Cholera Again

    Wednesday afternoon Mali, Whitney, me, and a kindly, elderly deacon from the church here took a little trip up the mountain to visit several sick and dying people at their houses. We parked our UTV on the road at the farthest point that we were able to drive to, grabbed our medical bag and started up the trail through the rocky, yet lush and green Haitian countryside. The narrow, muddy trail wound through green patches of young bean plants and past tidy little stone houses shaded by groves of fruit and nut trees. Nores, the Haitian brother that was with us, knew of an elderly lady who was shut up in her house and wasn't in the best of health and so he led the way to where she lived. We arrived to find a friendly  

I had to snap this picture of Nores on the trail ahead of us.

granny who claimed she had been born in 1908. Her family verified that she actually was that old. I don't know if that is possible but she seemed like she was still mentally with it and she was consistent with her figures. We checked her out and gave her gave her some appropriate medicine. The next stop was a 23 year old boy who had had a stroke several weeks earlier. It was wonderfully encouraging to see how he was beginning to use his right leg again and was actually starting to be able to walk around his house. We instructed him and his family on exercising the full range of motion on his right arm and leg to prevent contractures due to lack of use. They were very attentive and promised that they would keep doing the things that we had told them to do. We made one more stop at a house where a middle aged lady with what appeared to be advanced liver disease lived. At each one of these places Nores would lead in several Creole songs and pray with the people. Sometimes it seems that just the simple act of visiting someone and praying with them means far more to the people here than any amount of medical expertise and capabilities.
   

Several tombstones in the late afternoon light. A familiar sight in the Haitian countryside

  On other news, we had a lady come into the clinic with cholera about a week and a half ago. We put her in the little stone building that sits next to the clinic to help prevent the spread of the disease to our other patients. This lady's family, which included children, aunts, uncles, nephews and nieces, were NOT cooperative with our instructions about staying clear of where she was at. Well, to make a long story short, a relative of hers, a powerfully built young man, was brought in on a cot Wednesday evening with the characteristic watery diarrhea and dehydration of a cholera patient. He still hadn't recovered fully yet when this morning (Friday) at 4:00 another relative was brought in with the same thing. We did the usual procedure of IV fluids and antibiotics and we reinforced a strict quarantine on the little shed. Several hours later I had barely finished putting up caution tape ( as a visual reminder and obvious line to stay behind) when a nine year old boy ( from the same extended family ) was brought in on a cot with obvious cholera symptoms. We currently don't have the facilities to handle a large scale outbreak so we are hoping and praying that the three patients we now have in the little shed will be the last ones we get for now. The Haitian Red Cross came by today to investigate and try to help in educating the people involved on how to prevent transmission of the bacteria and to look for a possible source such as a contaminated water spigot where it could be originating.

the shed which is our current "cholera clinic"

  We keep having all the normal day to day challenges like trying to decide what to do with the many patients that come to our clinic requiring further treatment then what we can provide. Or, for me, trying to do a physical assessment and history taking on a patient while only being able to communicate on an approximately 5 year old level due to my still somewhat limited knowledge of the language. The beautiful thing is, that every time we feel like we can't take one more problem, somehow when that problem comes God is always comes through to provide the extra strength or patience needed to deal with it.

                He is still victorious!
                             -Hans