Santo Domingo, DR
With the introduction of the cholera vaccine, it can be expected that cases will be brought under control. Still, the country must maintain active disease surveillance to prevent new outbreaks.

This is the opinion of the epidemiologist Manuel Colomé, professor of the Masters in Public Health and Epidemiology of the Instituto Tecnológico de Santo Domingo (INTEC) and epidemiology manager of the Dr. Hugo Mendoza Pediatric Hospital, where children are treated for cholera. This disease, in recent weeks, has generated two major outbreaks in sectors of Greater Santo Domingo, one in La Zurza and the other in Villa Liberación.

The specialist understands that the success and the extent of these control measures carried out by the Ministry of Public Health, which he considers adequate, will depend a lot on social and environmental factors, health care, human behavior, public health infrastructure, adaptation, and microbial changes and food management, among others.

Answering questions for Listin Diario, the epidemiology expert, considering that solid waste management, access to drinking water, and proper excreta disposal could be improved at the local level. “I also want to emphasize that the humanitarian crisis that Haiti is experiencing can be an important risk factor because it increases the migratory flow,” he added. He noted that both countries must address Public Health measures to deal with cholera. He pointed out that this gap must also be overcome since cholera is a disease of poverty and social inequality.

Colomé said that society must also support the government in prevention and health promotion activities within the community, as knowledge of the signs and symptoms and the mode of transmission is vital to ensure timely care.

The Ministry of Public Health notified yesterday of seven new cholera cases, six Dominican residents of Villa Liberación and Solares del Almirante in Santo Domingo East.

A communication released through the General Directorate of Epidemiology states that among the positive cases, four males aged 66, 41, 35, and 23 years and two females aged 47 and 22.

The document also adds that the seventh case is imported and corresponds to a 47-year-old male patient of Haitian nationality.

The patients the text refers to were admitted between the 26th and 27th of this month after presenting with watery and whitish diarrhea accompanied by vomiting. They explained that since their admission to the health center, they were hydrated and immediately proceeded to take stool samples, which were positive for cholera.

Patients are stable
The medical report certifies that the patients have been without bowel movements for more than 30 hours, are stable, and remain hospitalized for observation, with possible discharge in the next few hours.

Public Health informed that they are ‘maintaining the epidemiological surveillance’ with the close relatives to whom they applied the corresponding vaccines to avoid new contagions.

The intervention continues in the areas to prevent and investigate any suspected disease cases. In addition, it maintains an installed mobile medical office to treat any emergency in the identified sectors.

The institution urges the population to take care of themselves, maintain hygiene, wash their hands before and after going to the bathroom, cook food well, consume chlorinated water and otherwise boil it to drink before consumption.

Those who have watery diarrhea several times a day are asked to stay hydrated and go to the nearest health center as soon as possible.

This was announced to Diario Libre by Dr. Yocasta Lara, director of Hospitals of the National Health Service (SNS), after confirming that yesterday three other patients were discharged because they tested negative for the disease, of which 36 cases have been registered at the national level from October to date.

The doctor explained that they are awaiting the results of the tests performed on those hospitalized to confirm or rule out the disease and recalled that stool cultures take three days to conclude.

Of the seven patients, five are at the Dr. Felix Maria Goico Hospital in the National District, one at the Dr. Rodolfo De La Cruz Lora Hospital in Pedro Brand, and one at the Dr. Hugo Mendoza Pediatric Hospital in Santo Domingo East.

Yocasta Lara said that the balance of patients admitted for suspicion of the disease is done every day at 8:00 a.m., so she cannot say if more people have been revealed this Saturday.

Since October 2022, 8,700 cholera tests have been applied in the country. However, so far, the health authorities have not provided information on the post-mortem tests used on five residents of the Villa Liberation sector, Santo Domingo East, who, according to their relatives, died of symptoms associated with cholera.

It is recalled that the authorities began to apply the Euvichol-Plus cholera vaccine to people from one to 60 years of age, residents of vulnerable areas where cases have already been detected.

The immunologic is a liquid formula for oral application, single dose, and protects against serotypes 01 and 0139, with protection for three years. It is being applied in the Goico Hospital, the mobile hospitals of La Zurza and Villa Liberación, and the Moscoso Puello Hospital.

It will also be distributed in selected schools in these sectors, including Capotillo and Villas Agrícolas.

At the provincial level, it will be applied in Elías Piña, Dajabón, Independencia, and Pedernales, provinces bordering Haiti, where health authorities have reported 511 deaths from cholera in the last four months.

