海地霍亂危機 禍首來自聯合國?

環境資訊中心
更新日期:2010/12/23 11:34
洪美惠

摘譯自2010年12月17日ENS美國,紐約報導;林可麗編譯;范仕穎審校

聯合國目前正成立一個獨立的科學小組來調查海地爆發的霍亂。有報導指出聯合國海地穩定特派團(又簡稱為MINUSTAH)的尼泊爾籍維和人員是可能的霍亂來源,受污染的水源由他們的基地流入鄰近的阿蒂博尼特河(Artibonite River)支流中。

聯合國祕書長潘基文表示,目前關於霍亂的爆發原因有數種說法,且在10月22日已經受到實驗室測試結果的確認。這個流行病在太子港破壞到剩下斷垣殘壁的強震發生9個月後爆發,使得數以千計的民眾被迫遷入臨時營地的帳篷內。

潘基文表示,「至今仍然有些問題與合理的顧慮需要科學來提供最好的答案。這也是為什麼在與世界衛生組織的陳博士(Margaret Chan)密切諮商後,我在今天宣布成立一個國際的科學小組來調查霍亂流行病的起源。」

霍亂這個以水為媒介傳染的疾病已經導致超過2,400位海地民眾死亡,並且感染了超過11萬名民眾,其中有5萬5千名民眾已經被安置到醫院。

聯合國海地穩定特派團與海地政府已經進行了一些測試以決定疾病的來源,但是到目前為止都沒有得到正面的結果確認。海地已經有超過50年沒有發生霍亂了。

潘基文強調,新的聯合國小組將會完全獨立運作,並有權自由進出聯合國的基地及與相關人員談話。他補充,小組底定後會公布更多的細節。

他表示,「我們想要盡全力了解霍亂事件的起源,並且找到海地人民應得的答案。」

聯合國祕書長已經要求更多的經費來拯救霍亂的受害者與避免更多人感染疾病,霍亂已經藉由受污染的食物與水四處傳播。

潘基文在紐約的新聞會議表示爭取的1億6千4百萬美元只有21%受到補助,「海地急需更多的醫生,護士,以及醫療補給品。我們的當務之急仍然是拯救生命。」

他說,霍亂可以藉由在早期的治療以及簡易的步驟獲得控制,包括洗手以及使用肥皂。而這些訊息散播的「廣度」和「深度」是極為重要的。

根據最新的資料顯示,霍亂的案例持續在海地增加,一小部分染病的人甚至因此喪命。

在霍亂開始流行的頭幾週,也就是10月底,送到醫院治療的病患死亡率高達9%。不過至今最新的海地衛生部報告中則顯示這個數字已經降到3.5%。

世界衛生組織區域分會泛美衛生組織(Pan American Health Organization)的副主任安德魯斯博士(Jon Andrus)表示,「這是一個進步,目前仍然有太多死亡案例,我們還是面臨很多的挑戰。但是海地的醫生,護士,與社區工作人員及配合的國際工作人員付出的辛勞實際上正拯救很多生命。」

泛美衛生組織/世界衛生組織以及美國疾病管制局(U.S. Centers for Disease Control and Prevention)的流行病模擬結果顯示,在流行開始的前12個月會有40萬個病例發生,其中有高達一半的病例會在頭3個月發生。

安德魯斯表示,這意味著工作量需要相對提高,因為「霍亂已經侵犯了海地,而目前的情勢看來我們需要有心理準備,可能會有更多的病例。」

海地的衛生部提議增加霍亂醫療中心,並且在家庭與社區的層級上拓展公共教育,提供消毒錠,以及口服補液鹽,以促進疾病預防以及治療。

安德魯斯博士表示,光是這個提議,就需要在未來的3個月內增加額外的350位醫生,2000位護士,以及2200位支援工作人員,還有訓練約3萬名社區醫療工作者及志工,以及額外的口服補液鹽補給品與淨水錠。

