Cholera, which had been reduced to very low case levels in Haiti after years of public health interventions, began resurging in late 2021, with cases confirmed in Port-au-Prince and surrounding areas. The resurgence came as a deeply unwelcome development in a country already overwhelmed by multiple simultaneous crises, and raised fears that conditions created by the gang blockade, the earthquake, and the breakdown of water and sanitation services could enable a new epidemic.
Public health authorities identified contaminated water sources in areas where the gang fuel blockade had disrupted water treatment and distribution operations. Without electricity for pumps and chemical inputs for water treatment, water systems that had previously delivered relatively safe water began distributing contaminated supplies. The connection between the gang-imposed fuel shortage and the cholera resurgence was direct and devastating.
The earthquake had also damaged water and sanitation infrastructure in the southern departments, creating conditions conducive to waterborne disease transmission in communities that were simultaneously displaced, traumatized, and lacking access to healthcare. The combination of compromised water sources, inadequate sanitation in displacement sites, and disrupted healthcare made the earthquake-affected population particularly vulnerable to cholera.
Public health organizations immediately activated cholera response protocols, deploying oral rehydration therapy supplies and medical personnel to affected areas. But the conditions driving the resurgence — inadequate water infrastructure, disrupted services, displacement, and poverty — could not be addressed quickly, and health officials warned that containing the outbreak would be difficult unless the underlying conditions were rapidly improved.