This is a dispatch from Partners in Health, the largest provider of health care in Haiti.

PORT-AU-PRINCE, Haiti — To the great relief of all, Hurricane Tomas passed by Haiti over the weekend with less destructive force than had been feared. However, heavy rains greatly exacerbated miserable conditions and heightened cholera risks throughout Haiti.

Partners In Health / Zanmi Lasante staff remained at their posts despite the storm and continued activities in the Artibonite, the Central Plateau and Port-au-Prince. This included staffing and support of cholera treatment centers, as well as crucial primary health care, nutrition programs and HIV/TB programs.

• In Port-au-Prince, living conditions at the camps of Internally Displaced Persons (IDP) served by PIH/ZL, have deteriorated as a result of the storm. Standing water, mud, lack of garbage collection, and limited sanitation availability make the camps a potential flashpoint for cholera outbreak. There is growing concern around 7 suspected cholera cases in Parc Jean-Marie Vincent (PJMV) — a sprawling settlement camp of people displaced by the earthquake where PIH/ZL provides health services—and additional suspected cases in the nearby Cité Soleil section of the city. In response, PIH/ZL continued its prevention campaign and set up a cholera stabilization center at PJMV in collaboration with the Red Cross.
• In the Central Plateau, more cholera cases continue to appear, with PIH/ZL-supported facilities there reporting 111 cholera cases hospitalized. To address and restrain the spread, training of community agents on cholera continues and a further 153 community health agents were training in Hinche on November 6. In Mirebalais, a fully functional cholera treatment center opened today, November 8.
• In the Artibonite Valley, the epicenter of the cholera outbreak, PIH/ZL continues to support facilities in St. Marc, Petite Riviere, and Verrettes. Before the storm’s arrival, the Haitian Ministry of Public Health and Sanitation reported 442 deaths and 6,742 cholera patients hospitalized throughout Haiti’s Lower Artibonite and Central Plateau regions.

Hurricane Tomas complicated treatment efforts at these facilities by forcing the evacuation of patients from tents into solid structures. Cholera patients are now being returned to restricted treatment areas and off-site locations for cholera.

The PIH/ZL logistical team is also providing a large volume of support in the form of medical supplies to 16 additional medical centers throughout the Artibonite Valley. As a result of their tremendous efforts, no PIH/ZL supported facility has experienced stock out of the supplies required for cholera treatment.

Amidst this progress the PIH/ZL team remains alert. Reports indicate that rain waters have forced a key hydroelectric dam on the Artibonite River in the Dominican Republic to release pressure, thus sending down a large volume of water. This release will affect communities all along the river in the Central Plateau and Artibonite–areas that suffered severe damage from flooding caused by a series of hurricanes and tropical storms in 2008.

Partners in Heaelth works in 12 countries around the world to provide quality health care to people and communities devastated by joint burdens of poverty and disease. PIH has been providing vital health care services in Haiti for more than 20 years and is the largest health care provider in the country, working with the Haitian Ministry of Health to deliver comprehensive health care services to a catchment area of 1.2 million across the Central Plateau and the Lower Artibonite Valley. PIH had nearly 5,000 staff in Haiti before the January 12 earthquake.

Editor’s note: This is a brief dispatch from Brittany Eddy, the Monitoring and Evaluation Officer for the Children’s Nutrition Program. Eddy has been in Haiti working with CNP since long before the January earthquake further devastated the country. Now water is the problem, both in the form of damaging rains and tropical storms and in the form of unclean drinking water.

The lack of government infrastructure has left the people in the grips of a deadly cholera outbreak that could kill many. CNP is working with Clean Springs International in an attempt to create a safe potable water supply in affected parts of the country.

LEOGANE, Haiti — The rains began yesterday, about 6 p.m., intensifying throughout the night.

Luckily, we have not gotten much wind, so many of the tarps and tents are still intact. However, the downtown is very flooded with areas of water about 3 feet deep. The main roads downtown look like rivers and the currents in some areas are extremely strong.

To our knowledge, there were emergency shelters set up around Leogane. We are unsure of the status of many of the tent camps around town.

Children’s Nutritional Program made preparations to suspend programs until the storm passed. All patients from the Stabilization Center were discharged yesterday, so
none of the patients were directly affected by the flooding of the hospital.

Deep Springs International has been busy helping with the cholera response and hurricane preparedness. DSI sent 500,000 aquatabs and 225 gallons of locally produced chlorine to Port-au-Prince yesterday to be used in tent camps there, distributed by MINUSTAH. Chlorine production continues here at the house for use here in Leogane and to send to Port-au-Prince.

The CNP/DSI residence is dry and unaffected. The internet at the house is out, but we were able to use a Digicel modem.

Zimbabwe President Robert Mugabe announced today that his country’s government has stopped the outbreak of cholera. ‚ Yea right.

“There is no cholera,” said Mugabe in a nationwide television broadcast.

