2010 10 Haiti Cholera Epidemic
Josh Kent, a university student from New York, who heard about the work of SOS DRS when I was making a fundraising appeal in Syracuse, New York last summer at St. Ann’s Parish, is our newest volunteer in Haiti.
Josh actually came primarily to teach English to Haitians and foreign volunteers and to integrate in to our community in Port au Prince. But because i wanted him to have a taste of the mission before beginning his work as an ESL teacher, i sent him to Grand Anse to help with the cholera work – almost immediately after his arrival. Josh went with our other new volunteer, Dr. Ed Glavey – a critical care surgeon from Florida. More about Dr. Ed later.
Josh has become an important part of the team assisting Dr. Ed with cholera care; helping SO DRS maintain its inventory; sending reports from the field; helping with other logistics issues. And he has even shown a desire to learn Kreyol, something which makes me happy. It is a beautiful language, and Kreyol will come in handy as Josh plans to spend six months in Haiti, which will be a blessing for us and hopefully a grace-filled experience for Josh.
Here is a brief report and some pictures sent by Josh.
Here is another taste of what it is like to provide cholera relief in remote Haiti.
Cholera patients come in all kinds. What they have in common is that they are sick with a terrible illness caused by an unrelenting organism – vibrio cholerae – that frequently causes significant diarrhea and vomiting, etc.
Not all patients become deathly ill though, and so we of SOS DRS have to be able to separate people from one another - those who are very sick from those who can be treated with oral solution, and then those who need to be evaluated and observed and treated only minimally.
And we also have to have a place to put supplies and medical staff who are helping the patients: you can’t stray too far from the cholera patients because they need constant care. Some need numerous bags of IV fluids every day and that means a process: starting an IV in a dehydrated patient; placing the bag; changing the bag; restarting the IV when access is lost, etc.
Part of my job as the coordinator of Project Perpetual Help Haiti is to make sure the patients and the staff have enough materials and the conditions to work. And I am doing that in strict collaboration with Theresia Sinaga who is the program director of our cholera relief efforts.
On January 10 Theresia, MarcDaly and I were in Port au Prince together. I had just returned from 10 days in Grand Anse. T and MD had been in PaP for only 3 days after spending 14 days in GA themselves. They are the ones who really got the cholera response going when we made a decision to respond to the epidemic in addition to our hurricane and earthquake relief efforts.
That was a decision that took them right before Christmas to Les Irois where for days they took care of patients and helped to deliver medications. Then there was an outbreak in Carcasse on December 26. A series of events took place that have helped us take care of hundreds of cholera patients who would have otherwise likely died. Of course we have been working together with locals, especially two nurses in Carcasse – Veronica and Vendredi – whose efforts have been close to heroic: working with cholera patients ia a 24-hour-job. And of course we have done all this together with Fr. Verdieu, a priest of the Diocese of Jeremie and the Pastor of St. Joseph’s Parish in Carcasse.
Collaboration is important. And recognizing one’s limitations is important as well. SOS DRS is a growing NGO that is part of the CTF network, and it is now working in a very difficult situation in remote Haiti. One thing we do not have access to is tents. And we cannot make them ourselves. And patients need to sleep and be treated somewhere. So when Therese, MarcDaly and I were together on 1/10 we went to the healthcare officer of a UN organization to ask for tents. It is usually this UN organization that provides tents in disaster situations.
And then I wrote a follow-up e-mail to reiterate our need. Here is that e-mail, which gives you a sense of what we are doing in GA and a taste of what it is like to provide relief in remote Haiti.
Subject: Tents for Cholera Treatment Centers in Grand Anse – (SOS Doctors) – Fr. Scott Binet
Date: Tue, 11 Jan 2011 18:27:49 +0100
Health and peace to you.
We met last night at the UN logistics base in PaP. I was with Therese and MarcDaly, two other members of SOS DRS (SOS Doctors). As I indicated SOS DRS is presently authorized to respond to the cholera epidemic in Grand Anse, which we have been doing since mid-December Right now we have 2 Cholera Treatment Centers – one is in Les Irois and one is in Carcasse. And we are preparing a mobile cholera unit because the number of cases is increasing and preparing for mobile medical work. Thus we need some help – specifically with tents.
As I mentioned last night, we could really benefit from 8 tents – 4 large tents [72 m] and 4 medium tents:
Here is how we think we will use the tents:
CTC – Les Irois:
1. Large Tent – [CTF - pt. care - ORS, less serious on IVF]
2. Medium Tent – more serious patients – IVF, etc.]
CTC – Carcasse:
1. Medium Tent – more serious patients – IVF, etc.]
Mobile Cholera [in case of another outbreak]
1. Large Tent – [CTF - pt. care - ORS, less serious on IVF]
2. Medium Tent – more serious patients – IVF, etc.]
Mobile Medical [to underserved areas]
1. Large Tent – pt registration, evaluation, consultation, treatment, pharmacy area]
2. Medium Tent – for patients who need to be treated and then observed while supine – IVF, some storage
3. Large tent – for the team – personal items, sleeping, supplies
I did not mention this last night, but If by chance you have 20-24 gauge catheters for IV fluid administration, that would be great. We are in significant need.
My telephone number is 3858-4909. I can be reached via e-mail as well. Theresia and Mark will pick up the supplies. Her number is 3858-4904.
Father Scott F. Binet, MD, MI
We will see what the response is. Stay tuned.
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Cholera 6 – Petite Riviere – The first Mission
Cholera 5 - Update – 500 deaths so far
Cholera 3 - Overview of cholera and the situation as of Nov. 1, 2010
Cholera 2 - Will the outbreak head to Port au Prince? We stay.
Cholera 1 - Preparing to go to Artibonite: a decision to make
The relief effort in Les Irois continues.
Therese, Marc Daly and Vickens are working together with Fr. Francien of Our Lady of Mercy Parish and nurses at the local hospital to help the 10-15 patients that are arriving every day with suspected cholera. They have all the telltale signs: dehydration and days of diarrhea. Some are even vomiting blood according to Therese’s reports – not a good sign. Anyway, she tells me that the three of them are working 10-hour-days, at least, providing: IV hydration, oral rehydration solution [ORS} and antibiotics - not to mention pastoral care for the dying and the living - and humanitarian support. But they are running low on medications and ORS.
