October 25th to 28th

After going through a number UN quarantine checkpoints we finally arrived at our base around 6pm. The base was at a beach house, which was owned by a member of one of the other NGO’s there and was in a town just outside of Saint Marc called Mont-Rouis. Upon arrival we were briefed on the de-contamination procedures and updated on the current situation at St. Nicolas hospital -it was made pretty clear that no one actually knew how many people had been affected by cholera or how well it had been controlled.

Our team was assigned the night shift and initially, they said they had no need for non-medical volunteers at the hospital (and that I would mainly be helping to decontaminate the vehicles and deliver medical supplies to the other hospitals) but I managed to weasel my way in using my kreole skills…

As soon as the door of the bus opened up the strong smell of bleach filled the air. To get into the hospital we had to walk over foam pads that had been soaked in bleach. Each ward of the hospital was in its own stand-alone building; most of them also had terraces both in front and behind. The majority of St Nicolas was dedicated to treating Cholera patients but the maternity ward and surgical ward were still open but separate from where the cholera patients were staying. 

It turned out that there was a lot for me to do there. There were over 250 patients my first night all of which either needed constant monitoring of IV’s or top ups on their oral re-hydration serum. I ended up spending most of my time there translating for the nurses and teaching the families of the patients and Haitian nurses about what we knew about Cholera and how to prevent it from spreading. (Kenley and I had quite a heartfelt conversation after my 1^st night in the hospital when I told him how his teaching me Kreyol had helped so many other people.)

Many of the patients had “cholera beds”, which were actually just army cots that had a hole cut out from the middle of the bed and a bucket underneath. The families of the patients do most of the personal care in the hospitals here, that includes bringing their own sheets and enough food for the duration of their stay as well as bathing and disposing of any bodily fluids. Cholera can kill a healthy person within 5 hours and is often not caught soon enough, so because of how serious the illness is and the fact that many of the people who were affected were from rural areas most of the families were unable to buy food by the 2^nd day.

For the patients that didn’t have any family of families with multiple members who were sick the quality of care was much less.  Myself and 2 of the other non medical volunteers took it upon ourselves to give those patients some extra attention and went around making sure everyone else also had enough blankets to cover themselves. I began giving many of the ones in critical condition hand and foot massages to help ease some of the pain and helped to bathe them to give the families a break.

One of the men I was tending to was all smiles and when asked how he was feeling he would always reply that he was doing well. It was apparent that he had other medical issue but it wasn’t until I was bathing him that I noticed his high temperature. It turned out that he had malaria as well as cholera. After he started his treatment for that his recovery became obvious and he was up and about and walking out by the third day.

On the way back from the hospital I would talk to David who was one of the other translators for the nurses, he told me about his view on healthcare and how to better understand the way the Haitian nurses approached the situation.

Over all it was incredibly challenging for me to be at the hospital. I struggled with the callous manor of the visiting nurses and the lack of dignity the patients were given. It was heart wrenching to see how arrogant the visiting nurses were towards the Haitian nurses.

 

One lady came in on my second night there that was in critical condition, the nurse was convinced that she wouldn’t make it through the night but by squeezing her iv bags and giving her antibiotics she managed to pull through. When she came in she looked so thin and lifeless but as she became hydrated her face and body completely changed shape and by the 3^rd day she looked beautiful and was once again able to drink on her own.

The difficulty with having visiting nurses is in the maintenance of the standard of care. By the 2^nd day the hospital had the set up a renal ward to help manage the patients who were having kidney problems due to an excess of water –meaning that some patients were given too much and nothing was documented or monitored so it went un noticed until they were showing signs of renal failure.

My last night in the hospital there were much fewer patients and many of the newly admitted were actually the family of the patients we had seen earlier in the week. After a long swim an a sleep I woke up around 6 to be picked up by David (on a motorcycle) to go to the market. It was nice to finally have that freedom from fear that was so much a part of the compound life and illuminated a whole other side to the Haitian culture. One of the local churches had music playing while a man spoke into a megaphone, he was talking about how to prevent cholera and explaining the symptoms. After the market we went for dinner and listened to Davids friend’s band play kompa music.

The outbreak had been down graded and many of the medicall teams were leaving so there was no need for Terry Charlie and I (2 other the other non medicals). We decided that we would spend Friday catching up on sleep (we all averaged about 3 hours a day that week) and to make tracks for PAP on Saturday.