更糟的消息是,一場短暫而強烈的風暴將太子港掃得面目全非,吹倒了樹木,並且將安置民眾的營地帳篷摧毀。

根據獨立的海地媒體組織蓋伊(Bri Kouri Nouvel Gaye)指出,在太子港的街道上以及鄉間的城鎮中,揉合著失望與憤怒的新草根改革運動已經開始動員。

蓋依的網站上寫著,「強震過後的11個月,幾乎甚麼都沒有改變。這些日子以來被迫露天而居的海地人民已經開始失去耐性,就如同上週民眾憤怒的遊行示威所顯示的情況。」

蓋依表示,「雖然海地整個國家的情況比太子港更為嚴重,但在市區裡海地人居住的帳棚儼然成為令人痛心的明證,國際人道救援團體以及海地當局失敗了,他們無法果斷地協助無家可歸的地震倖存者改善現有的狀況。」

蓋依指出,「海地人從未期望被拯救,而在最近的幾個月內,太子港的社區內及國內的貧民運動整體而言,草根性的改革動員已經開始在IDP營區內茁壯。經由和平的示威以及大學內的普遍討論,人民已經開始預見自己未來的路。」

聯合國兒童基金會(UNICEF)的執行主任雷克(Anthony Lake)拜訪了一個在首都太子港貧困區域內的霍亂治療中心,他宣示要持續聯合國的支援以及呼籲國際間對兒童的持續支持援助。

雷克表示,「如同往常一樣,兒童是受到像霍亂及今年1月地震等危機衝擊最嚴重的族群。我們共享的責任保護兒童與家庭不受這些災害傷害,同時也不受近來的政治緊張情勢所影響。」這裡指的政治緊張情勢是上個月備受爭議的總統大選及立法選舉。

雷克表示,現今海地的不確定與不安全環境讓兒童與家庭陷於更大的人身風險中,並且導致人道救援組織如聯合國兒童基金會的努力機會被抹煞。

安德魯斯及其他的專家皆表示,海地的霍亂造成的衝擊相當嚴重,因為大部分的人口取得乾淨水源不易,衛生條件也很差。同時海地人口從未暴露於霍亂之下,因此沒有天然的免疫力。而如何將病患及時送到醫療設施接受有效的治療也是困難重重。

地震摧毀了當地的醫院,水資源,以及污水處理的基礎設施,並且導致超過1百萬的海地人口無家可歸。UN Panel to Probe UN Role in Haiti's Cholera CrisisNEW YORK, New York, December 17, 2010 (ENS)

The United Nations is creating an independent scientific panel to investigate the source of the cholera outbreak in Haiti amid reports that Nepalese peacekeepers from the United Nations Stabilization Mission in Haiti, MINUSTAH, are the likely source, with infected water spreading from their base into a nearby tributary of the Artibonite River.

Ban said there are several theories about the origin of the cholera outbreak, which was confirmed by lab tests on October 22. The disease struck about nine months after a devastating earthquake left much of the capital Port-au-Prince in ruins, forcing hundreds of thousands of people into makeshift camps of tarp tents.

"There remain fair questions and legitimate concerns that demand the best answer that science can provide," Ban said. "That is why, pursuant to close consultation with Dr. Margaret Chan of the UN World Health Organization, I am announcing today the creation of an international scientific panel to investigate the source of the cholera epidemic."

The waterborne disease has already killed more than 2,400 Haitian people and infected nearly 110,000 others, 55,000 of whom had to be hospitalized.MINUSTAH and the Haitian government have conducted a number of tests to determine where the disease originated, but all so far have been negative. Haiti had been cholera-free for over 50 years.

The new UN panel will be completely independent and have full access to all United Nations premises and personnel, Ban stressed, adding that further details will be provided when the panel is finalized.

"We want to make the best effort to get to the bottom of this and find answers that the people of Haiti deserve," he said.

The secretary-general appealed for more funds to save lives of cholera victims and prevent more people from getting the disease, which is spread by contaminated food and water.