Here is an interesting communication I had with Therese - via SKYPE, a brief dialogue that is one of the few that we have been able to have in the last 2 days because communication has been difficult: the CTF-SOS DRS mission is in a remote part of Haiti, and for communication we rely on a mobile internet device connected to the local phone grid.
[12/21/2010 1:10:09 PM] Theresia Sinaga: Fr. S, are you there?
[12/21/2010 1:12:02 PM] Scott Binet: Yes. Hi Therese.
[12/21/2010 1:12:09 PM] Theresia Sinaga: HI
[12/21/2010 1:12:15 PM] Theresia Sinaga: How are you?
[12/21/2010 1:12:24 PM] Theresia Sinaga: I have been looking for you this morning
[12/21/2010 1:12:37 PM] Theresia Sinaga: Yes, I need some medicines
[12/21/2010 1:13:42 PM] Scott Binet: What do you need?
[12/21/2010 1:13:59 PM] Theresia Sinaga: I need more ORS
[12/21/2010 1:14:44 PM] Theresia Sinaga: Some antibiotics (doxycyline)
[12/21/2010 1:15:11 PM] Theresia Sinaga: and if Theresa Banks could provide tents it would be good for us
[12/21/2010 1:15:14 PM] Theresia Sinaga: do they have it
[12/21/2010 1:15:51 PM] Theresia Sinaga: At least we have 10-15 people per day who has problem with diarrhea and vomiting
[12/21/2010 1:16:07 PM] Theresia Sinaga: though we do not know exactly if they have cholera
[12/21/2010 1:16:17 PM] Theresia Sinaga: but we suspect them have cholera\
[12/21/2010 1:16:31 PM] Theresia Sinaga: I tried to get the cholera bed from the hospital
[12/21/2010 1:16:40 PM] Theresia Sinaga: because you could not buy it here
[12/21/2010 1:16:53 PM] Theresia Sinaga: one way to have it is by making it
[12/21/2010 1:17:06 PM] Theresia Sinaga: MD, V and I are thinking to make it
[12/21/2010 1:17:37 PM] Theresia Sinaga: the tents that I request it would be for cholera
[12/21/2010 1:18:03 PM] Theresia Sinaga: I would like to separate the people who are suspected cholera with anothet patients
[12/21/2010 1:18:59 PM] Theresia Sinaga: I am thinking to buy tents probably and some woods so we can set up the cholera place
Yes, you can see from Therese’s communication that the needs in Les Irois are great. She confirmed that for me when we spoke this morning – Dec. 23rd. I arrived in Port au Prince last night in the evening and am now preparing for a mission to Les Irois.
Thanks to several benefactors in Houston – especially my brother Todd [an SOS DRS board member] and a generous new friend of the organization named Mike Hanks - and some collaborators in Florida [Light of the World Charities], I was able to bring some medical supplies into Haiti last night. That is actually no small accomplishment given the difficulty of getting items through customs, etc.
I will look to take the items to Les Irois on December 25 when I go there with 2 members of CTF-SOS DRS – Vickens [who just returned to PaP today], and Wesbee, the newest member of the community who I first worked with in Goniaves, Haiti in 2004 when Hurricane Jeanne devastated that city.
The supplies include items from our inventory in PaP and two duffle bags weighing 70 lbs each with: portable cots - 10; IV tubing - 60; 2×2 guaze - 2 pkgs; alcohol wipes - 1000 each; IV extension tubing- 25; nonsterile gloves - 200; Cipro 500 mg - 1,500 tabs; large bottles children’s tylenol - 6; Nacl IV bags 100cc - 60; IV -cathlons #18 - 250; Amoxicillin liq child susp - 27; Lomotil - 25; cipro IV -10 bottles; Tylenol Adult - boxes.
The patients that we treat in Les Irois are young and old – and some come in pairs. Below are pictures of a couple we treated. She came with diarrhea and dehydration and was very sick. And of course that put her little child at serious risk: madamn is pregnant.Read Full Post | Make a Comment ( None so far )
AMERICA/HAITI – The only hospital in Les Irois lacks medicines and doctors to combat the cholera
Jeremie (Agenzia Fides) – The Camillian Task Force (CTF) continues its activities in Haiti. Father Scott Binet and his collaborators, residing permanently in the Country for several months, are trying to respond to not only the affects of the earthquake on 12 January, but also to the many humanitarian emergencies that are endemic in the Caribbean Country.
In recent days, Fr Scott is trying to bring aid to cholera victims in the region of Jeremie, which does not always receive humanitarian aid.
Radio Vaticana – notizia del 17/12/2010 14.33.08
Haiti: l’impegno della Camillian task force nella regione di Jeremie colpita dal colera
Continua l’azione della Camillian task force ad Haiti. Il gruppo, guidato da padre Scott Binet, da qualche tempo risiede nell’isola per portare soccorso sia alle persone rimaste senza casa a causa del terremoto del 12 gennaio, sia ai malati di colera della regione di Jeremie, dove raramente arrivano gli aiuti. “la situazione è peggiore di quanto pensassimo – ha raccontato all’agenzia Fides Theresia Sinaga, volontaria appena arrivata ad Haiti – un sacerdote del posto ci ha detto che la settimana scorsa sono morte 11 persone, ieri altre due e nell’unico ospedale della zona, a Irois, si registrano 375 casi sospetti”. (R.B.)
Leggi on-line – http://www.vaticanradio.org/it1/Articolo.asp?c=447591Read Full Post | Make a Comment ( None so far )
Port au Prince, Haiti, December 15 (CNA) .- The cholera outbreak in Haiti has caused a deteriorating situation that could cause 200,000 deaths without intervention, a Catholic priest in the country has warned.
Fr. Antonio Menegon, head of the Camillian Mission in Haiti, told Fides news agency that the situation is “dramatic” because of the violence raging in the country after the elections.
“Everything is closed and blocked,” he reported, noting the closure of ports and airports.
“Because of the violence, the United States and Canada have closed their embassies. The stores have been besieged. We cannot supply medicines or oil, everything is closed,” he said.
“Our hospital continues to welcome people sick with cholera. Some have died, others recovered. In one family … 25 have died,” Fr. Menegon reported.
