Haiti’s cholera outbreak continued to claim lives through December 2022, with the death toll surpassing 300 as health authorities struggled to contain a disease that was spreading through communities where water and sanitation systems had been disrupted by months of crisis. The outbreak, which had emerged in October in the aftermath of the gang fuel blockade, showed no signs of rapid resolution as the underlying conditions that had enabled its spread remained largely unchanged.
Health facilities managing cholera cases faced persistent challenges: shortages of oral rehydration therapy supplies, limited intravenous fluid availability for severe cases, inadequate isolation facilities to prevent transmission within health settings, and the continued security constraints that prevented free movement of health workers and supplies. MSF and other emergency medical organizations had scaled up their responses but the coverage remained insufficient for the scale of need.
Community health workers who had been reaching patients in their homes — often the most effective mechanism for early identification and treatment of cholera in Haitian communities — faced security constraints in areas of active gang presence that prevented them from conducting outreach. The combination of gang territorial control and the resulting inability to deliver community health services created dangerous blind spots in the surveillance and response system.
Public health officials warned that the winter months could see cholera spread further as rainy season flooding contaminated water sources and as the continued disruption of water and sanitation services left more communities drinking from compromised sources. The cholera outbreak was a direct consequence of the security crisis, and its elimination required not just medical intervention but the restoration of the social and physical infrastructure that gang violence had destroyed.