Cholera is raging again. Rain and dirty conditions cause the cholera to thrive. Dr. John Carroll has been making trips to Haiti for years working in difficult places to help the Haitian people. He is a dedicated person with a strong heart for the haitian people. This is one of his posts that he has written about the cholera conditions:
A link to a blog is http://blogs.pjstar.com/haiti/author/jcarroll/
Pray for all those who are racing to stop the advance of the cholera epidemic and for financial support for all who are helping in Haiti. The emergency situation continues for 18 months now and the development struggles.
Karen
July 3, 2011
We now have seven cholera tents at the Cholera Treatment Center at Hopital Albert Schweitzer.
They are a dirty white and some say UNICEF on the front flap.
We refer to them by their number. And we say "the guy with the IV in his ankle was just moved to "tent five""; brilliant things like that.
More tents are added all the time for the huge numbers of cholera patients that arrive here each day and need to stay for treatment. We send as many people home as possible each day, but the sickest are kept in the building or in the tents.
The smallest tent has about 8 patients and the largest has 25 patients.
Each tent has green cots placed on jagged rocks. And the cots are so close together that one cannot walk between them. To get to a patient who is not far away, one may take a long convoluted route around other people and cots.
Family members tend to ther sick loved on. They change sheets, and empty their buckets and clean them up. They also provide food when the patient can begin to eat.
And family members hold IV tubing for me, and I stick tape to their arms near me so I can quickly secure the new IV I just placed.
A Haitian nurse is in charge of one or two tents depending on the numbers of nurses and patients. She is in charge of maintaining IVs and passing meds and seeing if people are still breathing.
These tents have helped save the lives of many hundreds of people during the last several weeks.
But.....
When I round in the tents during the day, I cannot stay in the tent for more than five minutes. The heat and humidity are just overwhelming.
After examining a patient or trouble shooting an IV in a tent, I will attempt to chart on the patient?s dossier. And I frequently find myself confused and sometimes don't even know which page to chart on and sometimes find myself writing gibberish notes.
If I step out of the tent to correct and finish my note, I am ok and can re-enter the tent and start on the next patient.
And the patients are in the tents 24 hours per day. I have no idea how they do it especially with acute cholera.
These tents remind me of the tents in Port-au-Prince camps that are "homes" to hundreds of thousands of internally displaced people from the earthquake. These tents and camps in the capital are pure hell.
The social dynamics in the cholera tents here at the Cholera Treatment Center are interesting and say a lot about poor Haitian society.
We have one tent just a few feet from the front door of the admission room.
It is a small tent that has about eight cots in it. The people in this tent have been quite ill, all hooked up to IVs, and in different states of consciousness. Their family members hover over them and constantly motion to me and say things to me that drive me crazy, but they need to be said. (My mother can't talk any more, her stomach hurts, her IV is empty, she has a fever, etc.)
When I enter this tent I need to bend down some and when I examine the people along the walls, I have to really bend down or the plunging tent roof pushes against my head.
This tent had one man in the middle who was hooked up to an IV and he would tell me who was sickest and who to tend to first. I lugged in the heavy box of Ringer's Lactate in each day and placed it at the head of his cot. And he would open the box and then open the liters of Ringer?s Lactate for me and hand them to me as I inched around the tent tending to the patients.
He helped me a lot and made me more efficient. Hanging new bags, changing tubing, removing the air from the tubing, and hooking the patient back up does not sound like much, but it is here. Especially when it is hard to breathe or think.
This man slowly got better and I DC'd his IV and put him on all oral rehydration solution and he could even help me more in this tent. Four of the women in the tent were especially bad all week last week and this patient did quite a job alerting me to their need for more fluid each day.
I sent the man home a couple of days ago, because he was too good to stay.
No one has died in this tent yet.
This tent with this sick man acting as a valuable cholera assistant is emblematic of Haitian society. The poor take care of their neighbors as much as they can. They laugh when they have the strength to laugh. And I think this "force" that they exhibit to stick together in their villages, cholera tents, or internally displaced people camps, is the number one most important virtue in Haitian society that keeps 10 million people as functional as they are.
Who extricated the most people trapped in buildings after the earthquake? Was it the international community who flooded in to Haiti, the UN, the Haitian government, or poor Haitians?
