Commentary: Haiti's tent cities' lack of sanitation is spawning diseases

PORT-AU-PRINCE — We stopped on the roadside to photograph two cute little boys kicking an empty water bottle like a soccer ball, a reminder that this brown dirt pitch, before the catastrophe, was once a playing field.

Earthquake survivors transformed the church school soccer field, like nearly every open space in Port-au-Prince, into yet another of the city's impromptu survivor camps.

But "survivor" -- unless the coming public-health disaster festering in these squalid camps can be stanched -- may become a brutally ironic term. These are potential death camps.

As the two boys played, a third child emerged from the jumble of makeshift tents, carrying the family slop bucket. He dumped the fetid contents, an accumulation of human waste, just at the edge of the field. He illustrated the city's sanitation crisis in microcosm.

Dr. André Vulcain of the University Of Miami Miller School of Medicine, back from seven days with the UM medical team in Port-au-Prince, talked about the horrible potential brewing in camps that have become the semi-permanent address for a million, maybe two million people. (The official numbers, like most of the purported facts cited in the anarchic aftermath of the earthquake, are little better than guesses.)

"These camps have no sanitation in a city that had a weak sanitation system before the earthquake," he said.

The settlements have become open depositories of human waste. The extent of the crisis can be measured by the escalating stench. Miami Herald photographer Pat Farrell and I visited the vast camp across from the ruined National Palace, then returned a day later. The odor had become, in one day, so overwhelming that it seemed less gaseous then something physical that crawled down the gullet.

"People can't live like this much longer," our interpreter Abraham Pierre volunteered, interpreting my very thoughts.

Dr. Vulcain worries about dysentery and diarrhea lurking in the camps. Other public-health doctors warn that the open dumping of human waste will nurture E. coli. The untreated water could lead to an outbreak of typhoid.

It gets worse. Vulcain talked about the potential for tuberculosis and other respiratory diseases.

The dry season, at least, has forestalled some other serious health risks. The British-based Malaria Risk Index, which already had listed Haiti as one of the world's most vulnerable nations, has now upped the odds that the mosquito-borne disease (as well as dengue fever) will add to Haiti's great miseries. The lack of a substantial rain has postponed that particular catastrophe.

But the dry weather perpetuates the dust plumes that loom over the residents of Port-au-Prince -- always a problem -- and now include whatever materials were loosed in the earthquake rubble along with airborne horrors caused by a lack of sanitation.

There's talk of flu. Dr. Greg Elder, deputy operations manager for Médecins sans Frontie`res in Haiti, told reporters that he has seen death in those awful camps from septic and gangrene from wounds in the Jan. 12 quake.

Other doctors have reported signs of salmonella, shigella and campylobacter and bacterium leptospirosis, a skin disease.

Dr. Vulcain said scabies, caused by a mite that burrows into the flesh, will flourish in the camp squalor. He talked about an urgent -- life-and-death urgent -- need to bring not only some measure of sanitation into the camps, but a renewed emphasis on hygiene, given the circumstances. Bringing fresh, clean water and soap into the camps without emphasizing the heightened necessity of frequent hand-washing, he worried, won't stave off the second disaster stalking Haiti.

"Even before the earthquake, Haiti's children had a high mortality rate from diarrhea," he said. "Now, children in the camp are at a very high risk. We're going to have children die."

The Haitian government wants to move 472,000 survivors into new tent cities with at least basic sanitation at the edge of the city. The number seems inadequate against the apparent need, with so much of the city living outdoors. The logistics just seem impossible.

And who knows if Haiti has the time it will take to build the tent cities and move that many people out of the capital before the second disaster hits Port-Au-Prince.

Before survivor camps become death camps.