Santo Domingo DR
The environment in which many families in popular neighborhoods of Greater Santo Domingo live is clouded by the precarious hygienic conditions in which they develop their daily life.

Dirty and stagnant water in different sectors such as La Zurza, Villa Almirante, and Villas Agrícolas are some of the causes for which the bacterial disease of cholera has taken hold in these places.
According to some community members of La Zurza, the conditions in which they live do not allow them to live in an environment with optimal conditions to prevent viral diseases.

“One tries to be clean in one’s little house, but there are many people here who do not have water and have to go to do their things in the river and they bring the disease to one’s house,” said Monica Peralta, a community member of La Zurza, who was inoculated against cholera.

In the same sector, a journalist of Listín Diario approached a 32-year-old man walking towards one of the pools to wash, and when he answered why he was doing it, he limited himself to express that “it is better to bathe like that.”
“We are used to it, this cholera is not going to hit us because we are immune to it,” said the man.

In addition to the lack of safe drinking water, hand washing, and hygiene in the handling of food, the national territory is also plagued by a lack of education on the subject of neighborhood cleanliness, as commented by a psychologist who resides in the community of Villa Almirante. “Look what happens; many residents here (Villa Almirante) do not have enough hygienic education to be able to fight this type of disease, on the contrary, there are those who believe that living in a very poor way will create an immune system and nothing will ever happen to them,” said Leidy Bautista, a psychologist who attended to be inoculated in the Villa Almirante tent.

The Ministry of Public Health, aware of the seriousness of a probable cholera epidemic, began vaccinating the citizens. Although the number of inoculated people has been fruitful so far, some want to avoid going to the vaccination tents.
Such is the case of Manuel Domínguez, a resident of Villas Agrícolas, who told this newspaper that he does not trust the vaccine because it is oral. “If I have to take it, forget it, I’m not going to take the vaccine,” Dominguez said confidently.

Awareness campaign

Given the increase in cholera cases, the Public Health authorities initiated meetings with community members to discuss the different measures to avoid contracting the diarrheal disease, which is currently registering an outbreak in the sector of Villa Liberación in Santo Domingo East.

Since October, 36 cases of the disease have been confirmed, most of them in Greater Santo Domingo. Yesterday, the Ministry of Public Health teams continued the cholera vaccination campaign for people at higher risk, residents of vulnerable sectors, and provinces.

The Toribio Bencosme Provincial Hospital received an Echo Cardiograph for an investment of RD$3,557,615.18, while at the President Estrella Ureña Regional Hospital, an image digitizer or CR and five surgical lamps with rolling feet, valued at RD$2,933,920, were delivered.

Likewise, the Hospital Municipal Licey al Medio was given a table for primary operations for RD$668,197.80, while the Hospital Regional Infantil Doctor Arturo Grullón received four transport stretchers valued at RD$787,296.00.
At the meeting of health indicators, where the delivery of the equipment was announced, the director of the SNS, Dr. Mario Lama, said that the action is part of the commitment assumed by the institution to equip the country’s hospitals and reduce the gap in access to health services.

During the socialization with the hospital directors, which was attended by the director of the North Central SRS, Manuel Lora, and other SNS and regional authorities, Dr. Lama also informed that, as was done in the Metropolitan and Central Cibao health regions, in the North Central region there will also be an increase in the financial advance to the hospitals of eight million, four hundred thousand pesos.

“I do not end my life as a coward, I do it because I need to feel the peace that I have not found in this world” were some of the words written by the young woman in a post that she titled “depression kills”. According to social media reports, her plans were thwarted by police officers, and she is now in custody.

Thousands of people commented on the young woman’s writing on social media. Hundreds of people echoed her words in an attempt to locate her and prevent her from taking her own life.

The message written by Cristy Mateo

I will be on my way out of this world when you read this. I am not leaving because I am a coward; I am leaving because I need to feel the peace that I have not found in this world. Depression has slowly taken over my life; I haven’t slept in weeks, cried every night, lost interest in things I enjoy, and my emotional state is a roller coaster.

I’ve asked for help on several occasions, but people dismiss depression as if it were a fad or an attempt to attract attention when for those of us who suffer from it, our lives pass us by while we are stuck in a rut, unable to do anything because our positive thinking is obstructed.

I thank those who were always nice to me and there for me, I thank the Lord who gave me a rose every time he saw me, my spirits rose to a thousand, and I thank the Lord for everything.

who was aware of my situation and was always attentive and encouraging when I needed it most. I don’t fit in here anymore.”

