Haiti, round 7: cholera lab

In early February, I travelled to the South of Haiti with the estimable young flight instructor, Cameron King, in a Bahamas Habitat BE55, and we put the considerable weight of Cowboy (Brian Ferguson, the SIFAT water man) in the back.

I do like a Baron- not as good as a Cirrus in turbulence, but hardly anything is. It’s a by the numbers plane. I read Eckalbar’s “IFR: a structured approach”, based on a Baron. A terrific book, and the plane flies exactly as he describes it. Don’t you love it when that happens?

Cowboy occupied much of the midplane. When Cameron turned to check on him, he’d say “Cameron, I’m not just eye candy! I have thoughts and feelings! Besides, I’m old enough to be your PeePaw, and that’s just icky!” He kept us in stitches.

We waited out some ice, then climbed through through some cold clouds in Cullman, AL, pretty fully loaded, but the plane is smooth. Ft Pierce with flightplan.com makes eAPIS easy, and we spent the night in Governor’s Harbor, at the BH camp site.

It’s a nice island. I’m still trying to make up my mind between Eleuthera and the Exumas- we’ll need a few more trips.

The Bahamas Habitat folks are having a fly-in and help out trip next weekend- a little short notice, but they can get you through the process. And the accommodations are fine, featuring a solar heated shower… on this trip, it’s the last hot water you’ll see for awhile.

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The plan was to go to Port au Prince, and talk with the St Damien staff about setting up a GI lab there, check on my daughter’s friend, Joanna Brown at Grassroots, then fly to Les Cayes and drive North an hour to Bonne Fin, a Baptist mission hospital in the South peninsula where an urgent cholera email had been sent out. Cowboy planned to wow them with his water treatment device, and I was to set up a cholera treatment center adjacent to the hospital.

3666.map_of_haiti.jpg.

The situation in Port is calmer- cholera is under pretty good control, and they are cleaning out the gutters- a nasty job, and way overdue.

At Grassroots, the Earthship group is building little eco friendly houses, using trash, and low energy substrates, and water catchment runnels, then gray water/black water/irrigation/back to gray water- all new to me and interesting. The effluvia and atria of old Rome came to mind, but the builders were pirates at heart, all energy and spirit, but less history.

A competing structure, made of local materials, is nearing completion next door- costs about $3000 to build this house for 7.

Anyway, Joanna Brown is their organic farmer, working on a rooftop garden here:

She also made a puppet show for village discussion of cholera- a pretty good idea, since the understanding of the disease is limited, the populace 85% illiterate.

Earthship hired her to run their organic farm in Taos- I’ll have to read up on DA and go visit her! They must have been impressed. Finding paying jobs in Haiti is out of the ordinary.

Bonne Fin is in the hills, and the air is pretty clean.

The hospital was originally moved there in 1980 from Gastonia NC, lock, stock and barrel. It was mostly an orthopedic center, and it had fallen on hard times, and was to be closed in Feb 2010. But the earthquake made the beds look good again. It’s run down still, needs some paint and sprucing up, but could be a reasonable 50 bed unit.

The interior is more medieval, dark and crowded:

The nurses’ station is rudimentary:

Dr Rudoph Richeme runs the shop, and he has 13 interns. Sheila Moser is the MEBSH (Baptist missionary) presence.

The Emergency Room was taken over for cholera. Cholera requires careful segregation of patients, obsessive management of ingress and egress, chlorine sprays for hands and feet every time in and out.

It’s an imprecise country, but for the most part everybody shifted accordingly. But when I did a solo walk through before the grand tour to get a count and look things over, I found four interns had snuck in the back- apparently the only good WIFI on the hospital grounds- so they’d waltz through with their computers and snacks.

There was some resistance to setting up the center, mostly related to the Haitian nurses and interns wanting to be paid extra to staff it- thought I was back in Alabama.

But Dr Richeme wanted it done.

The new treatment center wasn’t much to look at- old staff housing. But it was separated from the hospital, and I thought we could isolate it.

So we put Cameron to work mopping it up,

Cowboy fixed up a pure water source, I found a chlorine sprayer,

we raided the pharmacy,

brought our supplies in,

set up the cots,

and trucked the patients over, one of them an Alabama fan.

We put them in beds, and were open for business.

We were still getting the wrinkles out when a call came to go to Plaisance, an hour toward Mirogoane.

I met up with Dr Anika Tas of MSF and went to look things over.

Things were dire there, with really sick patients, and an exhausted Dr Lammare trying to hold up the rest of the hospital. We pitched in out back in the tents, and there was a good bit of medical drama. A bloated young boy puked quite a number of Ascarids onto my shoes- shoot, another pair left in Haiti.

There was plenty of that cholera look at Plaisance:

I noticed their tarps were incomplete, so people could walk through without sterilization.

Back at Bonne Fin, I’d been thinking MSF is a stuffy old bureaucracy (you sign a release to ride in their truck)…most of their rules are of a big outfit, and seemed excessively cautious- more in keeping with the conflict countries they usually serve than Haiti.

But they do deliver the goods.

We calculated the number of cholera patients we expected, and they told me how many buckets we’d need, how much tarp. Then they brought it, and helped us set it up.

Very French, of course, I see Jean Pierre sucking Galois held like Peter Lore, between thumb and index fingers, and reading Sartre. But they got the job done.

But it’s Mina, the linens cleaner, who’ll keep them safe.

The interns revolted, said they couldn’t work in the cholera lab because it was too dangerous, failed to show for a couple of shifts- got me tired and pissed.

Had to buck them up at the cholera lecture, remind them their grandchildren were going to ask if they were stand up guys when Haiti was under assault.

But mostly I reminded them they weren’t so scared when they needed WIFI.

I was angry with them, and a little ashamed for them.

But I remembered the early '80s, when AIDS was just heating up.

I was working in the gay district in Philadelphia, and handsome young men were dying of dreadful pneumonias, skin rashes, hectic fevers, and bloody diarrhea- Job got off easy. We knew it was catching, but we didn’t know much else.

And I was scared.

So maybe they’ll get the hang of it.

We left too soon, the American technique- here’s how you fix this, bing, bang, boom, I gotta go.

So I’ll go back, see what they’ve done with it.

Cameron took us back along beatiful views,

to Norman Cay (3000X60, tree lined, but you can give up blue line a quarter mile out at 30 feet over the water, drag it in with 1000 feet to spare, and walk the 50 ft to MacDuff’s)

No more cocaine at Norman’s, just pretty beaches

and conch fritters.

Cowboy found these acceptable.