How did disaster and lack of improved sanitation and drinking water sources contribute to the 2008 cholera outbreak in Zimbabwe and the 2010 cholera outbreak in Haiti?
Creators: name: Williams-Singleton, Nickie
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2015

description: Background: Cholera is an acute, communicable diarrheal disease caused by the bacterium Vibrio cholerae. Because of its short incubation period of two hours to five days, cholera has a high propensity to spread within a population. Contaminated water supplies are often the primary modes of transmission for sudden cholera outbreaks. During outbreaks, cholera is typically spread by compromised sanitation and drinking water sources. The purpose of this collective case study is to conduct a comparative analysis of cholera outbreaks in Zimbabwe and Haiti and examine factors that most significantly contributed to both outbreaks. Haiti and Zimbabwe were chosen as comparative studies based on five criteria: (1) socioeconomics, (2) political instability, (3) use of improved sanitation facilities and improved drinking water sources, (4) cholera outbreak history (2000 to present), and (5) disaster occurrence - manmade or natural. Methods: Data for this case study were collected via primary, secondary, and grey literature reviews. PubMed, Google Scholar, and Google were the primary database and search engines use to collect data. Guidelines outlined by Watson, Gayer, and Connolly, Johns Hopkins University, and the World Health Organization (WHO) on assessing the threat of and detecting cholera outbreaks served as frameworks for the data review. Data were collected for each country based on their relevance and support of each point in the guidelines. Upon review, side-by-side data comparisons were made for each country. Results: Two contributing factors heavily influenced the cholera outbreaks in Zimbabwe and Haiti: (1) the occurrence of natural and manmade disasters, in Haiti and Zimbabwe respectively, and (2) the lack of and/or maintained improved water and sanitation. Research revealed after being absent from the country for more than a century cholera was introduced to Haiti by human activities following the January 2010 earthquake. It proliferated through the country by way of unprotected water sources and poor sanitation conditions. While cholera was endemic to Zimbabwe, it reached unprecedented proportions in 2008. The disease spread through compromised water and sanitation sources that had been neglected due to civil unrest and a decimated economy. Conclusion: Natural and manmade disasters and compromised water and sanitation sources were major factors that contributed to cholera outbreaks in Haiti and Zimbabwe. Cholera was introduced to Haiti and was able to quickly manifest to outbreak level as a result of an earthquake-damaged country and lack of improved sanitation and drinking water sources. Not only did the country lack these resources, but in many regions of the country, the basic infrastructure to support these resources was not in place. Unlike Haiti, Zimbabwe did have improved sanitation and clean drinking water infrastructure in place for majority of its population in urban cities where its cholera outbreak began. However, it was the lack of maintenance of this urban infrastructure led to the proliferation of cholera in the urban populations of a country where the disease was typically more endemic in rural areas.