ARTICLE - CANADIAN CHOLERA WORKERS

CANADIAN HEALTH-CARE WORKERS WARN CHOLERA EPIDEMIC ABOUT TO 'SKYROCKET' IN HAITI
(Winnipeg Free Press) - By: Bill Graveland, CP

CALGARY - There's a permanent smell of bleach at the cholera treatment centre in Bercy, Haiti, where doctors and nurses, many of them Canadian, attempt to provide medical aid for those who are still paying the price from January's devastating earthquake.

The tents at the 180-patient centre, run by Samaritan's Purse, are crammed with rows of Haitians lying quietly on makeshift cots, suffering from a cholera epidemic that experts predict is only going to get worse.

The alternative to the smell of bleach could be much worse considering the dirt floors are often covered with the vomit and diarrhea from patients who flock to the centre and others like it run by aid organizations in the island nation.

"I'm wearing my rubber boots and you are constantly in vomit and diarrhea," said Dr. Jeff Way of Calgary, who returned from a one-week tour at the centre last month along with his wife Mary Ann, who is a registered nurse.

"They hired local people to come around with big insecticide spray tanks filled with Clorox bleach and they are constantly spraying that on the ground," he added.

"We're going to smell like bleach for a long time," said Mary Ann.

"When they have their diarrhea and vomiting it is like someone has turned on a tap or a fountain," she told The Canadian Press. "I have never seen anything like it before in my life — how much fluid some of these guys could put out — two or three litres of fluid in one episode of diarrhea and vomiting."

Way said kneeling on the ground, especially with limited light during the night shift, proved to be an additional challenge when it came to putting in IVs because often the patient's veins have collapsed.

"We've had to pray them in."

More than 250,000 people died as a result of the Jan. 12, 2010, earthquake. It is not unusual for cholera to follow a major disaster. The cramped and crowded conditions and a lack of clean water and sanitation create a new health emergency.

Cholera was first recorded in the early 1800s and is still responsible for 100,000 to 130,000 deaths a year around the world. The treatment is simple. Usually rehydration and antibiotics will cure it in short order.

"I think the numbers are going to skyrocket because I think it's about to hit Cite Soleil (the poorest densely populated area in Haiti) and Port-au-Prince and the numbers are so much higher," she said.

"The worry is it's going to hit this highly densely populated area and then I don't know how we'll keep up. I hope there isn't people waiting at the gate, you know dying, before they can get in. That's my big fear."

Jeff Way, a surgeon at Calgary's Rocky View Hospital who also works in the trauma department at Foothills Hospital, said it makes you realize just how good the medical system is in North America.

"The patients arrived all at once, particularly at first light because they are afraid to travel at night and have their own forms of transportation. We were inundated each morning at about 5:30-6 a.m. with people coming in," he said.

"This is sitting on North America's doorstep and in North America we have excellent health care, but this is most of the world. This is Third World conditions and that's what people in most of the world have."

Samaritan's Purse flies in 40 to 45 volunteer doctors and nurses from Canada and the U.S. every week or two to serve in the cholera treatment centres where they work eight-hour or 12-hour shifts to “rehydrate" patients.

The United Nations has predicted that as many as 200,000 Haitians will ultimately be affected by the cholera epidemic.

"They're very weak. They can hardly walk; they're being carried in by family members. They're not able to hold anything for themselves. It's very sad," said Jane Noble, 50, a licensed practical nurse from Grimsby, Ont.

"After the initial earthquake I think we were all paying attention to what was happening here.

All the staff that were here in January and February say the situation now is an awful lot worse than it was back then," she said in a recent interview from the centre in Bercy.

Rebekah Schreiner, 32, a nurse from Calgary, admits she was expecting more "rubble and devastation" when she arrived in Bercy but said there are tent cities everywhere.

The treatment provides almost immediate results.

"The patients can be really sick if they are dehydrated and kind of listless and lethargic. They perk up amazingly well with the fluids and IV hydration and their families kind of take care of a lot of things," Schreiner added during an interview from Haiti. She and Noble returned to Canada on the weekend.

There are three different cholera vaccines available, but the medicine is in short supply and the window of opportunity for administering it effectively is limited.

The only real treatment is rest and lots of fluids.

"It's been hard. I've never worked in a situation where there is that many sick and dying people," said Mary Ann Way.

"I think the memories are really we had a lot of success. I remember pausing one night and looking around at my 40-plus patients and thinking if we weren't here they would all be dead."