UNICEF Dominican Republic Humanitarian Situation Report No. 1 (cholera outbreak) 28 October 2022 – Dominican Republic

Attachments

Situation in numbers

1 confirmed case of cholera in the DR

1,874,792 children and adolescents in the Dominican Republic receive water contaminated with E. Coli (54.8%)

506,331 children and adolescents in the poorest quintile do not have soap and water to wash their hands (74%)

27,822 people per month entering the DR through the Haitian border (average)

Strong points

  • In the Dominican Republic, the first case of cholera was confirmed on October 20, 2022, in the province of La Altagracia, located in the eastern region of the country, in which the water and sanitation systems were seriously affected by the Hurricane Fiona and there are still communities where people do not have access to clean water and excreta disposal.

  • The above shows a significant scenario of vulnerability for the Dominican Republic, such as i) the high human mobility between the two countries, due to the increase in deportations by the migration authorities of the Dominican Republic, ii) certain social behaviors towards the Haitian migrants who could hinder the demand for timely care in health centers for fear of being deported and iii) the effects caused by Hurricane Fiona, which to this day keeps the population of the East region without meet their basic needs, and iv) the poor supply of drinking water and sanitation, in terms of coverage, quantity and quality, both at household level and in public services, making it difficult to prevent the disease

  • The Dominican Republic’s Ministry of Public Health has activated its emergency plan and focused cholera prevention operations on the border provinces (Dajabon, Elias Piña, Jimani and Pedernales) and the eastern region of the country. The strategic axes of the plan are epidemiological surveillance, the strengthening of health centers for the management of cases, water/sanitation and the promotion of hygiene at the community level.

  • UNICEF has launched prevention and response actions to the cholera epidemic in the Dominican Republic, based on experience and in coordination with PAHO/WHO. Among these is the strengthening of the leadership of the Ministry of Public Health so that it coordinates actions and guarantees the complementarity and homogenization of approaches for a global approach to people at risk.

  • For the moment, no action is planned to support the humanitarian response in Haiti, but communication and epidemiological surveillance are ongoing.

Overview of the situation and humanitarian needs

On October 1, 2022, Haitian national authorities reported a confirmed case of Vibrio cholerae in the greater Port-au-Prince area, Haiti. The disease has spread and as of October 26, the Haitian Ministry of Public Health reports 2,274 suspected cases, of which 1,642 cases are hospitalized and 52 have died. 51% of reported suspected cases are under the age of 19. The most affected age group is 1 to 4 years old, followed by 5 to 9 years old.

Despite the efforts of the Haitian government and international support, the political and social situation in Haiti does not favor the control of the epidemic. The violence of the gangs that operate in and around Puerto Principe makes it difficult to access the most affected areas, making it impossible to detect and treat cases quickly. Access to clean water, basic hygiene products and energy is limited, which affects both disease prevention and case management.

In the Dominican Republic, the first case of cholera was confirmed on October 20, 2022, in the province of La Altagracia, located in the eastern region of the country, in which the water and sanitation systems were seriously affected by the Hurricane Fiona and there are still communities where people do not have access to clean water and excreta disposal.

In the Dominican Republic, the number of Haitians deported to Haiti is increasing. They are taken to detention centers for migrants which have neither water nor sanitation solutions and hygiene services, which constitute a route for the transmission and spread of cholera between the two countries, since many deported people find other ways to return to the Dominican Republic. The social and economic crisis in Haiti has generated a more intense migratory flow towards the east of the island, thus increasing the risk of the spread of cholera.

According to Enhogar 2019, although 98% of households use improved drinking water sources, E. Coli contamination in drinking water affects 54.8% of children and adolescents in the Dominican Republic (increased to 79% when is measured inside the house). In addition to this, it is pointed out that access to water is not continuous, especially for the poorest population of the country, forcing families to store water from public sources or other dangerous sources. .

Just 8.8% of households with children and adolescents use drinking water purification methods such as boiling, adding bleach or chlorine, filtering with a cloth, using a water filter, among other things, and only 26% of children, girls and adolescents in the poorest quintile have soap and water to wash their hands

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