In actuality, the epidemic has risen to new heights. ‚ The outbreak has spread across the border into South Africa, where sick refugees have forced South African officials to declare its border a disaster area.

Mugabe did have a reason for saying what he did, he’s not totally unbalanced. ‚ Just a little deranged.

He claims that the U.S., France and the UK have been using the cholera outbreak as an excuse for intervening in the country with military power.

Now, since the outbreak is “over” Mugabe says, “there is no cause for war any more …the cholera cause doesn’t exist any more.”

Obviously he’s wrong. The World Health Organization recently reported nearly 800 cholera related deaths in Zimbabwe. ‚ With the current food and economic crisis there, the epidemic could keep getting worse, especially with someone like Mugabe at the helm.

French President Nicolas Sarkozy, UK Prime Minister Gordon Brown, U.S. President George Bush and the UN ambassador to Zimbabwe, have all‚ called for Mugabe to step down as leader in Zimbabwe. ‚ 

His denial of the problem is only making it worse, and it’s only a matter of time until that death toll reaches 1000.

Peter Muturedzanwa, an aid worker in Zimbabwe has a grim outlook. ‚ 

“The rains are not promising to come, cholera is increasing, there is no food in shops. The situation is pathetic,” he said.

Your people are suffering, Mugabe. ‚ Get it together.

As cholera and crisis continue to ravage Zimbabwe, the World Health Organization has pledged to aid the ailing nation after meeting with Zimbabwean officials Monday, Voice of America reports.

The WHO is still deciding on how to best provide Zimbabwe with‚ additional‚ aid in their attempts to fight the increasingly lethal cholera epidemic sweeping the nation. ‚ 

So far, 589 lives have been lost due to the disease. ‚ Almost 14,000 cases were reported just last week.

The epidemic has reached unthinkable heights. ‚ In a recent interview conducted by the African Free Press, Roselyn Moyo, a Zimbabwean resident, revealed that she no longer allows her children to play outside, for fear they will catch cholera.

“I am afraid…uncollected refuse is lying all over our neighbourhood with flies flying all over. I can’t risk my children playing outside,” Moyo told AFP.

The epidemic could not have come at a worse time. ‚ The country is facing some ridiculous inflation rates, the cost of various items have been raised by millions of per cent. ‚ The country recently issued a new $100 million note, worth nearly $880 U.S. ‚ 

A $100 million note! ‚ But really what’s the point of a $100 million bill when the bank has placed a $500,000 (nearly $4.50 U.S) cap on withdrawals. ‚ 

Strange to introduce a bill no one can really withdraw…‚ 

In addition to Zimbabwe’s economic woes, its government is in disarray. ‚ Robert Mugabe and Morgan Tsvangirai are locked in a power-sharing government that literally can’t get much done.

More power to the WHO for‚ increasing‚ aid, the country really needs international help. ‚ 

French President Nicolas Sarkozy recently called for Mugabe to step down. ‚ Totally agree.

More than 100 Zimbabwean doctors and nurses protested for better pay and working conditions Wednesday in Harare, only to have their demonstration cut short by police brandishing batons, according to the International Herald Tribune.

The doctors and nurses were easily distinguishable as many donned work uniforms. ‚ Nearby school teachers attempted to join the protest, only to be beaten away by police.

Fifteen were arrested in the peaceful demonstration, IHT reports.

The protest, demanding better pay and working conditions, was in response to the nation’s Cholera epidemic. ‚ Citizens are finding it harder and harder to survive in an economy hit with an unreal 231 million per cent inflation rate, therefore basic‚ necessities‚ like health care is not available for all. ‚ Hospitals throughout the country are closing.

Since August, deaths due to Cholera have risen to 565, according to the UN. ‚ More than 12,500 are infected in a society that lacks proper water purification chemicals.

Chaos is rule nowadays in Zimbabwe. ‚ Soldiers, angry with their meager salaries, have started‚ looting communities and assaulting women.

Many workers don’t have enough money to survive on a week-to-week basis. ‚ Employees do not have access to their full salaries since the Reserve Bank has put a cap on withdrawals, limiting them to 500,000 Zimbabwean dollars a week, equal to a ridiculous 20 cents.

Workers have submitted petitions to the chairman of the nation’s Reserve Bank, demanding the withdrawal limit be raised to 100 million Zimbabwean dollars per week, equal to about $40.

It is good that the‚ power-sharing government of the ruthless Robert Mugabe and Morgan Tsvangirai‚ recently admitted that its country does have a Cholera epidemic; for a long while the government denied its existence. ‚ It has appealed to the World Health Organization for immediate help since it cannot tackle the problem on its own.

On the other hand, the action taken by police against the doctors and nurses is unacceptable. ‚ Peaceful protesters should never be attacked for any reason, especially when their message makes so much sense. I’m sure not one person thinks doctors and nurses protesting for better pay and working conditions is an outrageous cause.