He said the hospital is working with others to try to curb the emergency and has received aid from the Camillian Province in Turin.
“There are many problems and the situation is getting worse.”
Fr. Crescenzo Mazzella, who is also in Haiti, told Fides that relief workers have received medicines sent by air with the Red Cross nurses but supplies are increasingly problematic.
“Help us, here they need everything,” he urged.
Fr. Massimo, another Camillian priest in the western Tiburon Peninsula town of Jeremie, reported that there are 500 confirmed dead there but the true number is twice that. There are sick and dying even in religious houses and in public hospitals there are thousands of abandoned and infected people.
Haiti’s Public Health and Population Ministry reports that more than 2,300 have died and more than 100,000 infected with cholera. In the last three days 130 people have died, according to Fox News.
About 748 people have died in the northern province of Artibonite, where the disease was first reported. A French medical study has claimed the outbreak has its source in human waste which drained into a river from an encampment of Nepalese soldiers who are members of the U.N. Mission for Stabilization in Haiti.
Haitians have demonstrated against U.N. troops because of the accusations.Read Full Post | Make a Comment ( None so far )
Dear Fr. Scott,
Greetings from Irois. Yes, we are fine. MD, Vickens and I are fine. We were so busy yesterday. We worked yesterday from 8 AM till 6 PM in the hospital. We helped the nurses who do not know much about cholera. We had to send a patient also yesterday to another hospital. And the bad news was there were 2 people died because of cholera. They were old people. The have been in the hospital for a week. But like I said because the hospital lacked of medicines they could not do anything.
It was painful for me. I had a chance to meet them and to stay with them. But my heart was so painful when I saw them dying. I was trying my best to do what I can do to help them. But the Lord decided in a different way. However, I want to continue this work.
There are more people who are still in need. Our help was in the right time yesterday. We were able to help around 9 people with our medicines. Now the patients in the hospital decreased. Some of them has been sent to Hauns de Naux hospital (around 45 minutes from Irois) which has more equipment and also medicines. To be honest the cholera is a bit complicated here.
Those people who are affected by cholera are malnourished. So It’s more easy for them to get cholera. And the problem also is the water. They are using water from a river for all (cooking, bathing, etc).
Yesterday it was just like a crazy day for us. I am sorry we did not have many pictures because we did not have any time to take. In the morning MD, Vickens were busy to prepare the ORS for the patients. Because the patients did not have any water for them except their own water from their house. Thanks God we brought many gallons with us.
I was busy to prepare the tent for the patients. The nurses mixed all the patients which is not good. And Vickens was helping the nurse to go to Hauns de Naux hospital to get more needles for the IV fluids. MD and I continued to help the patients to give them ORS and also to prepare tents. The hospital did not have enough vehicles. They only have an ambulance which is not really well. So yesterday our vehicle was the only one that we can used for picking medicines and also for sending patients. Thank God our vehicle is doing well.
We did not have any problems yesterday. MD also gave the information about cholera t patients – just like what he did in Petit Riviere.
Well, we did not realize that the time was move forward so fast. Then at 6 PM we realized that we were very tired. But thank God everything went well. Now I am thinking and preparing to buy many things (big garbage cans, big drums for the water, etc.) for the mission. MD, Vickens and I are working on how to organize the hospital to be able to use a center for the cholera. Please stay tuned. I will update you more.
In my last request I would like you to keep praying for us and those people who are dying because of cholera.
ThereseRead Full Post | Make a Comment ( None so far )
It happened – our worst nightmare. The cholera epidemic spread from the Artibonite region to Port au Prince. And now the nightmare is getting worse: cholera is spreading throughout Haiti and it is sure to get endemic. In Les Irois in southern Haiti there are 753 cases and 11 people have died over the last 5 days. And there will likely be outbreaks of this terrible, diarrhea-dehydration-death causing disease throughout Haiti for an indefinite time period in the future. In fact, there is no end in sight – except more body bags with victims.
CTF-SOS DRS is doing its part to help. In addition to a mission to Artibonite in October and a co-sponsored cholera treatment facility on the grounds of our community in Port au Prince, we have now landed in southern Haiti in the town of Les Irois (roughly halfway down the coast between Jeremie and Port Salut [see the map] .
The situation is urgent. And events happened quite quickly. Here are a series of e-mail conversations that show how quickly things have developed. Now you will be update on the urgent situation in Les Irois.
On December 15 I responded to the urgent pleas of Fr. Norbert, a Haitian priest, via an e-mail directed to the Executive Director of Light of the World in Florida, Theresa Banks. I wrote:
Health and peace.
SOS DRS is the first outside group to arrive at the hospital given its remote location. Fr. Francine, the local parish priest, and the nurse in charge of the cholera response welcomed our group. And the medical and hygiene supplies they had brought from Jeremie were a welcome sight as well.
Therese, MD and Vickens arrived in Jeremie only after many hours of traveling on difficult roads. The new [used] vehicle that we had purchased the day before held up well though. In Jeremie Therese met with a member of one of our collaborators – Medecins du Monde [MDM] (Doctors of the World). We are collaborating with them in medical/cholera care on the grounds of our community in Port au Prince. There is an intermediate level cholera center in our side yard and numerous medical tents on the front lawn. All this is to serve the people in the camp of 6,500 that is directly in front of the community.
Our MDM colleague was helping at the hospital in Jeremie as the group was given responsibility for the cholera response there. He facilitated our acquisition of numerous bags of Lactated Ringers solution, oral rehydration salts, IV sets, doxycycline, ciprofloxacin and gloves. And then T.MD and V bought soap and drinking water elsewhere. Much as we did when T, MD and I went to respond to the cholera epidemic in Petite Riviere, Artibonite in late October/early November, these three left a hospital in a larger city to go to a more rural and underserved area – Les Irois.
Therese and I had heard 2 days before this Dec. 15 mission that 8 people had died from cholera in Les Irois. Therese had just returned from that town a few weeks before so she was particularly concerned. We both looked at each other when we received the news – wanting to help, but feeling helpless. We wanted to serve those with cholera and give our donors a chance to help them as well – e.g. St. Peter’s Catholic Church in Jupiter, Florida. But we were not sure what to do. We were particularly frustrated in our efforts because we could not leave the community on the 13th when we heard the news: they were burning tires in the streets in Port au Prince after the release of the November 28 election results. Then on the 14th in one hectic day - when there was relative calm in the city - we prepared for the mission and I sent Therese, MD and Vickens to the earthquake, hurricane and cholera-affected affected area. Stay tuned for more.
