Of the many wrenching stories coming out of Haiti, two stories about the public-health challenges facing earthquake survivors do a particularly good job encapsulating just how daunting the weeks ahead will be.

In the Los Angeles Times, Shari Roan reports that emergency medical responders “will have to create a public health system on the fly.” Only one hospital is functioning, and the large numbers of people infected with HIV and tuberculosis will struggle to access the treatments they need. Many Haitians are already undernourished, so it’s crucial that food shortages be addressed – but, as most of us have already heard, transporting basic supplies is difficult given heavily damaged infrastructure. Roan goes on to explain how a range of illnesses can spread under current conditions:

There is also the risk that people could resort to eating contaminated food, making food-borne illness likely.

“When you’re hungry, you’ll eat whatever you can find,” [American Public Health Association Executive Director Dr. Georges] Benjamin said. “People may eat food that’s not safe and we’ll have water- and food-borne illnesses like E. coli and salmonella.”

If Haitians flock to shelters, which seems likely considering their limited options, crowding will increase the threat of disease. Haiti already has high rates of communicable diseases such as tuberculosis and measles.

“You have worry about hand-washing and hygiene and roaches and vermin that carry disease,” Benjamin said. “Waste disposal is so important. Anyone who has ever been on a cruise ship knows how easily a gastrointestinal illness like norovirus can spread.” …

Diseases such as tetanus and diphtheria — much more common there because of low rates of childhood vaccination — could spread easily. And people injured in the quake may be susceptible to infections, such as tetanus, sepsis and meningitis, which would be fatal if untreated. 

The Washington Post’s Rob Stein focuses on what may be the most immediate and pressing need: adequate supplies of clean water. Here’s his stark summary of the problem:

In addition to causing death from dehydration, a lack of clean water can trigger outbreaks of dysentery, cholera, typhoid fever and other illnesses. …

The water purification and sanitation systems of an impoverished nation such as Haiti are typically old, poorly maintained and reliant on aging pipes and trucks for distribution. After the earthquake, the fragile system that existed was probably devastated as pipes broke, bathrooms were destroyed, pumps lost power and existing water supplies were contaminated.

Stein reports that nations and organizations are quick to offer water donations, but the problem is transporting heavy containers over damaged roads. Disinfecting tablets and chemicals are easier to distribute, but the article notes that experts say these items “are difficult to consistently use correctly and cannot provide large amounts” of potable water. The best solution seems to be water-purification equipment, and according to Stein such systems are on their way to Haiti:

U.S. officials, for example, plan to send four major purification systems soon by ship, and six more might be brought to Haiti later from elsewhere in the world. Each can produce enough water for 10,000 people a day.

Water Missions International, a Charleston, S.C., charity that provides clean water in Haiti and 39 other countries, sent 10 water filtration systems to Port-au-Prince by plane on Friday and was rushing to assemble as many additional systems as quickly as possible.

The 1,700-pound, $25,000 systems, which can run on diesel fuel or solar power, can purify water from ponds, lakes, streams, springs, wells and other sources to produce 10 gallons of water a minute — enough to supply up to about 5,000 people a day.

“They’re kind of like small municipal water treatment plants,” said Patrick Haughney, the group’s director of international programs.

The good news here is that Haughney told the Post that there are adequate freshwater supplies for this equipment to draw on.

These two articles are well worth a read. They also remind us of the importance of building strong public-health infrastructure (which includes things like water systems as well as obvious health-related facilities like hospitals) in Haiti and other vulnerable countries. Even once the population’s immediate needs for water, food, and shelter are met, and international attention turns elsewhere, Haiti will continue to need resources to build up this infrastructure so it won’t be in such dire straits when the next disaster strikes.