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Medical Response

Michael D. McDonald's picture

The Haiti cholera outbreak demonstrates the critical need for agile rapid response teams in Haiti.  This working group is devoted to building this rapid response capacity in Haiti. 

Working Group email address:

rapid_response@mphise.net

Cholera - Situation Report - Anse-a-Pitres - Haitian-Dominican Border

        

Refugee Camp–Anse-a-Pitres (Photo by John Carroll)

(SEE IMPORTANT LINKS TO HEALTH AND MIGRATION INFORMATION AT THE BOTTOM OF THIS POST)

blogs.pjstar.com - by John A. Carroll, MD - December 15, 2015

. . . During the last six weeks cholera HAS hit the camps in Anse-a-Pitres.  And cholera is crossing the border into the Dominican Republic once again.

Haitian doctors and nurses on the Haitian-Dominican border have recently complained that they do not have enough IV fluid to treat their cholera patients. And their patients are dying.

A liter of intravenous Ringer’s Lactate in the United States costs $1 US.

(CLICK HERE - READ COMPLETE ARTICLE)

Fearful, Haitian Migrants Flee Dominican Republic for Camps Along Border

             

In Anse-à-Pitres, Haiti, thousands reside in camps of tents, having left the Dominican Republic by force or by fear after its government began a crackdown on illegal migrants. Poor sanitation has led to a cholera outbreak. Credit Meridith Kohut for The New York Times

nytimes.com - by Azam Ahmed - December 12, 2015

PARC CADEAU 2, Haiti — Along this arid strip of borderland, the river brings life. Its languid waters are used to cook the food, quench the thirst and bathe the bodies of thousands of Haitian migrants who have poured onto its banks from the Dominican Republic, fleeing threats of violence and deportation.

These days, the river also brings death. Horrid sanitation has led to a cholera outbreak in the camps, infecting and killing people who spilled over the border in recent months in hopes of finding refuge here.

(READ COMPLETE ARTICLE)

More Than Two Dozen Cases of Cholera Recorded at Anse-à-Pitres Special

Site Overview Parc Cadeau II  Photo: Archive GARR

       

About 26 people from Anse-à-Pitres most of which comes from the Parc Cadeau I and II sites were infected with cholera. According to officials of the Cholera Treatment Centre (CTC) in this border town, the disease has already caused the death of 7 people.

garr-haiti.org - November 11, 2015

via: Google Translate

Cholera cases continue to increase in CTC of Anse-à-Pitres. This Wednesday, November 11, 2015, the center has 23 people infected with the virus Vibrio cholerae. 3 other people who were infected have already had their medical discharge.

"We get almost to cholera cases daily. Yesterday, the center had 19 cases. After only 24 hours, we went to 23. The situation may escalate because the CTC is not really equipped to accommodate large numbers of people. Furthermore, the means are very limited to prevent the disease is spreading in different localities of the city. "Says chief physician of the center.

According to the observations, infrastructure and equipment are lacking in the center. Not enough beds and oral serum is already out of stock.

Cholera Alert - Bon Samaritan Nursing Home in Ouanamithe

submitted by Albert Gomez

      

https://www.facebook.com/bill.waterman.10/posts/10202141413724766 - October 17, 2013

CHOLERA ALERT
We have had two cases of Cholera from the elderly at our nursing home Bon Samaritan. One passed away last night and the other is being treated at the cholera center. There has been at least 6 local cases I am told. Please keep all of us here in your prayers. I have had this once already and it is by far the worst you can have. We have lost four of our people in 10 days now, counting a grandchild of one of our staff. It has been a rough week for all of us.

