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Rapid response teams: a real rampart against cholera

A rapid response team in the Department of Centre

The numbers of cholera cases have significantly reduced in 2017. They have never been so low. The new Cholera strategy has paid off. At the center of attention are the rapid response teams, who are true warriors. The members will fight cholera in the targeted departments, in good weather or rainy weather. Mainly in the department of Centre (Plateau Central), where the distances to be covered are sometimes immense. UNICEF is one of the key players in the fight against cholera in the country.

Mirebalais, November 23, 2017-The all-terrain car is rolling on the rocks, the road is not good. It is necessary to zigzag between the crevasses, to avoid the mud. It rained last night, but conditions are acceptable to reach Menaj, a locality close to the town of Laschaobas (Centre).

ACTED’s rapid response team, UNICEF’s partner, with their recognizable green T-shirts from several meters, is on the warpath. They come to conduct an awareness session. But the community is quiet because today is market day. However, there are still people who will be able to listen to messages and receive hygiene kits if it’s needed.

A member of the team with a loudspeaker has already broken off to bring together the people who are present. In the empty valley, his voice is echoed. He managed to gather about twenty women and a few children. Men are in the fields.

Important to continue awareness

A sensitization session

The team begins to raise awareness about hygiene. Today, the team is there for a reinforcement of awareness. It usually takes place after the distribution of hygiene kits. These kits contain soap, oral rehydration serum, and aquatabs (chlorine tablets) and a pail with a robinet.

“You have to wash your hands in crucial moments, before eating and after getting out of the toilet. Use treated water for your health and that of your children’’. After these messages, the team asks the residents who do not live too far to bring the water they use to test the chlorine residual, to check if they have followed the instructions.

The activities of rapid response teams consist of three parts: investigation, response, awareness. “Regarding the situation for the Lower Plateau, it’s pretty quiet because we went from 38 cases per week to 14 cases and for the moment it’s only 7 cases,” says Jennyfer Joseph, cholera project manager for the Lower – Central tray.

To travel long distances

One of the biggest challenges for rapid response teams is returning to the long distances they must travel to reach remote locations. Sometimes it can take hours or even days. Because they must sleep on the way, to continue their activities and to make sure that everyone is sensitized to the principles of hygiene.

“In some mountainous places, even mules cannot pass, but we have to go if there are cases of cholera. It’s part of our mission. Sometimes we do missions of several days in these localities to reach everyone, “recalls Nadia Delmond, emergency team leader for Acted, recalling that the reception of people is always positive.

152 schools received hygiene certification.

On November 21st, the hygiene certification ceremony of 152  schools took place at the Montana Hotel in Port-au-Prince.

Certification Ceremony of 152 Schools at the Montana Hotel in Port-au-Prince on 21 November 2017.

Certification Ceremony of 152 Schools at the Montana Hotel in Port-au-Prince on 21 November 2017.

This activity was organized by the Ministry of National Education in collaboration with the Ministry of Public Health and Population, DINEPA, UNICEF and several other partners including the Inter-American Development Bank.

The project/program officially launched in November 2014, aims at the constitution of a number of model schools, in hygiene, in each of the ten departments of the country. In order to receive their certification, the 152 schools had to comply with a number of standards and criteria related to hygiene, water and sanitation.

Deserving schools represented at the ceremony all demonstrated during the inspections that they had available toilets and latrines, handwashing points near the toilets, the availability of water for everyday use and that technical supervision was provided by school inspectors and engineers. School principals also presented their commitment and participation in hygiene education and the establishment of a functioning health club in their respective institutions.

New hygiene behaviors

Mrs. Emeline Rafael, director of the Lycée des Jeunes Filles of Jérémie.

Mrs. Emeline Rafael, director of the Lycée des Jeunes Filles of Jérémie.

“I find that there are a lot of differences because now we are trying to create new hygiene behaviors among students. Says Emeline Rafael, director of the Jérémie Young Women’s High School, just after receiving her plaque confirming the certification of her institution.

