Cholera: A Disease of Contrasts
When the combined ICDDR,B and Project HOPE team received word late Saturday evening that the airport in Cap Haitien, one of Haiti’s Northern coastal towns hardest hit by cholera, had reopened after it had been closed due to riots, they drove through the night back to Port Au Prince to catch the first morning flight to Cap Haitian. At 6:00 am Sunday morning, the team departed for Cap Haitien.
Upon arrival they moved due south to Hôpital Sacre Coeur (HSC) in Milot where many cholera patients have sought treatment. Here, in addition to training and assessment, one of the ICDDR,B’s two microbiologists, Dr. Zahid Hayat Mahmud, will collect samples from patients to test for culture and sensitivity to see which antibiotic the cholera bacteria in this region is sensitive to. The cholera bacteria can have different sensitivities to different antibiotics regionally in the same outbreak, necessitating the need to take several samples in all regions where outbreaks of cholera have occurred. These samples will be sent back to the National Lab in Port Au Prince where ICDDR,B team member and microbiologist Dr. Sirajul Islam is standing by to test the samples. Dr. Mahmud and other team members have reported that in their home country of Bangladesh they see more than 30,000 cholera patients a month and can treat as many as 1,000 per day. They have two cholera epidemics per year, pre monsoon and post monsoon, giving them the hands-on practical experience and knowledge base it requires to help Haiti learn about cholera.
HSC in Milot has seen more than 220 cholera patients and 12 cholera related deaths. On the first day of training a comprehensive plan was put in place to reach staff at all levels of the hospital from cleaning staff and security personnel to sanitation workers and clinical staff. Three classes took place at the hospital training over 150 personnel and an additional class took place at a church to more than 130 members of a local Haitian youth group and congregants.
HSC and their treatment of cholera patients is in stark contrast to the hospital the team had visited two days prior in Les Cayes. In Les Cayes fear of contracting cholera kept some local staff from touching or even come near cholera patients. In addition, lack of staffing and resources left their system poorly organized to be able to appropriately manage the numbers of cholera patients they were being asked to treat.
Although HSC is also burdened by supply issues they are much better staffed and have the resources to organize a system wide plan. The fear of cholera here has taken on a different form. Staff is digging in, treating and touching their patients, but they have adopted habits that will use valuable fiscal resources such as donning masks, full gowns, rubber boots and surgical hats. These habits are some of the things that the team hopes they can change with the education and training they have to offer. Cholera is a disease that can only be contracted through contaminated water or food. Trying to dispel the myths about contracting cholera from all sorts of other means is proving harder than the team had thought. This being Haiti’s first ever cholera outbreak, it is no wonder there is so much fear and misunderstanding and for this reason the team is hoping a little education goes a long way.
Photos and story submitted by HOPE volunteer, Carrie Alexander, a Pediatric Nurse Practitioner and Johns Hopkins MPH student.
Buildings Go Up and HOPE Grows
Today the HOPE team continued to develop. The roof on the clinic building is almost finished and we will put the metal on it tomorrow. We will also have another team start on building 2, the ward.
Many people visit the site each day and watch and ask questions. Most know someone who need the services and treatment that Project HOPE and its partners will provide here.
The local Haitian team members are most interesting. All just want an opportunity to help rebuild Haiti and to help someone, so we are looking for ways to assist them.
We are helping our two interpreters set up a new business to work with NGOs and companies that need their language skills and they already have their first client...a company building 2400 homes.
Both the interpreters were volunteers at the Adventist Hospital in Diquini for several months after the earthquake. They helped volunteer doctors and nurses communicate and calm those needing surgery. They spent many hours in the operating room and remember many of those that are coming back to the hospital to receive treatment.
We also have found possible opportunities for the local people helping on the team to continue working once our three buildings are complete building houses. We will also use the workers we have trained on future clinics.
Then there is Samuel, a mechanical engineer by degree and a maintenance person at the hospital. He has become a great asset. He helps with the construction coordination and he lets us use some of his tools, such as much need drill bits.
We are looking for ways for him to use his degree and work in some of the many communities being rebuilt.
These are great people who care...and who want to really make a difference in the lives of their fellow countrymen. It is a wonderful to be associated and part of the HOPE team.
Story by Ron White, Managing Director, The Humanitarian Network. Photos by Bonnie Hudlet, HOPE photographer.
Tuesday, November 23, 2010
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