13 January 2013 Last updated at 08:10 GMT
Cholera fear in Cuba as officials keep silent
By Sarah Rainsford BBC News, Havana
Uvaldo Pino was a neighbourhood barber in Cerro, one of the poorer and
more overcrowded districts of Cuba's capital, Havana.
In late December, the 46-year-old fell sick with vomiting and diarrhoea
and died in hospital on 6 January.
The barber's family say he had two separate tests and both came back
positive - for cholera.
"We don't know how he was infected," his sister, Yanisey Pino, told the
BBC at the family's home, a few blocks from the capital's Revolution Square.
"He was treated, he had all the medicine, but his organs didn't respond.
It was too late."
Yanisey added that her brother was a heavy drinker and had checked
himself out of hospital the first time he was admitted.
A week after Uvaldo's death, Cuba's health ministry has not yet made any
public pronouncement. But there are increasing signs that the barber's
case is not an isolated one.
'Dozens' of admissions
Doctors are now making door-to-door enquiries in Havana and anyone
displaying possible cholera symptoms is being tested. Suspected cases
are being sent to the Tropical Medicine Institute, the IPK.
"All our wards are dealing with this issue - they are almost full," an
IPK employee told the BBC by telephone, before saying she was not
authorised to comment further.
Another staff member, contacted later and also not authorised to speak
to the media, said the IPK did not have any confirmed cases of cholera
at this point.
But Yanisey Pino says her brother was diagnosed with cholera both by his
local hospital and the IPK.
The day Uvaldo died, health workers visited the family where they live -
in several cramped houses around a small yard. Relatives and neighbours
were issued antibiotics as a precaution.
The area has been disinfected and water samples were taken for testing.
Meanwhile, nearby bars and cafeterias have been closed or instructed not
to sell food or drink that is not pre-packed.
Elsewhere in the neighbourhood, there are similar scenes.
One resident, Yudermis, fell sick just before the New Year, along with
four other relatives including her seven-year-old son. The family
assumed they had food poisoning but Yudermis says her cousin then tested
positive for cholera at their local clinic.
"The health workers then came here asking questions, like if we had
diarrhoea," she explains inside their rundown family home as her son,
now fully recovered, plays nearby.
"They sent us all to hospital by ambulance and the tests came back positive.
"There were a lot of people at the IPK," Yudermis adds, describing
dozens of admissions while she was being treated, and not all from her
own district of Cerro.
"I was in a bad way. It was frightening. But we're fine now."
Before she fell sick, Yudermis had never even heard of cholera, which is
rare in Cuba.
Cold grills
The World Health Organisation (WHO) describes cholera as "extremely
virulent". Carried by contaminated water or food, it causes severe
dehydration through diarrhoea and can prove fatal if untreated.
Until last summer, there had been no significant outbreak on the island
since well before the revolution.
But in July the health ministry confirmed that three people had died of
cholera in the east of the country. A contaminated well was identified
as the source.
In Havana, Cuba's bustling and crowded capital and a key tourist centre,
strict measures are in place to contain the latest suspected outbreak.
"We can't sell anything that's not in sealed bottles until further
notice and all food sales have been suspended," explains Tony, at the
Cerro Moderno cafe, a short walk from the home of Yudermis. Its fridge
is now empty and the grills cold.
Local doctors confirmed this is standard procedure for several blocks
around every location where someone tests positive for cholera.
"If they take all the right measures, we'll be fine," Tony shrugs,
adding that everyone has been given antibiotics as a precaution.
"I took my pills straight away!" says Angel, as he buys cigarettes at
the cafe.
"I don't know what cholera is and I don't want to find out. People here
are using chlorine and boiling their water. You have to take care."
Rumour mill
Pharmacies across the city are now selling water purification drops,
rationed to two small bottles per person.
But in the tourist heart of Old Havana, cafes and restaurants remain
open and the streets are still full of mobile food and drink vendors.
Most say they have heard rumours of a cholera outbreak in Cerro and are
taking extra precautions, but none have received any official instructions.
The WHO stresses "public communication" as a key tool in controlling any
cholera outbreak.
In Havana, that task has so far been left to local doctors who are very
connected to their communities.
But as rumours fill the information void, concern on the streets is growing.
"I'm racking my brains trying to understand why there's nothing on TV
about this," says Yanisey Pino, echoing many peoples' comments.
"Why don't they say something? Inform people, like in other countries,
so they're not afraid and can protect themselves! But there's no
information at all."
http://www.bbc.co.uk/news/world-latin-america-21002191
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