And who brings sick Haitians with cholera to Cholera Treatment Centers? Is it President Martelly or Baby Doc who came back to help Haiti? Or is it the ?blue helmets? in their big white SUVs? Or is it strong Haitian men from "andeyo" carrying the infirm on their shoulders?
We all know the answer.
Haitians have no government to depend on. And the poor don't "touch" the international money.
If your IV runs dry, don't ask a politician to hang your next bag. Ask the sick guy on the green cot in the center of the tent.
John A. Carroll, MD
www.haitianhearts.org
Saturday, July 9, 2011
ARTICLE - CHOLERA SURGES IN CENTRAL PLATEAU
CHOLERA SURGES INHAITI'S CENTRAL PLATEAU
(AP) - By Trenton Daniel
MIREBALAIS — An old man with sunken cheeks is so dehydrated he must be carried down the dirt lane to a clinic where the air is thick with the odor of bleach. Minutes later, a worried father enters, carrying a two-year-old girl in a frilly white dress, her eyes sunken and unfocused.
Such scenes are once again common in Haiti where a deadly cholera epidemic that swept the country last fall has returned, fueled by weeks of heavy rains that have helped spread the waterborne bacteria that flourishes in the country's rivers and rice fields.
The treatment center in Mirebalais, a dusty crossroads town a one-hour drive north from the capital, Port-au-Prince, is again seeing dozens of new patients a day, many arriving at the edge of death from dehydration.
The center saw a fivefold jump from April to May and it hasn't let up since, said Louise Ivers, senior health and policy adviser to the U.S.-based Partners in Health, which runs the clinic in association with the Health Ministry.
"When people come here, they're in critical condition, ready to die," said Francole Adonis, who registers the new arrivals at the center. "They're collapsing in the yard. The situation is horrible."
The number of new cases each day spiked to 1,700 per day in mid-June, three times as many as sought treatment in March, according to the Health Ministry. The daily average dropped back down to about 1,000 a day by the end of June but could surge again as the rainy season develops.
The epidemic began in rural Haiti last fall, likely brought by U.N. peacekeepers from Nepal. It swept through the countryside of an impoverished nation already overwhelmed by a January 2010 earthquake that left hundreds of thousands homeless and by political instability following disputed elections.
Cholera has sickened at least 370,000 people and killed more than 5,500 since the outbreak started in October, according to the Health Ministry. The precise total is unknowable since many Haitians live in remote areas with no access to health care. The disease is relatively easy to treat if people can get help in time.
When the outbreak began, foreign volunteers descended on Haiti to staff rural clinics and help provide access to clean drinking water. Many feared it would devastate Port-au-Prince, where hundreds of thousands of people were living in densely packed refugee camps. But people in the capital had access to latrines and potable water, thanks to the huge international aid effort, and it was spared the worst of the disease.
The disease faded in winter and spring, when rain is less frequent, and many aid workers moved on. U.N. troops in Haiti turned their attention to the country's many other pressing problems.
Now there is a fear among aid workers who remain that there won't be enough resources if the latest surge gets much worse.
"If the cases continue on the same path we could see a lot of health-worker fatigue," said Cate Oswald, a Partners in Health coordinator. "The health care force is already stretched thin."
Oswald recalled how volunteers were everywhere during the first response to the outbreak, providing supplies such as bleach, which is sprayed on shoes and throughout the centers to prevent the spread of cholera.
"At one point we were worrying about too much duplication of efforts," Oswald said.
"Then the rains started coming." Oswald paused. "And cholera was still here."
The rains have deluged the Caribbean, including Haiti, in recent weeks. The rivers of the Artibonite, where rural Haitians drink, bathe and wash their clothes, are flowing through a valley ringed by chocolate-brown mountains, and cholera is again raging in the region.
"Sometimes, it's 50 patients a day. Sometimes it's 200 patients a day," Pierre-Marie Cherenfant, a Mirebalais doctor who oversees the clinic, said of the flow of cases coming to the facility.
Smaller treatment centers throughout Haiti's Central Plateau are also reporting sharp increases in recent weeks, though the most recent breakdown for Mirebalais is not yet available, Ivers said.
There are signs of a growing problem in Carrefour, a large and crowded city on the right at the western edge of the capital. Treatment centers there were reporting more than 300 new cases a day in early June, more than twice what they were seeing back in November, according to the aid group Oxfam.