Clemente Terrero, the health center’s director, stated that as a result of the cholera outbreak that erupted in Haiti at the end of last year, the hospital “has handled several patients with cholera who have come from different parts of the country” and that they realized it was “prudent” to have an exclusive unit for the reception of symptomatic patients. “Our hospital has prepared to continue providing first-class care to children affected by illness, with the highest quality standards and humane treatment,” he said.

This health center received seven suspected cholera cases, four confirmed as positive and three negative. Five of these cases involved minors from La Zurza, San Carlos, and Ocoa. The patients were between one and four years old. Irma Coradin, the hospital’s in-charge of infectious diseases, explained that not all patients require intravenous hydration because some recover with oral hydration. “It is a disease that, if not treated promptly, ruins people’s lives due to the dehydration it causes,” she explained. Similarly, she stated that “no mortality has been recorded thus far, thank God.”

The hospital has not yet been added to the list of medical facilities where vulnerable patients can get the cholera vaccine. Cholera is a highly contagious bacterial disease that causes severe acute watery diarrhea. Symptoms can appear between 12 hours and 5 days after consuming contaminated food or water. Cholera affects both children and adults and, if left untreated, can be fatal in a matter of hours.

Two “white elephants” that cannot be used by a population of 7,000 families and have become a source of contamination for the residents of Villa Liberación, where a cholera outbreak has been declared and at least five people have died. Ruins of what was to be the plant to treat sanitary waste from part of the sector can be found in the Colina del Oriente II neighborhood. Old decanters, where liquids must have been stored, are now empty spaces where liana branches climb on all sides, transforming the space into a green leaf platform.

For years, the pipe that should have been discharged in the location was covered, and what was done was to channel pipes through the facilities, and fecal matter, urine, and other liquids were discharged directly into the Ozama River without any type of treatment. According to Leonardo López, president of the Colina Oriental Association of Neighborhood Councils, the plant began construction during the administration of former President Hipólito Mejia but was never completed. The plant only worked halfway for about three years, and since then, some engineers have received a while of quantifications to finish it. Still, the work did not progress until the project was abandoned entirely, he said, adding that even the soldiers who were in charge of the work were withdrawn.

Only the lagoon’s masonry works and the building where the caretakers lived remain. Doors, ironwork, furniture, grilles, and the entire waste treatment system that had been installed up until that point were all stolen. “The pipe is clogged every 20 meters, and cholera does not affect Villa Liberación, El Tamarindo, El Almirante, Sabana Pedida, Los Mina, or even the Caribbean Sea,” says the community leader.

The event was presided over by First Lady Raquel Arbaje, in her capacity as President of the Cabinet; Vice President Raquel Peña; the Ministers of Health, Dr. Daniel Rivera and Luis Miguel De Camps; the Director of the SNS, Dr. Mario Lama; and the Executive Director of Senasa, Dr. Santiago Hazim. The cochlear implant program for children with hearing impairments aims to reduce school dropout by facilitating language development at a young age. In its first stage, this project will respond to cases of hearing loss in boys and girls from low-income families that the first lady has received over the last two years, with the help of Senasa.

“From the moment I began to develop the idea, I found the support of many willing to join the cochlear implant program for the benefit, above all, of the boys and girls with the greatest social and economic disadvantages, who need us the most. That is why, with the help of many, they have a preferential place in all of our efforts to improve their quality of life,” Arbaje said. Meanwhile, the Vice President of the Republic, Raquel Peña, emphasized that the goal is for every kid born to have access to these services and care so that it never has to be because they meet an official who you will be attended to; that is the goal: to leave it institutionalized in the country.

Dr. Eddy Pérez-Then, the special adviser to Mispas, presented the initiative, explaining that the first two operations were performed in December on patients with profound severe hearing loss, whose experiences allow us to confirm that the program and its objectives are goals that are achievable, real, and have a significant impact in the Dominican health sector.

The Minister of the Presidency, Joel Santos, welcomed the Japanese government’s initiative in a press release, saying that it strengthens bilateral relations and friendship between the two countries by promoting technical cooperation through the supply of equipment, machinery, and materials.

“We thank you, His Excellency Mr. Takagi Masahiro, for this act of generosity and solidarity with the Dominican people, because the patients of these hospitals will now have the best care and services,” he said. He stated that the delivery of these three tomographs will provide the necessary modernization for the aforementioned hospital centers to develop a more accurate and early diagnosis.

“Our goal with these actions is to be able to provide health care that focuses on the timely detection of diseases and thus can provide timely treatment, and this can only be developed through the improvement and training of new equipment,” the official said. He assured that the healthcare system is evolving to improve quality, accessibility, and efficiency.