We have received more than 200 cases of cholera from the remote mountain community of Terre Nette. The zone, which is not accessible by road, and which has an estimated population of about 10,000 people, has been described by our community health team as having natural conditions which are “not favorable”.
Several weeks ago, Dr. Bien-Aime and I climbed to the nearby community Barbe to assess the situation ourselves, and we had to concur that the assessment of team was an understatement. A lack of water, soil, natural resources, education or employment opportunities all combine to make this zone among the poorest of the communities we serve, and the one from which we receive a disproportionately high rate of referrals for malnutrition, tuberculosis, respiratory and gastrointestinal infections. The closest HAS dispensary to the Terre Nette zone is Bastien, and many people from the region stop there for care before coming to the hospital.
When we climbed up to Barbe, we only saw a small portion of the region; last week, we went to a mobile clinic in Reoposte, nd the start of a walk up to Terre Nette from the east side. Because we were occupied with the mobile clinic, we did not get a chance to go up the mountain, but we did interview a number of residents who had come down for the clinic. They all depend on HAS for primary care, and for hospitalization when needed. All of our information was second-hand, and we were anxious to be able to get a closer look at the region.
For me, the chance to do so came last week. A helicopter from the German government relief agency came to HAS with a supply of medicines which we need for the cholera units, and it had to go back to Port au Prince to pick up another load. They offered me a ride, and I showed them on the topographic maps where the Terre Nette – Barbe ridge was. In 5 minutes, we were hovering over Barbe , and we could wave at the people we had visited two weeks ago. Then we floated along the ridge to Terre Nette, and could see down to Reoposte. It was a beautiful experience, but the view did nothing to dispel our concern for the people who live there, or for the dire conditions which they have to endure.
The trip was exciting, but a bit of an out-of-body experience, to replace a 2-hour walk with a ten-minute flight, and to be able to look down on people walking up and down the same steep trails. Once we had done our visit, the pilots tilted the nose and sped toward the Port au Prince airport, where we picked up more boxes of IV solution, and came back to HAS. The whole flight took 35 minutes, normally a 3-hour drive.
I am certain that the next time we walk up to Terre Nette, probably from Roposte, I will have flashbacks of pleasant memories in the helicopter…