An emergency latrine built in Carrefour collapsed as heavy rains fell and the waste spilled into a camp, according to a June report by the U.N.'s shelter cluster.
UNICEF's Mark Henderson, head of the U.N.'s water and sanitation response, said many non-governmental organizations tapped into earthquake-related funds in the fall in a desperate effort for treatment and prevention. That money is no longer available.
"The initial funding that everybody received has come to an end," Henderson said.
Though the number of new cases is again rising, Health Ministry statistics show the number of deaths is far less than what it was during the initial surge. On a single day in mid-December, about 110 people died, compared to almost 20 in a single day in mid-June, according to the Health Ministry. The mortality rate is now under 2 percent, half what it was when the outbreak started.
The reason for the lower percentage of deaths is that people aren't waiting to get better, as many did when the disease first emerged, and instead are rushing for help. A public health campaign has featured radio jingles and text messages to educate people about the disease.
Haiti had never had a reported cholera outbreak until October but the initial cause of the outbreak is now no longer so mysterious.
This month, an article in the U.S. Centers for Disease Control and Prevention journal said evidence "strongly suggests" that a Nepalese peacekeeping mission, based in Mirebalais, inadvertently imported the disease. The article points to "an exact correlation" in time and place between the arrival of a Nepalese battalion from an area of its South Asian homeland that was experiencing a cholera outbreak and the appearance of the first cases in a river a few days later.
The treatment center in Mirebalais started as a single one-story building. It quickly grew to include several large tents and temporary shelters, and now they are expanding again.
As Associated Press journalists toured the site recently, construction workers prepared the foundation for new buildings.
Thunder boomed in the background as health worker Rosette Jean-Philippe darted among beds and cots, adjusting IVs hooked to thin wrists and replacing bags of rehydration fluid.
"When you're here, that's what you have to do to save lives," Jean-Philippe said.
(AP) - By Trenton Daniel
MIREBALAIS — An old man with sunken cheeks is so dehydrated he must be carried down the dirt lane to a clinic where the air is thick with the odor of bleach. Minutes later, a worried father enters, carrying a two-year-old girl in a frilly white dress, her eyes sunken and unfocused.
Such scenes are once again common in Haiti where a deadly cholera epidemic that swept the country last fall has returned, fueled by weeks of heavy rains that have helped spread the waterborne bacteria that flourishes in the country's rivers and rice fields.
The treatment center in Mirebalais, a dusty crossroads town a one-hour drive north from the capital, Port-au-Prince, is again seeing dozens of new patients a day, many arriving at the edge of death from dehydration.
The center saw a fivefold jump from April to May and it hasn't let up since, said Louise Ivers, senior health and policy adviser to the U.S.-based Partners in Health, which runs the clinic in association with the Health Ministry.
"When people come here, they're in critical condition, ready to die," said Francole Adonis, who registers the new arrivals at the center. "They're collapsing in the yard. The situation is horrible."
The number of new cases each day spiked to 1,700 per day in mid-June, three times as many as sought treatment in March, according to the Health Ministry. The daily average dropped back down to about 1,000 a day by the end of June but could surge again as the rainy season develops.
The epidemic began in rural Haiti last fall, likely brought by U.N. peacekeepers from Nepal. It swept through the countryside of an impoverished nation already overwhelmed by a January 2010 earthquake that left hundreds of thousands homeless and by political instability following disputed elections.
Cholera has sickened at least 370,000 people and killed more than 5,500 since the outbreak started in October, according to the Health Ministry. The precise total is unknowable since many Haitians live in remote areas with no access to health care. The disease is relatively easy to treat if people can get help in time.
When the outbreak began, foreign volunteers descended on Haiti to staff rural clinics and help provide access to clean drinking water. Many feared it would devastate Port-au-Prince, where hundreds of thousands of people were living in densely packed refugee camps. But people in the capital had access to latrines and potable water, thanks to the huge international aid effort, and it was spared the worst of the disease.
The disease faded in winter and spring, when rain is less frequent, and many aid workers moved on. U.N. troops in Haiti turned their attention to the country's many other pressing problems.
Now there is a fear among aid workers who remain that there won't be enough resources if the latest surge gets much worse.
