When the rains first began in Haiti several weeks ago, we cautiously planned and prepared for our worst fear: more cholera. After the first few big rain storms of 2011 the number of patients in the Cholera Treatment Center (CTC) initially spiked up to about 20 patients but then dropped again as the grounds dried out as cholera, a water borne disease, would dissipate. In late May, after two steady weeks of rain, atypical for the Caribbean where rainstorms are most common only in the afternoon, the cholera surge began. The number of patients in the CTC crept up to 40 then 60 then 80 – and now 120 to 140 – all in the span of one week.
Preparing for a huge onslaught of very ill patients has challenged HAS staff to work harder than ever before. From staff in the physical plant who have been busy building more bathrooms for patients, to housekeepers who keep the CTC bacteria and odor free, to the education team who walks up to 8 hours into the mountains to distribute life-saving water purification tablets, everyone at HAS is involved in this massive operation. To put it in perspective, the number of patients in the cholera ward is about the same as the number in the hospital with far fewer doctors and nurses.
And it is these doctors and nurses who are the true heroes of this story. With the sweltering heat outside, about 90+ degrees, the cholera ward is even hotter but the nurses don’t complain and just keep working: changing IV bags, encouraging patients to drink fluids and helping patients who have no family members with them. With so many patients to manage, they are challenged every day. But with mortality rates at HAS way below the internationally expected 1%, the nurses have proven that they are an exceptional group.
Even with extra nurses from the area added to the staff, our team of Haitian doctors alone could not cover all of the patients in the hospital and in the CTC. Visiting doctors like Canadian Michael Aucoin and German Andreas Schindele stepped up the challenge but as the number continued to grow HAS called upon two-time HAS cholera volunteer doctor, Nick Van Sickels from Tulane University, to come down. Within 36 hours of hearing about the resurgence of cholera, Nick was on the ground in Haiti taking over the management of the most severe cases.
Now that hurricane season has officially started, we worry that more rain will mean more cholera. We are one step ahead of the disease now and with every person at HAS working as hard as they are now, we believe it will stay this way.