of, investigation that even a lot of public health experts, scientists, epidemiologists have been asking for. It is absolutely the fact that there is a lot of circumstantial evidence, as you said.

Basically the outbreak occurred in a remote, rural part of the country, along the river that there aren't a lot of foreigners living. But there are foreigners there who are U.N. peacekeepers. And the strain was found to be a strain that originated in South Asia, and there's a number of other things as well.

And so, essentially, there has been a lack of inquiry for most of the time since these rumors started in the weeks that the cholera outbreak has been going on.

But what we've seen is that as the evidence mounts, the head of the United Nations peacekeeping mission told us a couple days ago that he's taking these suspicions very seriously. I think they've moved from the realm of rumor into suspicion or an even well-founded allegation.

KEYES: Sophie - wait, let me bring in Sophie here and ask, are there efforts to try and determine exactly where this infection came from?

Ms. DELAUNAY: Yes, I know that some people on the ground are working on that. I also know that the Centers for Disease Control is working on that. As Jonathan said, the experts have not been pointed the origin of Haiti's epidemic yet, but the strain that we found is similar to strains from South Asia. But, also, similar to some strains found in recent cholera outbreaks.

In 2009, we had major cholera outbreak in Zimbabwe and Zambia and more recently, in 2010, these are the strains we found in Nigeria, Cameroon and Niger in Western Africa. So, you know, this is difficult to find the origin, but we find some similar cases throughout the world.

KEYES: Jonathan, really, really briefly, if it turns out that there - this evidence is correct, what does that do to the reputation of the peacekeepers there? And I mean, really briefly.

Mr. KATZ: Right. Well, there's two parts of it. If they're found to have brought cholera, then there's going to be an angry reaction on a lot of people's part. That as people have told us, the United Nations' reticence to investigate itself up until this point has also created a negative reaction because people feel that they are not being accountable.

KEYES: All right, we will be watching what happens and TELL ME MORE will keep covering this. Sophie Delaunay is executive director of Doctors without Borders USA. And Jonathan Katz reports for the Associated Press. Thank you both for an update on this continually disturbing story.

Mr. KATZ: Thank you.

Ms. DELAUNAY: Thanks, Allison.

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