What a difference a bacteria makes...

It's been about 4 months since the first cholera cases started to appear in the Dominican Republic. So much has changed as a result...

When the outbreak of cholera began in Haiti, Dominican health authorities (and my office as well as the CDC) knew that it was just a matter of time before the bacteria found its way over to our side of the island.  The plan was "prepare, prepare, prepare" - for prevention, as well as for diagnosis and treatment to prevent a full-fledged outbreak.  I think is safe to say, mission accomplished.  Whereas in Haiti the cholera outbreak has affected hundreds of thousands and killed over 3,000, there have been only 100s of cases in the DR and no fatalities.  The Dominican government (with the help of international groups) did a great job of educating Dominicans and of expressing the importance of hygiene, prevention and seeking medical attention at the first sign of symptoms. 

Now, 4 months later, authorities have figured out the origin of the bacteria in the DR - the rivers that run along the border between the countries, which are now forbidden for swimming, fishing, washing, etc.  (The same rivers/area where I swam when I visited the border in September!).  The presence of cholera in the country, as far as I understand the situation, is now being "down graded" to an endemic issue instead of a potential outbreak...meaning that we will continue to see cases appear here and there in the hospitals, but we should be out of the danger of seeing what happened in Haiti (unless an outbreak starts).

So, it would appear that the DR got away largely unscathed, right? much ado about nothing in the end....except that the emergence of cholera in the DR has opened wide other wounds that had seemed to be on the mend.  I'm talking about the Haitians. There is a long, complicated history with respect to the Dominican-Haitian relationship...too long to really go into here. Let's just say there is no trust and no love lost between the two.  After the earthquake, though, things had started to change. The DR did an incredible job with their response to the quake, and they've pretty much had an open door policy with respect to Haitians.  Now, though, as we pass the first anniversary and with the presence of cholera, the discrimination against Haitians is back in full effect. Haitians are being  blamed for the crime in communities, and for bringing cholera to this side of the island.  Community groups in the Santiago area have recently mobilized to kick out the Haitians in their neighborhoods (some recent arrivals, others long time residents).  In the middle of the cholera scare, Haitians were purportedly banned from getting on public buses in some parts of the country!  Now the government is rounding up hundreds of illegal Haitians and deporting them back to Haiti. 

I'm not suggesting that the DR continue to have an open door immigration policy, or that all Haitians are innocent of wrong doing in this country...but it is a shame to see how quickly the country can regress out of fear.  I think we're seeing that in many places these days....