And finally, in her most recent communication, Therese reiterate the urgency of the situation
Dear all in Christ,
As I am writing you I am already in Irois. Yes, the situation is worse than we thought. When we arrived last night at 11 PM I had a meeting with the local priest (Fr. Francine Bernard) who is a diocesan priest. He told us that last week on Friday 11 people died because of cholera. And yesterday 2 people died because of cholera. In the hospital now there are 375 people who are suspected of having cholera. This is the only hospital in Irois and it lacks medicines and doctors. Thank God carried some IV fluids, oral rehydration salts, antibiotics, water, soap, gloves, etc with us. This morning we are going to work in the hospital. As the mission coordinator I have decided that SOS DRS will stay and collaborate with the hospital to respond to the cholera ooutbreak. So far there is no other organization here to help the hospital and the nurses. Therefore I might extend my stay here if the situation is getting worse and Fr. Scott may join us.
Thank you so much for your concern. Let us keep praying for the people here and let us do something together for them - our brothers and sisters.
Theresia SinagaRead Full Post | Make a Comment ( None so far )
Unfortunately, it appears that the cholera epidemic has reached the capital of Port au Prince. This could prove to be a terrible disaster. There are some 1,300 camps housing 1,500,000 people in tents throughout metropolitan Port au Prince and nearby cities. All of this is happening in the context of Hurricane Thomas that left much flooding and damage in its wake, which could aggravate the epidemic of cholera through facilitating the spread of the bacterium. The situation does not look good. In fact, it looks terrible. Here is the latest – as of 9:30 AM EST – Nov. 10, 2010 (excerpts from Mail On-line)
“Another three million people are now at the mercy of the Haiti cholera epidemic after health officials confirmed the disease has spread to the capital city Port-au-Prince.”
“In other parts of the country the epidemic has already killed more than 580 people and hospitalized more than 9,500, with confirmed cases across the entire northern two-thirds of the country, and in the south.”
“But officials hoping that the capital city would remain unaffected have been devastated by the latest development and yesterday Haiti’s health ministry declared the disease a threat to the entire nation of 10 million people.”
“In a televised news conference, the ministry’s executive director, Dr Gabriel Timothee, said: ‘Now it is our duty as citizens to help solve this problem, which has gone from being an urgent humanitarian matter and gone to the level of national security.’ [see the video]
“Medics are warning of an expected explosion in the number of cases because around half of the city’s three million population has been living in homeless encampments since the January 12 earthquake ravaged the capital.”
City ripe for infection: A man bathes with water collected from a puddle in a street of Port-au-Prince
“We have to prepare for a large upsurge in numbers of cases and be prepared with supplies and human resources and everything that goes into a rapid response.”
“The aid group Doctors Without Borders has reported more than 200 residents of Port-au-Prince with severe symptoms at their facilities alone over the last three days.”
“More than 70 other cholera cases had been confirmed among people living in the capital, but those people became infected while outside the capital.”
“The disease’s move into the city was confirmed when a three-year-old boy from a tent camp near Cite Soleil was proved to have contracted cholera before October 31 without leaving the capital.”
“The hope against hope was that it an isolated incident, but two more cases have now been confirmed at the same hospital where the boy was treated.”
“Hundreds of people were already suspected of having cholera, suffering the disease’s symptoms of fever and diarrhoea while lying in hospital beds or inside shacks lining the putrid waste canals of Cite Soleil, Martissant and other slums.”
“A confirmed case of cholera had never been seen in this Caribbean country before last month, when it suddenly killed several dozen people and spread across the agricultural heartland of the Artibonite Valley.”
“The disease is primarily spread when infected fecal matter contaminates food or water.”
“It is relatively easy to treat, mainly by rehydrating the sick with safe water mixed with salt, sugar and potassium or with intravenous fluids. Antibiotics also are used sometimes.”
“However, decades of failing and often regressing infrastructure – wracked by political upheaval, unbalanced foreign trade, a 1990s embargo and natural disasters – have left millions of Haitians without access to clean water, sanitation or medical care.”
“Haitian and foreign aid workers continued campaigns to tell people to wash their hands, cook food thoroughly and take other precautions against the spread of cholera.”
“But health officials also warned that cholera will be part of the Haitian landscape for a long time, taking its place among the other challenges in one of the world’s most difficult places to live.”
‘The bacteria have a foothold in the rivers and the water system, so it will be there for a number of years.’”
CTF-SOS DRS – through the community of Our Lady of Perpetual Help - plans to stay in Haiti for a long time. We have already begun construction of the cholera treatment facility on the property of the community. We plan to help the people in this present crisis and in solidarity with Haiti help them as they continue to face many challenges. Help us help Haiti. And spread the message about what is happening in Haiti so others will help as well.Read Full Post | Make a Comment ( None so far )
Cholera 5 - Update – 500 deaths so far
Cholera 3 - Overview of cholera and the situation as of Nov. 1, 2010
Cholera 2 - Will the outbreak head to Port au Prince? We stay.
Cholera 1 - Preparing to go to Artibonite: a decision to make
The mission to Petite Riviere was short but productive, and we accomplished our goals. Theresia, MarcDaly and I went there for 4 days from Oct. 28- 31 for three reasons:
1. To help people affected by cholera and other illnesses.
2. To meet and work with Fr. Christoph, a Haitian priest and the pastor of St. Jerome Parish in Petite Riviere. And to pray and worship in solidarity with the people of St. Jerome.
3. To do medical and logistical reconnaissance in anticipation of a much larger mission in January 2011.
We spent half our time in Petite Riviere and the other in Savan Laroch. At the former we celebrated mass and prayed with the people while getting to know Fr. Christoph.
Light of the World Charities in Florida is planning a surgical mission in January 2011, and CTF-SOS DRS may prepare the way for and collaborate in that mission along with Fr. Christoph and the personnel at the healthcare facility near St. Jerome Parish, Charles Colmon Hospital. There I submitted my medical documentation, etc. in anticipation of working in Petite Riviere.
