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How to prevent and treat cholera

Category: Haiti


Many thanks to Mark and Monika at for providing advice on how cholera works, water filters and rehydration. We have compiled info on natural soaps, moringa filters and sanitation from a number of sources. Please forward this info as it could save lives! If someone wishes to translate to Kreyol, I will post it!

Here are some simple methods, which anyone can use, to prevent and treat cholera.


• Cholera does not kill directly; people die from the dehydration that intense diarrhea inflicts.

• People with cholera-induced diarrhea can pass many gallons of water a day.

• You get cholera from eating tiny amounts of poop from someone who has it. It is not airborne. That’s why clean water, effective sanitation, and hygiene keep it from spreading in “developed” countries. Cholera can survive in standing water and can be transmitted in bilge water of ships and other water sources. It is essential to filter or otherwise decontaminate water before using it. It is also important to isolate human waste from water supplies, including rivers, streams, lakes and ponds.

• Cholera spreads more during the rainy season. As water sweeps through villages and other settlements, it takes the pathogen to rivers, lakes and streams where it can survive and spread. Most people get cholera from contaminated water, not directly from other people.

• 80% of the people with cholera have no symptoms! Imagine how hard it is to stop when people are traveling all over Haiti without symptoms. Even if you quarantine those with symptoms, there are a lot more people spreading it that feel perfectly healthy – like one person that traveled to Florida last year.

• Cholera does its deed very fast. There are many reports of people getting symptoms in late afternoon and dying before morning. Most deaths are within two days of the onset of symptoms.

• If you can quickly get water back into the blood, most of the people with cholera-induced diarrhea will live. A percentage will survive even without treatment – this is especially true if you are healthy and eat a good diet.


• Human waste must be kept from entering any water supply. That would include wells, other groundwater, streams, lakes, ponds and rivers. It can continue to live in most water once it gets into the supply. The diarrhea caused by cholera is very runny and if not contained, can easily end up in a water supply somewhere. Fish and shellfish can carry cholera and must be thoroughly cooked.

• If there are no sanitary latrines in the area, dig emergency latrines immediately at least 30 meters from any water supply and ensure it is not in marshy ground nor does it penetrate the water table. Ensure all people use the latrine. Cover human waste with dried grass, soil or other brown organic material after each use. While you are building a latrine, make sure that all human waste is buried so that flies cannot access it and it cannot run into water supplies when it rains.

• A better solution than a pit latrine is to find out how to use a compost toilet and use fully composted human waste as fertilizer (correctly done, composting kills all pathogens). Here’s one method being used in Haiti successfully – Cite Soleil:

• Flies can spread cholera. It is important to keep food covered to prevent them from transmitting cholera. Flies are attracted to garbage and human waste, so keep garbage far away from food, and cover it if all possible. Ideally, toilets will be sealed so that flies cannot enter into them. The seating area can be sealed so that when the lid closes, flies cannot get into the toilet area. It is well worth taking the time to do this to keep the fly population down as they spread many types of diseases in the tropics.

• Create a “tippy-tap” to wash hands in after using the latrine, and educate people how to use it. A tippy tap is a large plastic jug and a soap container filled with water and hung next to the toilet. A foot pedal allows one to put soap and water on one’s hands without touching either bottle. Washing hands after going to the bathroom is vital to preventing spread of cholera

o If you don’t have soap, you can make some from the moringa plant:

o Yucca root can also be used as soap – just put some of the root directly in the water bottle that you are cleaning your hands with, shake it up, and remove root. The saponins in the root are what create the soap quality.

o Soap nuts can also be used as soap – boil a few nuts in water, pour in a jar and then seal the jar tightly – it will spoil after a bit.

o The fruit, leaves and bark of Acacia concinna can be dried and made into a soap paste – used in India for centuries as soap and shampoo. Shampoo ginger is another source of soap. 

• Contaminated clothing, bedding, etc (that human waste has gotten on), must be buried or boiled. Solarizing it (heating it up in the sun) can also kill cholera. D

• Cooking food will kill cholera. Shellfish should be cooked at 160 degrees F or higher for at least 10 minutes. If the bacteria is not killed in the food, it will multiply rapidly as the food cools.

• Filter and disinfect all water before using it to drink or wash vegetables or dishes. This is vital to prevent spread of disease as it is very difficult to keep the germ out of the water supply especially in the rainy season. Any water that could end up in the mouth should be treated, including water used to wash vegetables.

• How to disinfect water:

o Place water in clear plastic bottles and ideally set them on dark surface that collects heat, or shiny metal, and leave it in full sun for at least six hours. This kills water borne pathogens. The bottles should no bigger than 1.5 liters. This is the fastest and one of the most complete ways to kill all pathogens. If you do not have full sun, the bottle should be left out as long as two days. This method is called the SODIS (solar disinfection) method.
In Kreyol:
o If the water is cloudy, filter water through sand or cloth that has been folded several times. This is important as cholera and other disease germs can hide in sand particles or other particles and survive SODIS. Filtering with cloth or sand alone will not kill all the cholera – you must use SODIS or boil the water too.
o Boil water to a hard boil (many bubbles coming fast to the surface).

o Solarizing water is another option. You can build a fairly large solarizer that will handle lots of water.
o Here is a way to make a more complete filter, for a more long term solution. This takes 2-3 weeks before you get clean water from it:

If your water supply is filtered and human waste is composted and protected from flies, you will interrupt the disease vectors and will have no more cholera. Correct handling of human waste (keeping it isolated from water and flies and composting it), and filtering water is the only way to eliminate the disease from an area. Washing hands before preparing food is essential as well. If you do these three things, cholera cannot gain a foothold in your area. You will also eliminate dysentery, typhoid and other diseases.


• Dehydration kills. Rehydration will save lives. Drinking water is not enough – too much salt and potassium is lost in the diarrhea to absorb the water.

• Immediately upon getting symptoms, add one teaspoons of salt and 8 teaspoons of sugar to one liter of treated water and drink it. It is important you start rehydrating as early as possible.

• Continue to drink this preparation throughout the course of the disease.

Coconut juice has very complete electrolytes in it and if available should be consumed liberally by anyone with cholera symptoms during the course of the disease.

• If you have access to it, drink water mixed with oral rehydration packets.

In Kreyol… (