"We need more funding," Ban told a news conference in New York, saying that a $164 million appeal is only 21 percent funded. "Haiti needs more doctors, nurses, medical supplies, and it needs them urgently. Our first priority continues to be saving lives."

He said it is crucial to get the message "out, far and wide" that the disease can be managed through early treatment and some clear and simple steps, including washing hands with soap.

The number of cholera cases continues to grow in Haiti, but a smaller proportion of people who become ill are now dying from the disease, according to the latest data.

In the first weeks of the cholera epidemic, which began in late October, the proportion of hospitalized patients dying of cholera was as high as nine percent. In the latest reports from Haiti's Ministry of Health, that figure is down to 3.5 percent.

"This is progress," said Dr. Jon Andrus, deputy director of the Pan American Health Organization, a regional division of the World Health Organization. "There are still too many deaths, and we face many challenges. But the hard work of Haitian doctors, nurses, and community workers and their partners in the international community is, in fact, saving many lives."

Epidemiological modeling carried out by PAHO/WHO and the U.S. Centers for Disease Control and Prevention for planning purposes projects an estimated 400,000 cases over the first 12 months, with as many as half those cases occurring in the first three months of the epidemic.

Andrus said this means efforts need to be scaled up, since "cholera is now entrenched in Haiti, and conditions on the ground are such that we should expect many more cases."

Haiti's Ministry of Health proposes to increase the number of cholera treatment centers and expand efforts to promote prevention and treatment at the family and community levels through public education and by providing chlorination tablets and oral rehydration salts.

This work alone will require an additional 350 doctors, 2,000 nurses, and 2,200 support staff over the next three months, training for some 30,000 community health workers and volunteers, and additional supplies of oral rehydration salts and water purification tablets, said Dr. Andrus.

To make things even more difficult, a brief but intense wind storm tore through Port-au-Prince earlier this week, felling trees, and tearing tents apart in the camps for displaced people.

On the streets of Port-au-Prince and in the country towns, hopelessness and anger mingle with a new grassroots mobilization for change, according to the independent Haitian media organization Bri Kouri Nouvel Gaye.

"Eleven months after the earthquake, so little has changed. Haitians who have been living out in the open are beginning to lose patience, as we saw through the angry protests in the street last week," says BKNG on its website.

"While Haiti is much more than Port-au-Prince, the camps of internally displaced people living in the metropolitan area have become the most painful reminder of the failure of the international humanitarian community and Haitian authorities to decisively provide assistance that changes the conditions of homeless earthquake survivors," BKNG says.

"Haitians never expected to be rescued, and in recent months a new grassroots mobilization for change has begun to grow throughout the IDP camps, the neighborhoods of Port-au-Prince, and the peasant movements of the country as a whole. Through peaceful protests and popular university discussions, people are beginning to envision their own path for the future," says BKNG.

UN Children's Fund, UNICEF, Executive Director Anthony Lake visited a cholera treatment center in an impoverished area of the capital Port-au-Prince this week, where he pledged continued UN support and pleaded for international support for the children.

"As always, and without exception, children are the most adversely impacted by crises such as this cholera epidemic and the January earthquake. The responsibility we all share is to ensure that children and families are protected from these emergencies as well as from the recent political tensions," Lake said, referring to last month's disputed presidential and legislative elections.

Lake said the current environment of uncertainty and insecurity in Haiti places children and families at even greater physical risk and also inhibits the efforts of humanitarian agencies such as UNICEF.

The impact of cholera in Haiti has been particularly severe, Andrus and other experts say, because large sectors of the population have poor access to clean water and sanitation, because Haitians had not been previously exposed to the disease and therefore lacked natural immunity to it, and because of difficulties in getting patients to health facilities in time for effective treatment.

The earthquake destroyed hospitals, water supplies and sewage infrastructure, and left over a million Haitians homeless.

全文及圖片詳見:ENS報導


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