Bon Samaritan De Ouanamithe
https://www.facebook.com/pages/Bon-Samaritain-De-Ouanaminthe/331388730236644

13 Cases of Cholera in Marmelade (Mamlad) Between Sunday 26 August and Wednesday 29 August

On Aug 31, 2012, at 4:21 PM, june levinsohn <redacted> wrote:

13 cases of cholera in Mamlad bet. Sunday 26 August and Weds. 29 August...fyi. june

----- Original Message -----
From:
Oxamar St-Hubert
To:
<redacted>
Sent:
Wednesday, August 29, 2012 4:14 AM
Subject:
enfomasyon
kouman Iaask pase la ba? pou nou mamlad apre li fin kraze tout plantasyon pep la , li vin ogmante ka kolera. nou deja resevwa 13 ka kolera nan uct a , soti dimanch lan pou rive jodia , e kapab genyen anpil lot ka toujou.

-------------------------------------------------

(Per Google Translate - Below)

Subject:  information
Iaask than how low? we mamlad after it broke all touring people, increased cholera cases. We have already received 13 cases of cholera in the uct, from Sunday to today, and there may be many other cases still.

Red Cross Now Supporting the Need for Phase II Cholera Epidemic Management Initiative

International Federation of Red Cross and Red Crescent Societies (IFRC)
The Looming Threat - Advocacy Report on Cholera - June 2012

19 June 2012, Port-au-Prince - “There is a significant probability of a major cholera emergency in Haiti in the coming months but resources have been severely diminished”, urges the advocacy report launched today by the International Federation of Red Cross and Red Crescent in Haiti.

An increase in cholera cases has been reported in the Artibonite, Nord-Ouest, Nord-Est, and Ouest Departments, in the island of Gonave, as well as in displaced camps in the Port-au-Prince metropolitan area and surrounding communities. The Pan American Health Organization (PAHO) estimates that new cases diagnosed by the end of 2012 could reach 170,000.

Video - Laurent Lamothe Meets the American Red Cross to Engage Pledged Moneys in Benefiting the Haitian People Now

See video

"There are two objectives for meeting the Red Cross.  The first objective is to thank the Red Cross for all the efforts deployed in Haiti during the earthquake.  The second objective is that the Red Cross collected more than 1.13 billion dollars for Haiti and there are still several hundred million left.  So we came here with our team to discuss our priorities and where we would like the Red Cross to allocate these funds that they have for Haiti according to the priorities of the Haitian government and the Haitian people.  We came to talk to them, work alongside with them according to the priorities of the Haitian people."

youtube - June 13, 2012

http://www.youtube.com/watch?v=Z59O_6WYfkg

Décès de deux personnes ayant consommé de l’eau contaminée a Carrefour

(This post has been updated to include the English translation - translation by Dominique Martin)

shorthaitinews.com - May 31, 2012

Les autorités locales de Carrefour sont préoccupées par le décès de deux personnes ayant consommé de l’eau contaminée distribuée sur le réseau de la Dinepa. Plusieurs responsables d’organismes nationaux dont ceux de la Direction Nationale de l’Eau et de l’Assainissement (DINEPA) ont diligenté une enquête afin de faire la lumière sur ce dossier.

L’agent exécutif intérimaire de Carrefour, Yvon Jérôme, indique que selon les premiers éléments de l’enquête des prises clandestines sur le réseau seraient à l’origine de la contamination.

Le réseau aurait été contaminé par le vibrio Cholérae dans le quartier d’Arcachon 32, explique M. Jérôme. Des bactéries et virus ont pu s’infiltrer dans les tuyaux de la Dinepa entrainant une contamination dans le périmètre d’Arcachon 32 insiste t-il.

http://www.shorthaitinews.com/2012/05/31/deces-de-deux-personnes-ayant-consomme-de-leau-contaminee-a-carrefour/

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Cholera Response - OCHA - Humanitarian Bulletin - June 1, 2012

                                  

Excerpt from OCHA - Humanitarian Bulletin - June 1, 2012 (pages 2-3, of 6 page .PDF file)

Multiplication of cholera alerts

Four of the 10 departments - Artibonite, Nord-Est, Nord-Ouest and Ouest - have reported cholera alerts in May. The island of Gonave, IDP camps in Martissant and Carrefour in the Port-au-Prince metropolitan area, as well as surrounding communities, also indicated an increase in new cases.

