Cholera in Cuba
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Cuba stays silent about deadly cholera outbreak

Posted on Saturday, 12.08.12

Life on the island

Cuba stays silent about deadly cholera outbreak

It's the disease that the government doesn't acknowledge, because it

might deter tourists from coming to the island.

By Juan O. Tamayo

jtamayo@ElNuevoHerald.com

Cuban dissident Walter Clavel says that when he took his 2-year-old son

to a hospital Wednesday with a case of diarrhea, the boy was tested for

a sometimes fatal disease that the government is stubbornly refusing to

acknowledge — cholera.

Nurses told him the test was negative, and the boy was not quarantined

in the three wards reserved for cholera patients at the North Pediatric

Hospital in the eastern city of Santiago de Cuba, Clavel said.

Cuba, especially the eastern third of the island, is suffering through

an alarming outbreak of cholera — as well as the mosquito-borne dengue

fever — brewed in its decrepit water and sewer systems and fueled by

Hurricane Sandy's floods, according to residents.

More than a dozen deaths have been reliably reported. Hospitals and

prisons have been quarantined at times. Schools have been shut down, and

so have restaurants and street kiosks selling juices and other products

made with water.

Government buildings have established hand and shoe disinfection stands

at their entrances. Some public health officials have gone door to door

asking if anyone is suffering from diarrhea, vomiting or fevers, and

others distributed water purification tablets.

Cuba's government has said nothing publicly about cholera since Aug. 28,

when it announced that an outbreak in the eastern city of Manzanillo —

the first in a century — had ended after three deaths and 417 confirmed

cases.

Spread by bacteria that cause severe diarrhea and vomiting, the disease

killed millions in the Middle Ages.

Police in uniform and plainclothes stationed at hospitals are telling

visitors to keep quiet about cholera and other diseases, Clavel told El

Nuevo Herald — apparently to avoid upsetting the Caribbean island's $2.5

billion-a-year tourism industry.

"We have to question whether the Cuban government today prioritizes

their need for tourism … more than local public health demands," wrote

Sherri Porcelain, a public health expert at the University of Miami and

researcher at its Institute for Cuban and Cuban American Studies.

Worst hit by the cholera has been eastern Cuba, where Sandy came ashore

last month halfway between Manzanillo and Santiago, the island's

second-largest city and capital of a province with the same name.

It damaged water, electricity and sewer systems, flooded latrines and

left behind puddles where dengue-carrying mosquitoes easily bred.

"There is tremendous worry in Santiago," said Clavel, one of a dozen

Cubans contacted for this story. Many were dissidents, unafraid to talk

about the epidemics. Their versions coincided in many ways, but could

not be individually confirmed.

In the only independent report, a Nov. 2 announcement by the Pan

American Health Organization in Washington, a branch of the U.N.'s World

Health Organization, noted that "suspected cholera cases detected in

several areas of the country continue to be investigated."

Two Cubans said the cholera spread rapidly in Sandy's wake in part

because infected inmates at the Mar Verde prison were transferred to the

Boniato prison, both in Santiago province, and later to another prison

in the neighboring province of Camaguey.

Mar Verde was quarantined as of Monday, said city of Santiago dissident

Eunices Madaula. More than 100 cholera cases were reportedly being

treated at the Boniato prison's infirmary and 80 more at the nearby

Ambrosio Grillo Hospital.

Hospital staffers hung up on El Nuevo Herald phone calls last week to

ask about the cholera cases. But Miami-based Radio/TV Martí reported

that when it called recently, a nurse answered, "You're asking if we

have cholera? All the wards are full!"

Havana dissident Dania Virgen García, who stays in contact with

political prisoners throughout the island, said cholera is spreading

prison to prison because of their notoriously bad hygiene. García added

that she had received several reports that some prisoners died from

cholera but were counted among Sandy's 11 Cuban fatalities.

Santiago dissident Pedro Montané said he spoke last week with several

people who confirmed to him in private that their relatives were being

treated for cholera at the 28th of September Clinic, but did not want to

give their names.

The government jailed the doctor who first reported a dengue epidemic in

2000 for more than a year, and is now holding Calixto Ramón Martínez

Arias, the independent journalist who first reported the cholera

outbreak in Manzanillo.

And Santiago blogger Janis Hernandez wrote that several young children

playing on a sidewalk recently were chanting, "Cholera's going around,

cholera's going around … I am going to inject you. Better wash your hands."

Scores of other cases were reported in Guantánamo, Ciego de Avila,

Yateras, Baracoa, Maisí, Palma Soriano, San Luis, Palmarito de Cauto,

Songo-La Maya, Sagua de Tánamo and Antilla. Guantánamo's Agostinho Neto

Provincial Hospital alone saw 80 suspected cases, said one resident who

asked for anonymity.

Smaller numbers of cholera cases were reported in western Cuba and

Havana. But the capital is suffering through an outbreak of dengue, also

known as Breakbone Fever. A 1981 epidemic killed 158 Cubans and affected

344,000 more.

So many dengue cases are now jamming Havana hospitals that long-running

shortages of medicines, needles, bandages, chlorine, soap and other

supplies are turning into emergencies, according to several recent

dissident reports.

What's more, Cuba's water and sewer systems are so deteriorated after

decades of little or no maintenance that experts say it will be

impossible to stop future outbreaks of contagious diseases like cholera

and dengue.

More than half the water pumped through the country's pipes never

reaches its destination because of breaks and waste, Cuban television

reported in June. Pipes with low or no water pressure can be

contaminated by bacteria or critters.

The country of 11.2 million people has only 3,300 miles of sewer lines

and eight waste treatment plants, according to a July report by the

National Institute for Hydraulic Resources to the legislative National

Assembly of People's Power.

A study conducted by researchers at the U.S. Agency for International

Development in 2007 showed only 65 percent of the population had access

to piped drinking water, and that sewage services reach only 38 percent

of the people.

Even in Havana, more than 100,000 residents were receiving potable water

by truck in April 2011 because of breaks in the pipes and a drought,

according to an article in the Granma newspaper, official voice of the

Communist Party.

Montané said his tap water in Santiago often runs the color of

chocolate, and Madaula said poor parts of the city still have no water

because of Sandy's disruptions. Most suburban and nearby farms have

latrines and water wells, she added.

Santiago's small waste treatment plant can handle only 45 percent of the

flow and is often down altogether. The rest goes directly into the bay,

said Manuel Cereijo, an electrical and computer engineering professor at

the University of Miami.

With such tattered infrastructure, and with the government lacking the

money to fix it, infectious diseases likely will continue to hit the

island, said Julio Cesar Alfonso, a Cuban-trained Miami doctor who keeps

in touch with physicians on the island.

"It is very probable that in coming years cholera will remain in Cuba as

an endemic disease … as part of the island's suffering.""

http://www.miamiherald.com/2012/12/08/v-fullstory/3133744/cuba-stays-silent-about-deadly.html

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