"If the cases continue on the same path we could see a lot of health-worker fatigue," said Cate Oswald, a Partners in Health coordinator. "The health care force is already stretched thin."
Oswald recalled how volunteers were everywhere during the first response to the outbreak, providing supplies such as bleach, which is sprayed on shoes and throughout the centers to prevent the spread of cholera.
"At one point we were worrying about too much duplication of efforts," Oswald said.
"Then the rains started coming." Oswald paused. "And cholera was still here."
The rains have deluged the Caribbean, including Haiti, in recent weeks. The rivers of the Artibonite, where rural Haitians drink, bathe and wash their clothes, are flowing through a valley ringed by chocolate-brown mountains, and cholera is again raging in the region.
"Sometimes, it's 50 patients a day. Sometimes it's 200 patients a day," Pierre-Marie Cherenfant, a Mirebalais doctor who oversees the clinic, said of the flow of cases coming to the facility.
Smaller treatment centers throughout Haiti's Central Plateau are also reporting sharp increases in recent weeks, though the most recent breakdown for Mirebalais is not yet available, Ivers said.
There are signs of a growing problem in Carrefour, a large and crowded city on the right at the western edge of the capital. Treatment centers there were reporting more than 300 new cases a day in early June, more than twice what they were seeing back in November, according to the aid group Oxfam.
An emergency latrine built in Carrefour collapsed as heavy rains fell and the waste spilled into a camp, according to a June report by the U.N.'s shelter cluster.
UNICEF's Mark Henderson, head of the U.N.'s water and sanitation response, said many non-governmental organizations tapped into earthquake-related funds in the fall in a desperate effort for treatment and prevention. That money is no longer available.
"The initial funding that everybody received has come to an end," Henderson said.
Though the number of new cases is again rising, Health Ministry statistics show the number of deaths is far less than what it was during the initial surge. On a single day in mid-December, about 110 people died, compared to almost 20 in a single day in mid-June, according to the Health Ministry. The mortality rate is now under 2 percent, half what it was when the outbreak started.
The reason for the lower percentage of deaths is that people aren't waiting to get better, as many did when the disease first emerged, and instead are rushing for help. A public health campaign has featured radio jingles and text messages to educate people about the disease.
Haiti had never had a reported cholera outbreak until October but the initial cause of the outbreak is now no longer so mysterious.
This month, an article in the U.S. Centers for Disease Control and Prevention journal said evidence "strongly suggests" that a Nepalese peacekeeping mission, based in Mirebalais, inadvertently imported the disease. The article points to "an exact correlation" in time and place between the arrival of a Nepalese battalion from an area of its South Asian homeland that was experiencing a cholera outbreak and the appearance of the first cases in a river a few days later.
The treatment center in Mirebalais started as a single one-story building. It quickly grew to include several large tents and temporary shelters, and now they are expanding again.
As Associated Press journalists toured the site recently, construction workers prepared the foundation for new buildings.
Thunder boomed in the background as health worker Rosette Jean-Philippe darted among beds and cots, adjusting IVs hooked to thin wrists and replacing bags of rehydration fluid.
"When you're here, that's what you have to do to save lives," Jean-Philippe said.
ARTICLE - DIASPORA - CONCERN FOR HAITI
THE DIASPORA BELIEVE IN THE SURPASSING OF THE HAITIAN POLITICAL ACTORS
(Haiti Libre) -
In a press release, the Coalition of Organizations and Associations of Haitians Living Abroad (ROAHVE) is concerned about the political situation in Haiti since the ascension to power of President Joseph Michel Martelly. A democratic process that is in trouble and seeking its way into the tumult of the interests of clans and a fighting rearguard, stating that during this time "women, youth, children and farmers, who constitute the largest majority of people, are awaiting an improvement of their daily lives."
The group supports the designation of Mr. Bernard Gousse, as the next Prime Minister of the Government, remaining convinced that he is "a man of experience, discipline, courage and able to meet the challenges of governance and stability in Haiti."
The ROAHVE still believes in the surpassing of the Haitian political actors to find a solution, that it believes to be a patriotic opportunity for the benefit of the common interest.