The Artibonite department is particularly affected because of its many cholera hotspots, including in remote areas, the lack of protection of water sources and poor hygiene practices. The Health Cluster indicates that 20 per cent of the cases and 17 per cent of the deaths nationwide come from the department. On the other hand, the number of partners has gradually decreased from 20 to 7 due to funding constraints.

Funding Dries Up Even as Rains Worsen Cholera Deaths

      

A Cholera Treatment Center in Carrefours run by MSF. For the most serious cases, seen here, patients' lives are saved using IV hydration.  Photo Credit - Jude Stanley Roy / IPS

ipsnews.net - by Jane Regan

PORT-AU-PRINCE, May 18, 2012 (IPS) - As predicted, the beginning of the rainy season in Haiti brought exponential increases in the numbers of people sickened and killed by cholera.

While the number of new cases in December was about 300 per day nationwide, this week one centre in the capital alone reported receiving 95 cases per day. And the numbers are expected to increase.

(READ COMPLETE ARTICLE)

Haiti - Cholera : Petit Goâve Needs Help !

by Guyto Mathieu (Correspondent Petit-Goâve)

haitilibre.com - May 20, 2012

Following heavy rains that fell on the town of Petit-Goâve, cholera has resurfaced. The rural communities of: Pijon, Lancet, Delatte, Nicolas, Lissade, Mapou Blaise, Lompray of the 7th communal section, are most affected by the epidemic.

There are already at least five people dead and more than thirty other people have contracted cholera after consuming contaminated water. The Cholera Treatment Centre of the 7th section are overloaded with cases and need materials, medicines and doctors...

The Notre-Dame Hospital is not able to treat people with cholera. Two peasants from the countryside, transported in emergency in this Hospital, died for lack of proper care...

http://www.haitilibre.com/en/news-5692-haiti-cholera-petit-goave-needs-help.html

Haiti-Cholera: 109 Cases and 4 Deaths in Ten Days in the Central Plateau

by Ronel Odatte - alterpresse.org - May 14, 2012

Per Google Translate (from French to English):

Hinche, May 14, 2012 [AlterPresse] --- One hundred and nine new cases of cholera have been reported, including four deaths between 1 and May 10 in several remote areas of the Central Plateau, according to information provided by health officials and local to AlterPresse.

According to figures provided by Mary Maude Caesar, head of seven cholera treatment centers (CTC) in the high Central Plateau, a sexagenarian died Régalus (locality Juanaria) before he could reach a health center. A man aged 38, resident Sandy (locality Juanaria) died after reinfection with cholera. A 38 year old female, living in a communal section of Cerca-Cavajal is among the victims of the last 10 days of the epidemic in the region.

The coordinator of the Board of Directors section of Juanaria, Philip Edner, confirmed the death of another person who suffered from acute diarrhea and vomiting, when his family was about to take her to the Ctc of Abriot.

The infections were identified in recent days in Hinche, Abriot, Rincon, Labi, Rhode, Los palma, Bouhouk, and Cerca-Cavajal.

Situation more and more critical

Cholera Treatment Shipment Arrives in Haiti

AlertNet - May 11, 2012

A shipment of 100,000 liters of IV solutions - enough to treat 17,000 severe cholera patients - arrived in Haiti amid a worsening epidemic. The delivery will ensure the only treatment center in the impoverished community of Cite Soleil is stocked with enough lifesaving rehydration fluids to help the most seriously ill patients.

AmeriCares responded to an urgent request by long-time partner, Saint Luc Foundation, after a noticeable rise in the number of cholera cases at their two treatment centers.

(READ COMPLETE ARTICLE)

Haiti Unprepared in the Face of Resurgent Cholera

      

Patients affected by cholera receive treatment at an MSF cholera treatment center in Port-au-Prince.

PORT-AU-PRINCE, MAY 9, 2012—Cholera cases are on the rise in Haiti following the onset of the rainy season, and the country is not adequately prepared to combat the deadly disease, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today.

