All in the - American University of Beirut

Beyond Bliss Streetc l a s s n o t e sYou returned from acholera relief effort inHaiti last spring. What didyou see there?They haven’t rebuilt anythingyet and there are piles of rubblestill in the street. Waterand hygiene infrastructure isalmost nonexistent, whichsignificantly contributed tothe rapid spread of the choleraepidemic. I had to stayin a tent on the US Embassygrounds for three weeksbecause there aren’t manyhotels in Port au Prince thatare safe enough to stay in. Interms of the cholera, peoplein refugee camps actuallyfared much better than peopleoutside because mostof the refugee camps areoperated by relief organizationsand NGOs and theyprovide cleaner water thanis available to the rest of thecountry. In Haiti, especially inrural areas, people go to therivers directly for everythingthey need. Until the infrastructurein Haiti is rebuiltso that people have accessto safe water, it will be verydifficult to control the choleraoutbreak completely and toprevent future outbreaks.Is there a vaccine forcholera?Cholera vaccines are notvery effective. There’s a newone now, but it’s availableonly in limited quantities. Themain intervention is to educatethe public about theimportance of using cleanwater. They hadn’t had asingle case of cholera inHaiti for 100 years, so thepopulation was completelynaïve and vulnerable to theorganism which spread veryquickly. Even the physiciansweren’t trained because theyhad never seen a case ofcholera.Are you seeing widergaps in public healthbetween developed andundeveloped countries?Some public health interventionscan be costly. Indeveloping countries it takesa lot more resources toimplement them. New vaccinesthat deal with pneumoniaand diarrhea aremuch more expensive thanroutine vaccines, so they’regenerally introduced in theUnited States and other highincome countries at leastten years before they makeit to low income countries.However, there are manyglobal efforts ongoing rightnow to change this trend,such as the work done byGAVI [the Global Alliance forVaccines and Immunization].What makes you mosthopeful about the workyou do?I strongly believe that theimplementation of publichealth interventions is theway to better health for theworld. You are literally savingthousands of lives as yougo. To see so many childrenhave access to life savinginterventions and feeling thatI’ve played a part in that isextremely rewarding.—B.R.More On-linewww.aub.edu.lb/maingate | MainGate Fall 2011 63