The group warns the Parliamentarians against sectarian drifts and the frivolous squaring of accounts. "We urge elected representatives to take into consideration the 10 million Haitians who are languishing and without access to basic services. The peasants, who are still at the mercy of nature to meet their needs. To the thousands of families living under tents, who are seeing the arrival of the opening of classes (new school year), without having the means". The group launched a solemn appeal to the representatives of the people, and they give a vote of confidence to Mr. Bernard Gousse "without denying their conviction, but rather to facilitate the dynamics of democracy in its classical understanding, which is the game of compromise, the ultimate recourse to any political crisis."
(Haiti Libre) -
In a press release, the Coalition of Organizations and Associations of Haitians Living Abroad (ROAHVE) is concerned about the political situation in Haiti since the ascension to power of President Joseph Michel Martelly. A democratic process that is in trouble and seeking its way into the tumult of the interests of clans and a fighting rearguard, stating that during this time "women, youth, children and farmers, who constitute the largest majority of people, are awaiting an improvement of their daily lives."
The group supports the designation of Mr. Bernard Gousse, as the next Prime Minister of the Government, remaining convinced that he is "a man of experience, discipline, courage and able to meet the challenges of governance and stability in Haiti."
The ROAHVE still believes in the surpassing of the Haitian political actors to find a solution, that it believes to be a patriotic opportunity for the benefit of the common interest.
The group warns the Parliamentarians against sectarian drifts and the frivolous squaring of accounts. "We urge elected representatives to take into consideration the 10 million Haitians who are languishing and without access to basic services. The peasants, who are still at the mercy of nature to meet their needs. To the thousands of families living under tents, who are seeing the arrival of the opening of classes (new school year), without having the means". The group launched a solemn appeal to the representatives of the people, and they give a vote of confidence to Mr. Bernard Gousse "without denying their conviction, but rather to facilitate the dynamics of democracy in its classical understanding, which is the game of compromise, the ultimate recourse to any political crisis."
ARTICLE - SENATORS REJECT GOUSSE
16 SENATORS FORMALLY OPPOSE BERNARD GOUSSE FOR PRIME MINISTER
(Defend Haiti) - By Orlando Aurelien
PORT-AU-PRINCE - At least sixteen out of 30 Senators adopted on Friday, a resolution rejecting in advance the candidacy of Mr. Bernard Gousse as prime minister and asking President Michel Martelly to appoint a new prime minister.
Submitted to the President of the Senate, Rudolph Joazile, which was in turn forward it to the Head of State, the resolution of the Parliamentary Group for the Renewal (GPR) practically kills any chances of MR. Bernard Gousse to be the next prime minister.
Senator Joazile confirmed to having received the correspondence of his described colleagues and hoped to inform Mr. Gousse if he still wanted to submit his document to the parliament for evaluation.
"The prime minister-designate is politically dead, and when a person dies, you have no other choice but to bury him," shouted Jean-Charles Moses, the Northern senator elected on the banner of INITE, the platform of former President Rene Preval.
"The chances of Mr. Gousse to succeed in parliament are zero," said the head of the parliamentary group, Senator Joseph Lambert and asked the president to reconsider his decision by appointing a new prime minister.
In their "political solution", the 16 members of the Grand Corps, which should be joined by other parliamentarians criticized Bernard Gousse for his alleged involvement, as former minister of justice, in "repression, arbitrary arrests and killings in the neighborhoods of Port-au-Prince", during the transition that followed in 2004; the fall of President Jean-Bertrand Aristide.
The rejection of the appointment of Bernard Gousse is the second political blow inflicted by the Parliament to Michel Martelly and a further manifestation of his inability to form the first government of his five-year mandate, two months after coming to power in a post-earthquake extreme emergency...
(Defend Haiti) - By Orlando Aurelien
PORT-AU-PRINCE - At least sixteen out of 30 Senators adopted on Friday, a resolution rejecting in advance the candidacy of Mr. Bernard Gousse as prime minister and asking President Michel Martelly to appoint a new prime minister.
Submitted to the President of the Senate, Rudolph Joazile, which was in turn forward it to the Head of State, the resolution of the Parliamentary Group for the Renewal (GPR) practically kills any chances of MR. Bernard Gousse to be the next prime minister.
Senator Joazile confirmed to having received the correspondence of his described colleagues and hoped to inform Mr. Gousse if he still wanted to submit his document to the parliament for evaluation.