In Savan Laroch we had a good medical, pastoral and humanitarian mission over 2 days. We decided to go to this remote region given that the Caritas- run dispensary had reported suspected cases of cholera.
In fact, I treated at least 2 cases amidst other types of maladies.
We also prayed with people, celebrated mass, delivered medications to the dispensary, and slept in tents! A congregation of sisters of St. Paul of Chartres hosted us during our visit, which was an enjoyable experience.Read Full Post | Make a Comment ( 2 so far )
The cholera epidemic that started in the Artibonite region of Haiti has now produced in excess of 500 deaths. 7,000 cases have been reported, and the situation may get worse because of the flooding and stagnant water produced by Hurricane Thomas.
The storm hit parts of western Haiti on Friday and is blamed for eight deaths. The cholera outbreak began in northern Haiti about three weeks ago, but health authorities say there have been more cases since the hurricane struck. Contaminated water is a major source of the cholera bacteria.
On Saturday, President René Préval warned the outbreak could grow because of floodwaters. “On one side we have the rivers that will carry the bacteria everywhere, and on the other hand, we have the people who have been displaced that could also carry the bacteria.”
Thomas inundated camps harbouring earthquake refugees, and in Léogâne, west of Port-au-Prince, some camps turned into squalid islands. But according to an International Red Cross spokesperson in Leogane, “it definitely could have been a lot worse. In Port-au-Prince, the capital, Thomas turned streets into canals of flowing garbage but spared most camps that were set up after the devastating Jan. 12 quake.
A very contagious illness, cholera can kill within 24-48 hours by dehydration as a result of profuse watery diarrhea. It is not a pretty picture: I know from first hand experience as a result of our recent mission to Petite Riviere.
The illness caused by the bacterium, vibrio cholerae - according to the news - has not reached Port au Prince in a significant way. I say according to the news because nobody is really sure. Port au Prince is home to some 1,300 camps and 1,500,000 people – and the news of a pending epidemic in the camps would cause panic. We are waiting.
CTF-SOS DRS is preparing for the day the epidemic does come. We are located next to a camp of 6,500 people. We are going to be collaborating with others to set up a cholera treatment center on the grounds of our community in case the illness rears its head in the camp next to us. Let us pray it does not.
The center will have 4-8 beds and will be a place to isolate and treat people suspected of cholera. The most important aspect of treating cholera is hydration. and it is equally important to maintain good sanitation and hygiene. Stay tuned, and hope together with us that the epidemic does not come to Port au Prince.Read Full Post | Make a Comment ( None so far )
AMERICA/HAITI – “Pregate, aiutate, sostenete gli haitiani, siate solidali con loro in ogni modo” dice a Fides padre Binet
Petite Riviere (Agenzia Fides) – Continua l’emergenza colera ad Haiti dove si parla di centinaia di morti confermate per la grave infezione che sta colpendo il paese. Lo ha dichiarato all’Agenzia Fides dalla località Petite Riviere, vicino all’epicentro dell’epidemia, padre Scott Binet, medico camilliano, Coordinatore Internazionale della Camillian Task Force, Presidente di SOS Doctors (CTF-SOS DRS). “E’ molto difficile dare dettagli precisi su questa situazione che continua ad evolvere nel paese insieme agli effetti del grave terremoto che lo ha devastato lo scorso gennaio e che ha privato la popolazione di infrastrutture sanitarie e sociali. Nella regione centrale di Artibonite, dove sono comparsi i primi casi di colera, migliaia di persone soffrono di episodi di diarrea acquosa, febbre e disidratazione acuta, tutti sintomi di una possibile infezione, che mancava nel paese da oltre 50 anni”, continua p. Scott.
“Tuttavia il tasso di morte sta diminuendo grazie ad una maggiore consapevolezza sulla malattia da parte degli abitanti dell’isola ai quali gli agenti sanitari stanno fornendo cure e prevenzioni attraverso una adeguata igiene.”
Stando alle ultime stime, ci sono circa 1300 campi per 1.500.000 profughi (IDPs), molti dei quali nelle vicinanze della capitale Port au Prince. Al Charles Colimon Hospital di Petite Riviere, dove si trova la CTF-SOS DRS, sono stati registrati oltre 500 casi di diarrea acquosa acuta, circa 60 al giorno. L’ospedale è pieno di bambini e adulti distribuiti in tende. Sempre CTF-SOS DRS, insieme all’ong di Port au Prince Doctors of the World, sono impegnati nell’apertura di un centro per il trattamento e la prevenzione del colera a Solino vicino ad un campo che ospita 6500 IDPs”.
Riguardo alle cause che hanno potuto scatenare questa epidemia, il medico camilliano sostiene che non sono ancora chiare dal momento che nell’isola non si verificava dal 1960. “Gli esperti, secondo padre Scott, concordano nel fatto che le precarie situazioni sanitarie e igieniche hanno favorito i contagi. Il batterio del colera poteva essere presente nel fiume Artibonite o nelle sorgenti di acqua stagnante ancora prima del terremoto. Mancano dati concreti sulla malattia, ma dal 5% al 16% delle morti tra i bambini haitiani sono dovute alla diarrea acquosa che è difficile diagnosticare. La cosa più importante da fare adesso è contenere la malattia che rischia di raggiungere le coste dell’isola di Hispaniola e la Repubblica Domenicana.
Haiti purtroppo rimarrà in stato di crisi umanitaria anche nel 2011. La ripresa e la ricostruzione del paese procede molto lentamente, si deve lavorare su più fronti, compresa la tutela di donne e bambine vittime di violenze sessuali, oltre che sul piano sanitario e sulla sistemazione dei sopravvissuti. Servono urgentemente rifugi, acqua potabile e farmaci. Molte case sono andate distrutte e altre sono in rifacimento. A breve ci saranno le elezioni e si vedrà se risentiranno di questa situazione”.
Nel suo appello alla comunità internazionale, padre Scott conclude invitando tutti a “non dimenticare Haiti e la sua gente, ad avere compassione di questa povera gente colpita dal terremoto e da questa grave epidemia di colera, senza però dimenticare le sofferenze passate dalle quali provengono e che li vede in situazioni di povertà estrema e sottosviluppo”.