Emergency Aid Shipment for Haiti Cholera Epidemic

                                          

Treatment supplies for 17,000 patients expected to arrive next week

Stamford, Conn. – May 2, 2012 – AmeriCares is rushing to deliver more than 100,000 liters of IV solutions for victims of the worsening cholera epidemic in Haiti. The emergency shipment contains enough IV fluids to treat at least 17,000 of the most seriously ill patients. Already more than 7,000 people have died since the outbreak began in October 2010 and reported cases have been on the rise again with the return of the rainy season.

Doctors Without Borders Doing the Heavy Lifting for Cholera in Port-au-Prince

      

 

Doctors Without Borders-Drouillard Hospital in LaPlaine

This Cholera Treatment Center is located two miles north of Cite Soleil - April 29, 2012 (Photo by John Carroll)

 

Doctors Without Borders in Haiti is directing and staffing Cholera Treatment Centers (CTC) in the Port-au-Prince area. During this rainy season, the number of cholera cases increased and sick people need a place to go very quickly for IV hydration. From what I have seen here in Port, Doctors Without Borders is doing the heavy lifting regarding cholera. (I realize there are many more organizations involved in fighting cholera, but it seems like MSF is always "bailing me out" when I have a sick patient.)

 

The Lady in the Wheelbarrow

      

Lucy in Front of St. Catherine's Hospital, Cite Soleil  (Photo by John Carroll)

pjstar.com - by John Carroll - April 28, 2012

As I left St. Catherine’s Hospital several days ago, there was a distraught sweaty man standing a few in front of me. He was next to an unconscious lady in a wheelbarrow. 

 

I was not startled because this is a common way of transporting sick people in Cite Soleil. 
Wheelbarrows.

 

I reached for her neck to see if she had a carotid pulse. It was weak...but it was there. 

 

I asked the man what was wrong. He told me that the lady had a sudden and constant onset of diarrhea and vomiting the day before. She had been "bien prop" (very well) the day before that. 

 

She had cholera.

 

A Sign in Haiti

Claudia at St. Catherine's Hospital Cite Soleil--April 26, 2012 (Photo by John Carroll)

pjstar.com - by John Carroll - April 27, 2012

We lost our beautiful mother two years ago today. The last two years I have lived with a deep ache in my chest. 

My mom meant everything to me.

As I prepared for pediatric clinic in Cite Soleil today, I asked my mom to send me a good strong sign that she is ok.

And for some reason before I left for clinic today, I threw one sterile Vidacare intraosseous needle (IO) into my beat-up doctor bag. Vidacare Corporation generously donated many intraosseous needles for me to use to treat cholera patients.  IO needles are put directly into the marrow space in the bone for people who are in shock and have collapsed veins. The marrow contains a great plexus of venous channels that will accept iv fluid very quickly.

On this trip I have never packed an IO needle because we are not seeing much cholera in Soleil, and the Haitian nurses I work with are excellent at starting IV’s in the usual fashion. But today I packed the needle... 

MSF / Doctors Without Borders - Haiti's Rainy Season Brings Cholera Back to Port-au-Prince and Léogâne

        

Haiti 2012 © Mathieu Fortoul/MSF - Cholera patients recover in MSF's Martissant CTC.

doctorswithoutborders.org - April 26, 2012

With the rainy season now underway in Haiti, Doctors Without Borders/Médecins Sans Frontières (MSF) has seen an increase in the number of cholera patients. Admissions to MSF's treatment centers in Port-au-Prince and Léogâne have more than tripled in less than one month. 

New patients arrive daily at MSF's cholera treatment centers (CTCs). A woman named Marie was admitted to the Martissant CTC on April 16. "I had diarrhea and was vomiting a lot, then I fainted," she recounted. "A relative brought me here because it is the center closest to where I live. The doctors told me that I had cholera and was dehydrated." One hundred thirty-four other people like Marie arrived at the MSF center in Martissant between April 16 and 23 and nearly 400 more went to MSF's other CTCs in Port-au-Prince and Léogâne.

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