Bookmark this RN Journal Article or Manuscript

Digg Facebook Google Bookmarks Stumbleupon Livejournal Twitter

Memories from a Haitian Cholera Treatment Center

by Kevin Mollenhauer BS RN CNOR ONC

In January and February of this year I worked in Haiti with United States NDMS DMAT and ImSurt teams providing medical and surgical care to the victims of the January 12th earthquake. What I experienced during those weeks only partially prepared me for what I would experience upon my return to Haiti on November 19th. My earlier experiences were in dealing with less critical and more chronic medical conditions. This time I would experience acutely ill patients requiring immediate life-saving treatment…

In October of this year, cholera erupted in the earthquake ravaged nation of Haiti. By the evening of my arrival in Port-au-Prince, the number of cases had grown to over 21,000 with 1250 deaths reported. This time I would be working with the J/P Haitian Relief Organization in response to an international call for medical personnel to combat this deadly outbreak.

Upon arrival at the J/P HRO housing that night, I received updates on the status of the cholera outbreak and learned I would be part of a medical team of J/P HRO medical volunteers, New Reality Medical volunteers, and Partners in Health healthcare providers and would possibly be heading the next morning to Hopital Ste. Therese in Hinche. Early the next morning J/P HRO co-founder Sean Penn received a call from Dr Paul Farmer of Partners in Health who stated “If you don’t send us any of your doctors and nurses you have available, people will die.”

With that simple statement, our team of seven (4 nurses, 2 translators, and our driver/security guard) were cleared to travel to Hinche, a three hour drive along often narrow and broken roads through the beautiful and rugged mountains and countryside.

We arrived in late afternoon, unloaded our gear and got an immediate orientation to the cholera treatment center (CTC) located on the grounds of Hopital St Therese from the team nurses already there. I believe we were all shocked by the world we entered. The CTC was fenced off to isolate the cholera patients and control access to the treatment area. Each point of access had an attendant who would spray the shoes of each person entering or exiting the CTC with a bleach solution in an attempt to minimize the carrying of any cholera bacteria into or out of the CTC.

The CTC facilities consisted of a triage and short term oral rehydration tent staffed by Cuban and Mexican physicians and nurses, and three additional tents (men’s, women’s, children’s) and an old church for those critical patients requiring IV rehydration with each facility holding up to 24 patients. Our medical team of four US RNs, two Canadian RNs, and one US physician along with a limited Haitian nursing staff were responsible for these critical care patients.

The tents were old military heavy canvas, with USAID tarp floors constantly wet from the never ending mopping of human waste and with roots and old foundations underneath which presented constant trip hazards. The tents were dark and hot, even during the day when we would roll the sides up for some ventilation. Cots and cholera beds were crowded inside with very little space between them to provide care. We all became very adept at positioning ourselves to start or manage IVs. Even finding ways to hang the IV bottles became a skill as we had few IV poles and found creative ways to secure the IVs to the tent framework using pieces of rope often appropriated from parts of the tent support system. It was not uncommon to see chickens walk through the tents as well as the camp dogs wandering in and out. One of my most vivid memories of the tents is a member of our team, in what appeared to be a yoga position, starting an IV while a small dog sat in the tent entrance and a chicken pecked at the ground beside her.

The old church was dimly lit with little ventilation. It was downwind from the fire pit where medical waste, cholera patient’s clothing, and trash were constantly being burned. Late one evening, I witnessed an older Haitian woman perform a voodoo ceremony for a young patient in our care. In the morning I met the family, and though it was a bit unsettling, received a blessing from the same woman.

Working in the CTC at night provided additional challenges- less staff, poor lighting (both in and outside the tents and church), broken foundations, exposed tree roots, tent ropes and stakes, and a constant cacophony of noise- the cries from patients, sounds of dogs, goats, and chickens both in and outside the CTC, the sound of passing cars, trucks, motorcycles, U.N. vehicles, and occasional shouts from the gate for help from the families of arriving patients. And yet when you had the chance to look to the heavens you were struck by the beauty of the evening sky. One of my fondest memories was pointing out Orion’s Belt in the night sky to our Haitian security guard and him sharing the Haitian names for the stars in Orion’s Belt and how they were used for navigation.

<< Previous    [1]  2    Next >>