“In quanto sacerdote e medico, continua padre Scott, riconosco che l’uomo è composto da corpo e anima e che curare uno a discapito dell’altro è un disservizio per i nostri fratelli. Gli haitiani meritano il nostro aiuto e la nostra compassione come nessun altro, ancora di più in un certo senso, date le loro circostanze difficili. Pregate, aiutateli, sosteneteli economicamente o in qualsiasi altro modo anche attraverso organizzazioni solidali. Siate solidali con loro in ogni modo”. (AP/SB) (3/11/2010 Agenzia Fides)
October 29, 2010
I am writing from Petite Riviere near the epicenter of the cholera outbreak in Haiti in response to questions posed by a journalist from Agenzia Fides, a Catholic news service.
D. What news do you have about the situation in Haiti with regard to cholera?
Stando alle ultime informazioni dell’Oms, sono stati confermati un centinaio di casi di colera tra le popolazioni profughe del Pakistan ed Haiti. Quali notizie potete darci al riguardo?
It is difficult to give exact details about this ever-changing cholera epidemic in Haiti, a country still suffering from the effects of the Jan. 12 earthquake that devastated a people that were already subject to a very underdeveloped social and healthcare infrastructure. In any case, the number of confirmed deaths from the cholera epidemic in Haiti as of 10/26 has surpassed 300. And these have been confined largely to the Artibonite region where the illness first appeared. There thousands of people have presented with watery diarrhea, fever and severe dehydration – signs of a possible cholera infection. The appearance of cholera was much unexpected in a country that had not seen an outbreak of the illness in more than half a century.
The death rate from the disease seems to be diminishing though. People are becoming more aware of the disease and health experts are providing treatment and emphasizing prevention through correct hygiene. This is taking place at a series of medical facilities in the Artibonite region. As of 10/27 the death rate was around 7.7 percent — well above the 1 percent or below that the WHO considers normal, but below the 10 percent seen when the outbreak appeared last week, according to Dr. Claire Lise Chaignat, head of the WHO global task force on cholera control.
On October 27, Chaignat said “We have a serious cholera epidemic going on in Haiti,” Latest WHO figures show that 3,769 people have caught cholera in Haiti of whom 284 have died. The disease is spread by bacteria in contaminated water and food. And cholera can kill in 24 to 48 hours from dehydration and subsequent circulatory collapse. It is too soon to say when the outbreak will peak but the number of deaths and reported cases seems to be diminishing. The large number of medical staff and aid workers in Haiti since the earthquake mean there is a good chance of controlling the disease.
In all the people of Haiti seem to be facing this newest challenge, cholera, with their usual strength, and a full determination to plow ahead. The country is still suffering from the effects of the January 12 earthquake though. Recent figures indicate that there are some 1,300 camps for internally displaced persons that number around 1,500,000 – many living in and around the capital Port au Prince.
Doctors Without Borders (MSF) reports on 10/28 that in St. Marc at St. Nicholas Hospital, near the epicenter of the outbreak, around 450 patients were treated each of the previous 2 days – including those who received oral rehydration solution (ORS) and intravenous treatment. An isolation unit was established for cholera patients, but of late, people have been arriving in less severe condition than in days past. It suggests that people are taking precautions and that there is a greater understanding in the community of the need to maintain strict hygiene and to seek medical assistance at the first sign of symptoms.
At Charles Colimon Hospital in Petite Riviere out of which CTF-SOS DRS is based and that MSF is coordinating, there have been more than 500 cases of acute watery diarrhea that have been treated with IV or oral hydration. The number of cases arriving everyday is in the range of 60 and has been steady for several days now. The hospital is full of children and adults who are distributed in tents and receiving treatment as appropriate according to defined protocols. In all there are 8 cholera prevention/treatment centers in the Artibonite region. MSF is planning to construct a large 400-bed center in St. Marc that should be ready by now.
It is important to think about Port au Prince as well when thinking about the epidemic. Cholera is very contagious and can spread quickly, which could present a great threat to those living in the camps in and around Port au Prince if the illness arrives there.
On 10/23 it was reported that there were 5 cases of cholera in metropolitan Port au Prince. All of these cases represented people who had traveled from the Artibonite region. MSF reported on 10/27 that 34 people suffering from diarrhea presented at their facilities in Port au Prince. However, cases of watery diarrhea (AWD) that did not involve cholera have not been uncommon in Port-au-Prince since the January 12, 2010 earthquake.
MSF has a 20-bed cholera treatment center in place and is undertaking necessary measures and preparations at its Port-au-Prince facilities for any additional patients who present with cholera-like symptoms. Confirming cholera requires lab testing, but the treatment for cholera and AWD are the same, beginning with rehydration.
CTF-SOS DRS together with Doctors of the World, another NGO in Port au Prince, is looking to open up a 4-8 bed cholera prevention/treatment facility in Solino next to a camp containing 6,500 internally displaced persons (IDPs).
Because Leogane, a city right near the heart of the epicenter of the January 12 seismic event, is also home to many camps with IDPs, an additional cholera treatment center will be constructed there with 800 beds.
D. What are the cases of cholera due primarily to: precarious sanitary conditions, a lack of drinking water, a shortage of medical assistance?
Le cause sono dovute prevalentemente alle precarie condizioni sanitarie nelle quali vertono, la mancanza di acqua potabile e di assistenza specifica?
Exactly why Haiti was struck by this cholera epidemic at this point and with such devastating results is not totally clear. There had been no documented outbreak of the disease in Haiti since 1960. In fact, the US Centers for Disease Control and Prevention (CDC) said after the earthquake that while cholera testing should be carried out, the disease was “extremely unlikely to occur”.
So why has the epidemic struck now? It is not clear if the cause of the outbreak will ever be identified, but health experts agree that for cholera to occur, bad sanitation and hygiene have to coincide with people carrying the vibrio cholerae bacterium.
Sanitary conditions were poor in many parts of Haiti even before the earthquake, and it would be a stretch to link the outbreak directly with the quake.
