Social Foundations for a Community-Based Public Health Cholera Campaign in Borgne, Haiti

The rapid and widespread progression of cholera in rural Haiti can be attributed to a "perfect storm" of conditions, including the widespread use of unprotected water sources, rudimentary sanitation, the lack of means to afford simple necessities, and the near absence of basic health services to treat the sick. Accessibility of essential health care and reliable sources of clean water in remote areas of rural Haiti are fundamental barriers to addressing acute public health emergencies, including the ongoing cholera epidemic. This article explores the notion that positive health outcomes for hard to reach populations can be achieved through community mobilization. The gwoupman peyizan (peasant movement) in Borgne has established an extensive, capillary-like social network that served as a model for the mobilization of volunteers in the fight against the cholera epidemic. This case study from Borgne, Haiti describes the role of Alyans Sante Borgne (ASB) in coordinating community mobilization efforts against the epidemic. It suggests that the treatment of cholera and other infectious diseases requires a model of care delivery that efficiently brings resources to remote areas and recognizes the value of existing models of social organization in this process.