"The prime minister-designate is politically dead, and when a person dies, you have no other choice but to bury him," shouted Jean-Charles Moses, the Northern senator elected on the banner of INITE, the platform of former President Rene Preval.
"The chances of Mr. Gousse to succeed in parliament are zero," said the head of the parliamentary group, Senator Joseph Lambert and asked the president to reconsider his decision by appointing a new prime minister.
In their "political solution", the 16 members of the Grand Corps, which should be joined by other parliamentarians criticized Bernard Gousse for his alleged involvement, as former minister of justice, in "repression, arbitrary arrests and killings in the neighborhoods of Port-au-Prince", during the transition that followed in 2004; the fall of President Jean-Bertrand Aristide.
The rejection of the appointment of Bernard Gousse is the second political blow inflicted by the Parliament to Michel Martelly and a further manifestation of his inability to form the first government of his five-year mandate, two months after coming to power in a post-earthquake extreme emergency...
Friday, July 8, 2011
ARTICLE - COAST GUARD SENDS HOME BOAT PEOPLE
COAST GUARD SENDS HOME 122 HAITIAN, CUBAN BOATERS
(Miami Herald) - AP
MIAMI -- The U.S. Coast Guard has returned more than 120 Cuban and Haitian migrants to their Caribbean homelands.
The Coast Guard says 82 Haitians were aboard a 40-foot sailing vessel intercepted Friday northwest of Great Inagua, Bahamas. They were all returned Monday to Cap-Haitien, Haiti.
Fifteen Cuban migrants were returned Monday to Bahia de Cabanas, Cuba. The Coast Guard says they were picked up at sea in three separate interdictions since Thursday.
Another 25 Cuban migrants were repatriated Sunday. A Coast Guard vessel picked them up Wednesday after a Coast Guard aircraft spotted their vessel south of Key West.
Meanwhile seven rafters rescued Friday by a Royal Caribbean cruise ship returning to Port Everglades remain in Coast Guard custody. They are expected to be repatriated later this week.
(Miami Herald) - AP
MIAMI -- The U.S. Coast Guard has returned more than 120 Cuban and Haitian migrants to their Caribbean homelands.
The Coast Guard says 82 Haitians were aboard a 40-foot sailing vessel intercepted Friday northwest of Great Inagua, Bahamas. They were all returned Monday to Cap-Haitien, Haiti.
Fifteen Cuban migrants were returned Monday to Bahia de Cabanas, Cuba. The Coast Guard says they were picked up at sea in three separate interdictions since Thursday.
Another 25 Cuban migrants were repatriated Sunday. A Coast Guard vessel picked them up Wednesday after a Coast Guard aircraft spotted their vessel south of Key West.
Meanwhile seven rafters rescued Friday by a Royal Caribbean cruise ship returning to Port Everglades remain in Coast Guard custody. They are expected to be repatriated later this week.
ARTICLE - PROJECT KAY PAM
THE 'KAY PAM' PROJECT INCREASES FROM 30 MILLION TO 500 MILLION GOURDS
(Haiti Libre) -
The project "Kay pam", a major housing mortgage program, which was to be launched by the National Bank of credit (NLC) on Tuesday June 14 has been postponed, following the assassination of the President of the Board of Directors of the BNC, Guiteau Toussaint [on June 12].
The project "Kay pam" will finally be officially launched on Friday, July 22, announced last Saturday by President Michel Martelly. This large mortgage program aims to help people of the middle class to buy decent homes.
Initially provided with an amount of 30 million gourds, the Head of State has indicated that the funds available for this program have been increased to 500 million gourds, available at the beginning of the program.
(Haiti Libre) -
The project "Kay pam", a major housing mortgage program, which was to be launched by the National Bank of credit (NLC) on Tuesday June 14 has been postponed, following the assassination of the President of the Board of Directors of the BNC, Guiteau Toussaint [on June 12].
The project "Kay pam" will finally be officially launched on Friday, July 22, announced last Saturday by President Michel Martelly. This large mortgage program aims to help people of the middle class to buy decent homes.
Initially provided with an amount of 30 million gourds, the Head of State has indicated that the funds available for this program have been increased to 500 million gourds, available at the beginning of the program.
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