“They are given guidelines but it is up to them to manage their own health conditions, they are young teenagers from 11 to 12 years, they understand very well what we expect from them. They are asked to set up committees and give them instructions on hygiene. They are taught to have positive behaviors, to wash their hands after going to the bathroom if not, they do get sick and go out of school. If we are not in good health, we will not stay in school either, says the director.

“The certification of the schools is an absolute necessity. The analysis of the situation carried out in 2012 gives the following figures: 25% of Haitian schools have drinking water installation, 50% have functional toilets, 69% have handwashing station. 52% of them teach hygiene or promote it.” Said Mr. Marc Vincent, UNICEF Representative during his remarks.

13 schools supported by UNICEF

During this first evaluation in 2017, of the 17 certified schools in the departments of the Center and Artibonite, 13 are supported by UNICEF (9 in the Center and 4 in the Artibonite). 8 other schools in Artibonite are ready and awaiting evaluation for their certification.

The schools that UNICEF helped rebuild across the country, after the January 12 earthquake are all equipped with toilet blocks with possibility of collecting rainwater because the issue of water can be a challenge in some parts of the country. UNICEF also conducted hygiene awareness sessions for school staff and schoolchildren.

“This certification will help to make schools safer. Because of the insalubrity of some schools, they can become a threat to the health of children. School should be a protective environment. We know they are particularly vulnerable to microbes and the health of our children is a top priority, “said UNICEF Representative Marc Vincent.

Still a lot of effort

Despite the success of this program, there is still much work to be done. According to the latest available statistics, the pupil/toilet ratio in Haiti is currently 128, whereas the standards provide for 25 to 50 students per cabin. 72% of the Haitian population does not have access to adequate sanitation and 42% do not have adequate access to drinking water while access to health services is limited. Even though 20% of drinking water control in schools is provided by DINEPA, 73% of schools in the country still have no control over the quality of this water.

In this sense, through the representative of the Director General, Mr. Guito Edouard, DINEPA is committed to strengthening its collaboration in the project to enable the achievement of common objectives for the well-being of Haiti’s children.

All children have the same rights

Mr. Marc Vincent, UNICEF Representative during his address.

Mr. Marc Vincent, UNICEF Representative during his address.

“UNICEF places a lot of emphasis on equity that advocates for access to care and service for all children without distinction. All children have the same rights. These certified schools are in line with Sustainable Development Goals 3, 4 and 6, which refer to “good health and well-being, quality education, clean water and sanitation, respectively. We need to do a lot more, so that the SDGs, more than accounting goals, become a reality, “said UNICEF Representative Marc Vincent.

The project carried out by the School Health Department aimed to certify over 2 years, a minimum of 100 schools, (10 on average per department), from the point of view ” water, sanitation and hygiene “, so as to propose them as models at national level. With already 152 schools that have been awarded the certification, the country is on the right track.

Hygiene, keys to development

Mr. Charles Ernest Chatelier, Director General of the FAES, declared in front of the room: “Let’s all be friends of the hygiene because it is one of the keys of the development of the country.”

Establishments certified received a plaque of honor. This status will be reviewed every two or three years, after evaluation. A new sticker will then be affixed to the plate in case of maintenance of good hygiene practices. Other institutions will gradually be added to the list, at the level of each geographical department.

“We have to go beyond a simple project. We need to build better citizens, “said Pierre Josué Agénor Cadet, Minister of National Education.

Through this program, the Ministry of National Education intends to: make known and propose as models, at the national level, the certified schools; encourage principals, school staff, students, parents and the community to maintain schools, with the support of the School Health Department; to encourage the regular inspection of these schools from the physical, health and educational points of view; Encourage the establishment in these institutions of a health club made up of pupils and operating under the aegis of the Direction and / or the School Council; to show decision-makers and the general public that, as things stand, health is the best gateway to excellence and the quality of education.