Cholera arrived in Haiti last October 12th, the runoff from the Nepalese UN camp fouling the Artibonite River, flowing downstream to St Marc’s in the central plateau, and from there it was Katie bar the door. Initially, the treatment was chaotic, and widespread panic wasn’t just a doper’s band. The morgues filled way beyond capacity, people were afraid to bury their dead, and riots closed Cap Haitien. Many doctors and hospitals opted out. The great flood of earthquake sympathy and earthquake dollars dwindled to a trickle, more easily stanched than the disease. Before long, that river ran dry. The UN is still here in force, but NGOs squabble over ever smaller biscuits.
Sewage treatment, the grand grotesquerie underpinning all modern civilization, is unknown in Haiti, where roadside gutters are a stinking disgrace. The disease is on board for my lifetime, at a minimum.
St Damien’s, a high quality pediatric hospital, grew new divisions- I washed up at St Luc’s, which didn’t even exist before the quake, and mostly worked St Philomene’s, the cholera hospital, which of course was also brand new- both a couple hundred beds now, full fledged institutions.
We got good at it. Eventually, things settled down. Severity was ranked A,B and C- the treatment became algorithmic, a nurse’s checklist. Now they just call when they bleed or have fever, TB or HIV, or something besides. Over the summer, the numbers declined.
Lately, the rains have been intense, unseasonal. It’s coming back with a vengeance.
But first, let’s do the numbers.
20,000 patients came through St Luc’s this year. Some, “A” patients, where treatable with ORS alone. “B” and “C” patients also required Lactated Ringer’s, at $2.50 a bag, and an IV, or more likely 3-4 IV’s over 3-4 days, at a dollar fifty a pop. The NG tubes were free, since I stole them, but the intraosseous lines were high at $25 bucks each. Some of the C patients required 25 bags the first day- the fluid shifts amaze me still. Combining all, each cholera patient averaged 20 bags of Ringer’s.
We poured it in, and they poured it out, down the drain.
It was hot, so we ran some fans. We fed some families, mostly MREs, but beans and rice, too- had to buy that.
All in, a million 5.
A coupla FIKI Cirrus.
A large load carried cheap, if you ask me.
But they don’t. At least, they don’t ask about that.
Haiti’s too depressing, too close to home, a failure in too many ways. You can’t look at it hard without feeling worse about yourself, all of us, about humanity.
We should blame them.
So when people ask “Is anything really getting better down there? Where did all that earthquake money go?” They don’t really want details.
They want confirmation of widespread corruption.
They want absolution- forgiveness- what we all want, in case we skip an important moral step as we cruise through our blessedly sunny lives, at a safe altitude, our heading on autopilot.
In case our way of life is somehow integrally related to this penury.
In case this Jungian sense of connection, always felt, and reinforced by the net and global smalling, is real, and we really are meant to be our brother’s keepers.
But Hell, I like people.
I skip moral steps all the time- and never more than since I started coming to Haiti, for some reason.
So I let them off the hook.
I tell them I think it all went down the drain.
Quite a bit of it did.