After the earthquake in January, many patients were brought to the hospital from Port-au-Prince on improvised stretchers; the most stable way to carry the injured victims of the quake was on a door from the destroyed houses. During the weeks following the quake, the doors were stacked neatly by the exit, and each family took back their door when the patient was discharged.
Today, two months into the cholera epidemic in the Artibonite Valley, doors have emerged again under the large figuer tree in front of the hospital. They have been used to carry patients down to HAS from remote mountain localities which are far from a trailhead. Often, the patients who are carried down are elderly and vulnerable, and arrive in serious condition. In certain cases, they come in clusters from specific communities or even extended families.
During the past week, more than 20 patients, both adults and children, have arrived from the Terre Nette zone. This group represents one-quarter of the total patients who arrived during this week. These communities are served by a small community dispensary, which has received supplies during the past week by helicopter from Medecins Sans Frontieres. Most housholds now have packets of Oral Rehydration Solution. Families have been trained to begin to give patients the ORS as they are carried down to the hospital, and this has improved the outcomes of their treatment at HAS.
This zone neighbors the HAS primary service area, and many of the residents use the Bastien dispensary, and we are concerned about this pattern of disease. On Monday, I will take a team up to Terre Nette to conduct community surveys, using the model which the CDC had developed and deployed here several weeks ago. We hope to find out how the disease was transmitted among so many people, and to identify effective means of reducing the spread of cholera there.