When cholera resurfaced in Haiti in 2022, it threatened to wipe out years of progress. Against a backdrop of insecurity and limited resources, Zanmi Lasante (ZL) stood by the Ministry of Public Health and Population to halt the spread. Between September 2024 and August 2025, with technical and financial support from Massachusetts General Hospital (MGH), ZL pursued a clear mission: to maintain a healthcare system ready to detect, treat and contain cholera before it spread.
This project was not an emergency response, but a strategy of preparedness and sustainable capacity building. In 16 hospitals and health centers in Plateau Central and Bas-Artibonite, ZL kept diarrhea treatment units running with trained staff and a continuous supply of basic equipment.
During the reporting period, more than 9,200 suspected cases were managed at ZL sites, of which 994 were confirmed as cholera. Hospitals in Mirebalais and Hinche received the highest number of patients, but teams in Verrettes, Cange, Belladère and other localities remained ready to administer oral or intravenous rehydration and prevent complications. Before discharge, each patient and his or her family received practical advice on hygiene and drinking water to reduce the risk of recurrence.
The intervention also strengthened the water, sanitation and hygiene (WASH) infrastructure essential to prevention. Chlorination systems have been upgraded in Belladère, Tylori, Hinche, Boucan Carré and Saint-Marc. In Baptiste, the installation of a 400-gallon tank and pump now ensures constant access to clean water.
A total of 285 water quality tests were carried out in 12 major facilities to ensure the safety of patients and staff. Repair work on toilets, pipes and septic tanks was carried out at five health centers. In Cange, Boucan Carré and Thomonde, incinerators were rebuilt or refurbished, and a placenta shredder was added to the waste management system to limit the risk of contamination.
The project also reached communities beyond the healthcare facilities. More than 50,000 people took part in hygiene awareness sessions in at-risk areas. In Saint-Marc, 284 hygiene kits were distributed to displaced families with no access to clean water. Local water and hygiene committees were reactivated at all ZL sites to ensure the sustainability of actions.
Community surveillance was another major pillar. Through a network of over 300 multi-purpose community health workers (ASCPs), ZL maintained an early warning system in both remote and urban areas. Rapid diagnostic tests were available in facility laboratories, and cholera data were captured and tracked via digital platforms such as CommCare and OpenMRS. ZL teams continued to participate actively in regional and national coordination meetings led by the MSPP.
Despite security constraints, staff mobility or interruptions to laboratory services in the Mirebalais region, Zanmi Lasante teams were able to adapt. Cases were monitored, protocols applied and referrals maintained. The gradual decline in cases has not led to complacency; on the contrary, it has reinforced the conviction that preparation must be permanent.
The experience has highlighted an essential truth: the fight against cholera is not won only during emergencies. It is played out every day, when health centers have clean water, functional sanitation, trained staff and an active monitoring system. These foundations, consolidated throughout the year by ZL’s work, form a silent but effective shield for the communities of Plateau Central and Bas-Artibonite.
Zanmi Lasante will continue these efforts to ensure that cholera never takes root again. Thanks to strong partnerships and the constant commitment of its teams, access to clean water, health education and prompt care is gradually becoming the norm, not the exception, in Haiti’s most vulnerable regions. Make a donation today.