Central Haiti [Artibonite] where most people have been infected was not the region most affected by the earthquake. The cholera bacteria could have been present in the Artibonite River or a stagnant water source even before the earthquake. On the other hand, some are suggesting that the bacterium was imported and dumped into the river – maybe even by members of the United Nations. This last theory has not been substantiated though it is suggested in a paper of repute, Le Nouvelliste. Surveillance data on cholera in Haiti are not available. However, watery diarrhea has been common in the country, causing 5% to 16% of the deaths among Haitian children according to Center for Disease Control data. With diarrhea so prevalent and no stringent monitoring by health authorities and 80% of those with symptoms showing only moderate signs of infection, sporadic cases of cholera might not have registered by the Ministry of Health. Presenting another challenge is the fact that around 75% of people infected with vibrio cholerae do not develop symptoms. But they excrete the bacterium with their feces for up to 14 days – a potential source of infection for others. Those that are infected need to receive treatment immediately, If not, the death-rate of cholera can rise up to 50%.
In the end, it is difficult to predict when, why and where a cholera outbreak will take place. And then controlling it once there is an epidemic is quite a challenge. It is a matter of breaking the cycle of the disease. And the potentially deadly cholera cycle can only be broken when people also stay away from the contaminated water source until the bacteria have cleared.
The present epidemic Haiti is a perfect example of this. However, at a minimum one can say that the following contributed in one way or another to the outbreak and eventual spread of cholera: a source of water contaminated with the bacterium vibrio cholerae – most likely the Artibonite River [used for washing and drinking], a decreased immunity to the infectious agent, insufficient hygiene and sanitary conditions, a diminished awareness concerning the signs and symptoms of the illness in both the affected population and healthcare providers, and the varying availability of clean drinking water. Finally, and unfortunately, as soon as people have been infected with cholera and excrete the bacteria, the epidemic spreads very quickly. On the other hand, the health care workers in Haiti – here because of the post-earthquake relief effort, while not being able to prevent the beginning of the epidemic, nevertheless have been able to effectively limit its spread – through prevention and through providing rehydration to replace water and electrolytes and antibiotics. Among those helping in this regard are the Ministry of Health, MSF and teams from Our Little Brothers and Sisters Hospital in Port au Prince. CTF-SOS DRS is playing a significant role as well.
D. What must be done to prevent the situation from getting worse?
Di cosa c’è bisogno per evitare che la situazione si aggravi?
From the previous answer it is clear that avoiding the contaminated source of water, practicing good hygiene, improving sanitary conditions, providing prompt medical assistance, drinking clean water, and heightening an awareness of the illness on the part of all will go a long way in preventing the situation from getting worse. Saying a prayer or two would help as well!
A major emphasis should also be placed on preventing the spread of the illness to the camps and elsewhere in Port au Prince, having an early warning system in place to detect new cases, and then have cholera prevention and treatment centers strategically located in and around Port au Prince should the epidemic spread to the city. Unfortunately, predicting when, where and why an epidemic will erupt is very difficult. So even if there is a lull in the number of cases in the Artibonite and no new cases in Port au Prince, there could be a recrudescence and a new epidemic. If that happens in Port au Prince the results could be devastating.
Similarly, there is a need to work with the neighboring Dominican Republic in case cholera spreads there. The World health Organization (WHO) is doing that. The Pan American Health Organization, the regional office of the WHO, has said there is a “high risk” of the cholera spreading across the border of the island of Hispaniola to Dominican Republic. The border has not been formally closed but last Monday Dominican Republic authorities canceled the regular farm market normally held in the northern frontier town of Dajabon, and prevented hundreds of Haitians from crossing to attend it.
The main thing now is to contain the infection. The Ministry of Health and foreign organizations working in public health are trying to contain the spread of cholera by having people treated in centers in the Artibonite valley, as opposed to going to Port-au-Prince or other centers away from the Artibonite River, the source of contamination. There are also vigorous instructions on the radio as to the importance of thorough hand washing and proper food preparation.
The U.N., the government, and its foreign aid partners are expecting the disease to spread further in its epidemic phase. They have launched a combined treatment, containment and prevention strategy for the whole country, monitoring especially for new outbreak pockets in Port au Prince and elsewhere: The U.N. has said a nationwide outbreak with tens of thousands of cases is still “a real possibility”. So Health Minister Alex Larsen announced the government would train 30,000 health workers to join the anti-cholera campaign across the nation in the coming months.
D. What are the risks for the future in this population already so gravely affected?
Quali gli eventuali rischi per il futuro, già così incerto per questa popolazione così gravemente colpita?
The question pertains to Haiti and the rest of the world as well as concerns cholera. According to the WHO cholera is widespread and on the rise, with three to five million cases worldwide, More than 100,000 people die from the disease every year, with the majority of cases in Sub-Saharan Africa. Epidemics of vibrio cholerae are caused by one of two strains: 01, which has been identified as the cause of the current epidemic in Haiti, and the South-East Asian strain 0139.
Haiti is seeing its first cholera epidemic ion more than 50 years. More than nine months after the Caribbean country suffered a catastrophic quake that killed hundreds of thousands and left 1.3 million homeless, Haiti has been rocked by another emergency that killed 259 people in the first week.
In fact, Haiti will likely remain a humanitarian crisis well into 2011. The recovery and reconstruction effort in post-earthquake Haiti is going very slowly for all sorts of reasons. One of the biggest lessons to learn is to reduce the risk of disasters before they happen — a growing concern as climate change and urbanization mean natural disasters will become even harder to tackle in the future. Here enters Haiti, again, a country prone to natural disasters and one could argue an “ongoing man-made disaster.”
The management of the earthquake, especially in the camps – although good in many respects – is still faltering. There are issues to address including protection – especially of women and girls from sexual violence – sanitation, and assessment of survivors’ needs. Shelter, potable water and medicines are badly needed at this time as well. Many houses are destroyed and some are beyond repair. Many people live in tents or makeshifts which make them vulnerable to various diseases. The winter period will be in November and people are in need of a winter package. Many don’t even have toilets.
In the villages they need a potable water supply which can be remedied by building purification and filtration stations. This will minimize waterborne diseases and other infections. This could help prevent a reoccurrence of the illness in the Artibonite region where the vibrio cholerae bacterium has not taken a hold and will likely remain indefinitely – becoming endemic, joining illnesses like malaria, tuberculosis and HIV AIDS which have been afflicting impoverished Haitians for years,.
It remains to be seen how the upcoming Nov 28 elections will affect or be affected by the outbreak. Despite the disease outbreak, the polls are still set to go ahead as scheduled.
