Children’s staff return to Haiti

It’s been almost ten months since an earthquake ravaged the island of Haiti, leaving 300,000 dead and over a million people homeless. Since the disaster, clinicians from Children’s Hospital Boston have been traveling to the country to provide care.

May, 2010- A pediatric tent at the General Hospital in Port au Prince

This coming Saturday, another team of 8 nurses and 4 physicians will be traveling to Port au Prince to help with the relief efforts. Conditions there are extremely difficult: on top of the reports of a rapidly spreading outbreak of cholera, hurricane Tomas is forecast to tear through Haiti only a few hours before they arrive. This is likely to cause significant loss of life, render tens of thousands homeless once again, and lead to the further spread of infectious disease, including cholera.

Here, Dr. Rosen shares his thoughts on his impending trip to the embattled island nation and why aid to Haiti is more important now than ever.

This weekend, our team of 12 nurses and physicians will travel to Port au Prince, Haiti, one of the many medical relief teams which have gone to Haiti from Children’s Hospital Boston to help with the medical relief efforts since the earthquake of January 12, 2010.

We will be providing direct patient care in the pediatric inpatient and outpatient units of Bernard Mevs hospital, which is run in collaboration with Project Medishare and staffed by Haitian nurses and physicians and American volunteers. We will also be doing teaching, both formal and hands on, at Bernard Mevs and at the General Hospital (HUEH) to help improve the level of pediatric care given in Haiti.

In addition to collecting supplies, raising funds and preparing the talks and lectures we will give, we have all spent the past few weeks reaching out to school groups and others in the community, reminding them of how tenuous the situation remains for the people of Haiti and involving them in our efforts to maximize the impact of our work there.

Unfortunately, in many ways, the situation in Haiti now is no better than it was in the immediate aftermath of the earthquake. The news of the cholera outbreak of the last two weeks, which has sickened thousands and killed at least 337, is a stark reminder of this.  So far, most of the cases have been concentrated in St. Marc, approximately 60 miles north of Port au Prince, and the Artibonite river valley.  While 5 people were diagnosed with it in Port au Prince, it is believed that they had contracted it elsewhere. If cholera does spread to the crowded and unsanitary tent cities in which more than one million displaced persons live, the results could be catastrophic.

Cholera is an intestinal infection which causes the intestines to actively secrete fluid and electrolytes, causing copious diarrhea, dehydration and electrolyte imbalances, and can be fatal within hours.  So far, the mortality rate in Haiti has been about 6.4%, with infants and young children at a higher risk for complications.  The diarrhea can be so intense that people stricken with it are often put on special beds with an opening under their buttocks to allow for the constant passage of the watery diarrhea into a bucket placed below.

Cholera had not been seen in Haiti for more than a century, and it is still unclear how it returned to the island.  It is very easily spread, and when it first appeared the hospitals in St. Marc were unable to accommodate the huge demand for care. Most patients are treated with an oral rehydration solution (ORS) consisting of water, glucose, potassium, sodium and trisodium citrate. The more severe cases are treated with antibiotics and intravenous fluids.  It’s a disease closely associated with poverty, as simple measures such as hand washing and providing access to clean water can dramatically reduce its spread.  However, clean water is not easy to come by in many parts of Haiti.

The most uplifting part of getting ready for this trip has been to see just how many people genuinely care about the plight of the Haitian people and want to help.  We have received donations from the hospital and individuals of medical materials, medicines, vitamins, textbooks, baby clothes, shoes and money to take with us to distribute while there.  Others have made donations directly to Project Medishare through a webpage set up by our team members.  While many of the people who have donated items have been people we know personally, others have been only indirectly connected to us, such as the coworkers of spouses of people we work with who heard we were going and wanted to do something to help the Haitian people.  This has transformed our trip from one of 12 individuals into a communal effort of those who cannot remain oblivious to the suffering of others, who we are proud to represent.

I think I speak for the entire group when I say that we feel excitement mixed with nervousness knowing we will be caring for extremely sick children, many of them malnourished, unvaccinated and suffering from diseases which could be easily treated here in Boston, but are often fatal in Haiti. We also feel very privileged and grateful to have been given the opportunity to help so many in need and to make a true difference in their lives.