At our 4am census this morning, we saw 20 adults and 18 children with cholera – a constant level for the past 4 days. As I walked though the hospital between the adult cholera section to the childrens cholera section, both of which are isolated from the regular hospital, it was immediately apparent that there has been no change in the demand for clinical services at HAS.
The pediatrics ward had 63 patients, including 10 in the neonatal special care unit, and the medical and surgical ward had 31 patients. There were 38 patients in the Evaluation, Diagnostic and Stabilization unit, which is designed for about 20 patients, so the hallways were crowded with litters and cots as patients were stabilized pending the morning rounds and scheduling for lab tests and X-rays. This total of 132 inpatients does not include the several women who were in the high-risk pregnancy unit.
By mid-morning, referred patients and others with return appointments were filling the benches under the large mapou tree, waiting for the ambulatory clinics for medicine, surgery and pediatrics to open in the large donated tent.
While every disease outbreak or epidemic is unique, there appears to be strong indications that cholera will be found in Haiti for years to come, and that in the near future, we may continue to see new cases of the disease at HAS. However, the level of the future demand is unknown. At this time, and for the near term, we will have to plan on managing an institution with a total inpatient load of about 170, of which almost 40 will require special care as cholera patients.