D. What appeal would you like to make to the international community?
Qual’è l’appello che volete rivolgere alla Comunità Internazionale?
First of all, don’t forget Haiti and her people. And have compassion on them. Their suffering is both recent and longstanding: recently, because of the January 12 earthquake and now the cholera epidemic. But many Haitians were already in a situation of chronic poverty and underdevelopment. As a priest and a doctor I recognize that man is a composite of body and soul. To treat one to the neglect of the other is to do a disservice to our fellow man. And the Haitians are deserving of our help and compassion as much as anyone – even more in a certain sense given their difficult circumstances. So have compassion on them. Say a prayer, offer a hand, find an organization you can trust and support it in some way – financially or otherwise. Be in solidarity with the Haitians in any way you can. Thanks.
Fr. Scott Binet MD, MI
International Coordinator – Camillian Task Force
President SOS Doctors – www.sosdrs.orgRead Full Post | Make a Comment ( 1 so far )
Greetings from Peitite Riviere in the Department of Artibonite – just east of St. Marc. We are about 4 hours by car northeast of Port au Prince, Haiti – not far from the Artibonite River, the reputed source of the cholera outbreak that brought me to this area. I am with Theresia Sinaga and MarcDaly Joassaint, two members of our community in Solino.
The internet connection in Petite Riviere has been quite unreliable, one of the reasons you haven’t heard from me in a bit. The other is that we actually delayed our trip to Artibonite in light of the uncertainty regarding the progress of the epidemic. In fact when I last wrote the authorities had just reported five cases of cholera that had been discovered in metropolitan Port au Prince. That number increased to around 8 by the morning although we later learned that none of them actually originated in the city.
Given the uncertainty and the prospect that the epidemic was heading south faster than we were going north, we decided to stay in Solino – a slum area that is home to a camp of 6,500 people: our neighbors that live literally on our front doorstep.
We waited –and so did many others. The tension was palpable. People started to circulate flyers about proper hygiene and cholera while others used loudspeakers to blurt warnings about the hazards of eating raw food, etc. In fact, we – like many – decided to stock up on clean water and get out our chlorine tablets in order to purify what we might buy. We normally buy very big jugs of water at the market and then refill them at a very good price.
So off to the market we went. And much to our chagrin many other people had the same idea: the law of supply and demand kicked in. The amount of water jugs available had significantly diminished – a reality we encountered as we had to go from market to market. And the price was 3 times normal. Profiteering? In any case, it was a seller’s market.
On Sunday evening at 10 PM George, our night watchman and gatekeeper, showed up on our doorstep telling us that his daughter was very sick. She had been vomiting and had watery diarrhea for several hours. I immediately asked George to bring her to the community as she lived within walking distance. A mother of 6, Iselda left her children with George’s wife and came quickly – obviously very sick.
Theresia sprang into action per usual. Wearing gloves she checked the woman’s vital signs, assessed her overall condition and reported back to me that Iselda had a fever of 38.5 Celsius and was complaining of stomach pain with 4 bouts of “watery diarrhea” – a case of cholera until proven otherwise, particularly since no diagnostic means were available other than my clinical assessment. In any case, cholera is not something one wants to be wrong about – especially retrospectively, i.e, it can kill from dehydration and circulatory collapse within 24-48 hours.
Iselda was able to take small oral fluids and keep them down so we concocted a solution of sugar, salt, and bicarbonate – both to insure hydration and for the maintenance of her electrolytes. And I gave her an antipyretic and some doxycycline to treat suspected cholera. And then we waited – watching her closely for any signs of worsening. In fact, Iselda did not vomit anymore and had no diarrhea through the night. That was a relief for all of us. Iselda insisted that she wanted go home so the next day we gave her bars of soap, a sufficient quantity of our concoction, some water purification tablets and explicit instructions about hygiene and what to do in case her diarrhea continued. My clinical suspicion of cholera had diminished and she had no more diarrhea. In any case, with proper hygiene Iselda was much less likely to contaminate anyone. And her kids were showing no signs of the illness so there was a good chance that the acute watery diarrhea was viral in nature – something much more common than cholera anyway.
The concern about cholera led Doctors of the World, a medical NGO, to come to us and to propose the construction of a 4-bed cholera treatment unit on our property. Our premises are walled-in and thus somewhat isolated from the camp, which would help diminish the spread of the illness from the projected unit to the large number of people living on the other side of our walls. For their good we will likely collaborate with Doctors of the World.
Stay tuned for more from Petite Riviere.Read Full Post | Make a Comment ( 4 so far )
As I write this post it is 0130 on Sunday the 24th, and I just learned that 5 cases of cholera have been discovered in the capital of Haiti. For more info see http://www.alertnet.org/thenews/newsdesk/N22160215.htm
The epidemic has already killed some 200 people and left thousands sick in the area north of Port au Prince known as Artibonite. See the map.
In fact, in the AM on Sunday our 3-person assessment and relief team is leaving for St. Mark in Artibonite. I will coordinate the group. We will be parting from our base – the Our Lady of Perpetual Help Community – located in the capital of Port au Prince in one of its worst slums – Solino. Our community is located right next to a camp of 6,500 people. It is a place where we live, worship and work together.
Our team is heading north to help according to our mission which is medical, pastoral and humanitarian. And we will leave behind several members of the community who will move forward on our earthquake-related programs: help the Spiritans; feeding 650 orphans and students; an agriculture and husbandry-based microfinance program; tuition scholarships for primary and secondary school children affected by the earthquake; pastoral care, etc.
We are prepared to go to St. Mark for at least 5 days. There we plan to work together with primarily the Church and the Missionaries of Charity – our neighbors in Solino who also have a community of sisters in Gonaives that have already gone to the cholera-affected area.
Our team – Theresia Sinaga, MarcDaly and I will be heading north in the morning. Let us hope that the epidemic does not head south. However, the recently diagnosed cases in metropolitan Port au Prince are not a good omen.
We may have to return to Port au Prince sooner than we anticipated – to our community in the slum next to the camp – one of 1,300 camps containing only 6,500 of the 1,500,000 people who are internally displaced. Let us hope the epidemic does not get to these camps: the results could be disastrous.
May Our Lady of Perpetual Help intercede for those affected by this cholera epidemic.Read Full Post | Make a Comment ( None so far )