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Haiti launches massive cholera vaccination drive but worries remain

By Makini Brice

LES CAYES, Haiti (Reuters) - Haitihaslaunched a massive cholera vaccination campaign to battle a flare-up after Hurricane Matthew, but concerns remain about the capacity for longer-term improvements to water and sanitation infrastructure needed to eradicate the disease.

The cholera campaign, launchedon Tuesdayin two southern areas hammered by the storm, is aiming to be the world's largest, targeting 820,000 people, saidErnslyJackson, an immunization specialist for UNICEF Haiti.

Haiti has battled a cholera outbreak that has sickened more than 800,000 people and killed about 9,000 since 2010, when the bacteria was imported into the country by a contingent of United Nations peacekeepers.

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Although it had proved stubborn to eradicate, cases had declined sharply from a peak in 2010-11.

But Hurricane Matthew struck the island in early October, killing up to 1,000 people, leaving about 1.4 million in need of humanitarian assistance and damaging many health facilities. The storm largely destroyed much of the southwestern region's already meager water and sanitation infrastructure, leaving it ripe for a cholera outbreak, experts say.

Clifford Gauthier, the South department's head of the Ministry of Health, said there had been 1,200 suspected cholera cases since the hurricane hit, a sharp increase since the region had previously had fewer cases than other areas of the country. In total, the U.N. Office for the Coordination of Humanitarian Affairs says there have been 3,500 suspected cholera cases since the hurricane.

In the Immaculate Conception Hospital ofthe port town ofLesCayes, 19 people suspected of having cholerawerehooked up to IVs andlayon hospital bedframes.

MarieWilnineGaetan, the head nurse of a rapid-response team, said that the region had not seen so many cases since the disease was first spotted in Haiti.

SINGLE DOSES

The campaign will mark the first time thatso manypeople will be given only one dose of the cholera vaccine. Normally, the vaccine is given in two doses.

A previous initiative conducted by Doctors Without Borders in South Sudan found that a single dose of the cholera vaccine proved to be extremely effective at boosting immunity, according to a study published in medical journal The Lancet in November.

"This justifies the approach of using a single dose to achieve wider coverage, given the fact that there's not enough of the vaccine to give to everyone," said AlanHinman, a member of the Global Task Force on Cholera Prevention, who was not involved with the study.

The two-dose vaccine lasts for two years, according to the United Kingdom's National Health Service, but it is not known exactly how long the single dose lasts.

Despite officials' enthusiasm, some residentswere angry that help had taken a month to arrive.

"Many people died in the South department because of cholera, especially people who do not have access to a health center in their community," saidLaurientSeebien, a resident of LesCayes. "Maybe if the government had come quickly with those drugs, it would have saved more lives."

Officialsat the campaign launch were careful to stressthe vaccine wasnot intended to be the only tool to fight cholera in the region.

"The eradication of cholera must include the strengthening of sanitary infrastructures and the population must have access to safe water," saidDaphneeBenoitDelsoin, the Minister of Health. "That is to say, it is a very long struggle."

Butrapid-response team nurse Gaetan said that the water and sanitation authority's repairs appeared to be slow-going. "It's true that DINEPA has started, but I don't know if their means are limited," she said, using the authority's French acronym.

A DINEPA spokesman did not respond to multiple calls.

Donor financing for longer-term improvements to the water and sanitation system in the cash-strapped country had proved slow to materialize, U.N. officials said.

"There have been promises but there has been little funding," said FrancoisBellet, a UNICEF specialist in water and sanitation.

(Additional reporting by Robenson Sanon, editing by G Crosse)