Carter Center Launches Haiti/DR Malaria Eradication Initiative

Below is a piece by Miami Herald contributor Greg Blustein on a new initiative launched by the Carter Center to eradicate malaria in the Dominican Republic and Haiti within 10 years.  The funding will be used on house to house search for cases, free treatment and mosquito control, repellents for mosquito nets and walls in high risk areas, and for education and social mobilization in both countries.  Malaria is a nasty disease to which children and pregnant women are especially vulnerable.  However, it is preventable, treatable and the international community knows what works.  We hope that this initiative will be a success for both Haiti and the DR.

OUANAMINTHE, Haiti -- Former President Jimmy Carter traveled to Haiti and the Dominican Republic to meet political leaders, health workers and malaria victims Wednesday in hopes of jump-starting efforts to eradicate the disease in the Caribbean.

The battle against the mosquito-borne disease in the neighboring countries has been frustrating, with health officials complaining of a lack of cooperation between both country's governments.  Carter said on his visit to Ouanaminthe and to Dajabon in the Dominican Republic, just across a river border separating the two countries, that he hopes to expand a $200,000 pilot project established in those towns by the nonprofit Carter Center to curb malaria's spread.

The project's funding runs out early next year, but Carter said he hopes governments, nonprofit health groups and private foundations will pick up the tab for a broader effort.

"One of the most important developments has been the new cooperation between the two countries," Carter said while touring a Haitian hospital that treats many malaria victims. "And for the first time in history, they are targeting the complete elimination of the disease instead of just treating sick people."

An estimated 30,000 people in Haiti and several thousand more across the border suffer each year from malaria, which causes high fevers and flu-like symptoms that kills more than one million people each year, mostly in Africa.

It was the second visit to Haiti in a week by a former U.S. president. Bill Clinton, named U.N. special envoy to Haiti in May, attended an investment conference last Thursday in Haiti's capital and spent Friday promoting its tourist sites.

Health officials say a 10-year, Haiti-wide program to eliminate malaria by 2020 would likely cost $200 million. Another $50 million would be needed to wipe out lymphatic filariasis, another painful illness carried by mosquitoes that can swell limbs to grotesque proportions.

That price tag may seem daunting, particularly in Haiti, the poorest country in the Western Hemisphere. But Carter, who was quickly surrounded at each stop by dozens of Haitians and Dominicans seeking a glimpse of him, said the costs to eradicate the disease pale in comparison to pricier health initiatives in wealthier nations.

"A tiny bit of money can completely eradicate these diseases," he said. Ridding Hispaniola's two countries of the disease would also eliminate the threat that it could spread to nearby islands, including Jamaica and the Bahamas.

"We want to help both sides raise their sights up from the day-to-day battle," said Dr. Don Hopkins, the director of the Carter Center's health programs. The Atlanta-based center's project distributes nets treated with insecticide to drape over beds, microscopes to help lab technicians and motorbikes so field workers can zip through cramped alleys to test and treat residents.

It also helps bolster efforts in both countries to track, contain and treat a disease that spreads from fetid ditches and gullies of standing water.  In the Dominican Republic, for one, health workers journey each night to a foul-smelling farm in La Bomba, a Dajabon neighborhood with the highest infection rates, and test captured mosquitoes for the disease.

Across the border in Haiti, residents of the slums on the outskirts of Ouanaminthe greet health worker Jovind Fritzner as he makes his rounds, repeating verbatim his radio warnings on the dangers of malaria. They kid him about when he'll return with heavy equipment to wipe out mosquito breeding sites.

"If we had the equipment, I will make sure we kill them," Fritzner said in Creole as he waved his arms in a chopping motion. "It's a little bit frustrating. There's a lot more to be done. We'll need more equipment, we'll need more people - but I'm optimistic."

Health workers said it is difficult to develop a strategy that fits both Haiti and the more developed Dominican side. But they said getting leaders of both nations to commit to a long-term program may be the biggest challenge.

"We share the same island so it's impossible to eradicate malaria unless we're together," said Dr. Joanel Mondestin, who heads Haiti's northeast regional health office. "For the malaria, there is no border - it's all the same. This is a fight for both of us."

Few victims of malaria will venture to dream of a day when the disease is gone from the island. Paulane Antoine, who lives in a cinderblock house with one mosquito net for her and her eight children, said malaria is a constant concern in Ouanaminthe's slums, where barefoot children play on garbage-strewn streets.

Antoine's 6-year-old boy and 3-year-old girl were infected with malaria this year, but detection and medication saved them from death. Still, Antoine said, she worries about which of her neighbors or family members will contract the disease next.

"We already have enough problems," she said. "It's already hard enough to stay healthy here."