Cholera Outbrreak Confirmed

A Cholera Outbreak for Sure: Dye Mon, Gen Mon

Yesterday afternoon we learned that the US State Department is now on the ground in Port Au Prince. Anytime there is a possibility of an epidemic anywhere near the US – the State Department sends troops in to help control the flow of traffic and restrict movement back to the US. There are rumors that the main road to the Artibonite Valley will be shut off. We will not have access to Port Au Prince. We are unclear if new teams will be allowed in or if we will be allowed out. More news will follow later today (Friday, Oct. 22nd).

Apparently, the center of the trouble is near St. Marc which is on the road to the beach as the road makes a hairpin turn back toward Port Au Prince. We hear rumors that up to 2000 people are now infected. Unfortunately, too many wait too long to come to the hospital. Many are severely dehydrated and have sunken eyes. They appear to be a shell of a human, yet they are brought in to the hospital for care. All the nurses can do is hang IVs and encourage drinking oral rehydration fluids. There is the familiar blend of body odor, diarrhea, and vomit that pervades the air. It is not unlike the scent of sweat and body odor that hung in the air after the earth quake at the tent hospital in Jimaní last February. Back then the smell which might otherwise be considered offensive became a sign of survival. Now, the mixture of sweat, body odor, vomit, and feces represented a fight against death as these weary souls clung to life.

After our shift in the prosthetics center, Claire and I headed back to the hospital to see how we might best serve the weary staff and patients. People were coming from near and far. It was quite crowded in front of the hospital with family members peering into the sick wards where 20-30 dehydrated people lay on gurneys hooked up to IV fluids. One family member was allowed in to care for each patient. If there were no family members, the patient would be at the mercy of a busy staff to receive the badly needed tasks of personal cares.

Clair and I helped MJ and Debbie – an NP from New York. We assisted with the rehydration of the patients. Each patient is given a quart-sized Styrofoam container which we fill with filtered water that has been mixed with rehydration salts. We then go and encourage our patients to drink. “Bezwen bre dzlo.” “You need to drink water,” we tell them. We have plenty of gloves so we are safe. Many of the Haitian are quite fearful of getting the disease and are wearing masks even though cholera is not spread by airborne pathways – just contact oral fecal transmission. We love the gloves and hand sanitizer!

We occasionally hear the commotion of screaming and yelling once someone outside hears of the passing of a family member as they mourn. Quite luckily it is not very often that this occurs. Nevertheless, there are patients everywhere on the portal between life and death. It is truly miraculous what one bag of IV fluids can do. Many patients’ family members seek me out as the IV bag hanging by their family member runs low. I am able to get the nurses to replace the old bags with new ones. We move from bed to bed encouraging our patients to drink, assisting them to a sitting position if they are able. Otherwise, we simply raise their heads and shoulders in our arms and assist in getting the cup to their thirsty lips.

Occasionally, some vomit. Others defecate. Housekeeping moves in with a mixture of bleach and ammonia to clean the floors and we clean the patients and their beds. We often do not know if we are walking in vomit or feces as our patients are so ill. Although it may sound terrible, it is sacred work we do. Cura Personalis. The looks of gratitude we get from patients are amazing. They know they must drink but it is so difficult. With the care we are giving, it seems many of these souls are called back from death into life. They become reborn. Again, Haiti is beautifully difficult. How much suffering there is here and yet how the people cling to life!

That evening we were invited to the Mellon house for dinner with Ian and his wife Lucy. Ian is the son of the couple who started the Hopital Albert Schweitzer (HAS) here in Dechapelles. His parents greatly admired Albert Schweitzer and his work in Africa. Larry Mellon went to medical school in his mid forties and his wife Gwen completed a medical technology degree. They opened Hopital Albert Schweitzer in 1956and their home was spectacular. It seemed odd to be going to a dinner when there was so much going on in the hospital. Yet, it was important to take care of ourselves, too. We hiked under a full moon on narrow paths through the woods, across a bridge over a small stream, and through a fenced in pathway to the Mellon home. It was spectacular with textured stone walls, wooden floors, and cedar framed windows which open onto the Artibonite Valley. We had time to visit and learn what might next happen.

The Health System of Haiti was proposing that the hospitals at two neighboring towns of Verrette and Petite Riviere become the headquarters for the cholera patients. It was proposed that by noon on Saturday all patients with cholera should be moved to these two hospitals. Unfortunately, these hospitals are very small. The problem of containing the situation in this way was that patients who are not stable cannot be moved by noon the next day! If new patients arrive at our gaits, we cannot turn them away. Again, it is good to have plan A, B, C, and D here in Haiti. Dye mon, gen mon: Beyond the mountains, more mountains. And so it goes here in Haiti.