In late 2010 we thought we were busy with a full Cholera Treatment Center (CTC). This week, we have had well over 200 patients at any given time. We peaked at around 280 Thursday evening! The normal hospital bed count is well under 140, which means our CTC is now TWICE the size of the hospital.
Cholera is a disease that tests an entire health network like few others. Massive infectious vomiting and diarrhea require huge amounts of water, soap, and chlorine for cleaning patients, space, and clothing. All that waste and wastewater must be safely disposed of without contaminating the local community and spreading the disease. Fast treatment to save patients arriving day and night requires electricity and lights 24/7. HAS’ Physical Plant staff has been heroic at all hours in repairing and laying water lines, building bathrooms and facilities within the CTC, and dealing with the surge in nightly power requirements to keep everything functioning. Did I mention they previously built an entire new sewage lagoon in little more than a weekend to cope with the wastewater?
Community Services and individual employees raided their homes and offices for fans to provide patients and caregivers some relief in the blazing July heat. Materials Management is scouring the country to find whatever supplies are needed, before stocks are exhausted, so treatment and safety are not compromised. The medical staff puts in tremendous hours treating waves of patents. The cement garage yard and its controlled drainage system gets converted to a huge soap and chlorine scrubbing zone for beds, linens – and our trusty land cruisers, which sometimes double as ambulances. Security directs incoming patients and ensures that sanitation measures are respected entering and leaving the CTC so that the local community is not further exposed to cholera.
Cholera is a disease of water and sanitation, so Integrated Community Services is fully involved. Many patients needing only oral rehydration treatment will be seen at the Bastien dispensary. On Tuesday our SCI medical coordinator, our Water and Sanitation head, myself, and Bastien based staff did a grand tour of five mountain water sources to see how we could disinfect and protect them and shut down infections literally at the source. Health agents, animatrices, HTRIP staff, and community relations and mobilization staff are spreading the word to wash hands and treat water, encouraging families to build latrines, and handing out soap, rehydration salts, and water purifying tablets.
Community groups organize meetings to ensure neighbors know how to avoid cholera and when to seek treatment, and to improve their water sources and sanitation measures. Rotary clubs are building latrines and new wells. Other NGOs meet with HAS to coordinate water and sanitation efforts. The government water board DINEPA is starting a campaign to repair wells and reinvigorate water management committees.
As with no other disease I’ve seen in 14 years here, everyone here has a role to play and locally, they are rising to play them.