Day 1: Saturday, December 4, 2010, Arrival at La Puente and St. Louis du Nord
By now cholera has affected over 100,000 people in Haiti and close to 2400 have died. We were probably the sixth team sent by Medical Teams International. Our team members were six doctors and a nurse. There were Tom, our appointer leader, a family doctor, Mary, a neuroradiologist, Alan and Don, both pediatrician, Ian, a gastroenterologist, Sherry, a nurse who had experience in the ICU and me, an Infectious Disease specialist. The UN Humanitarian Air Services transported us and some of our supplies to Port-de-Paix. From the air, tents could be seen in Port-au-Prince, some lining the river where most likely many of the Haitians derive their water supplies. As we flew over the mountains towards the northern region, the scene looked peaceful enough.
We stopped first in La Puente after about forty-five minutes of bumpy ride through rutted, muddy and sometimes flooded roads. It was late afternoon. As we entered the compound, it was surreal to see patients and relatives lying on cots and sitting on chairs quietly in huge tents, one more crowded than the other. Many patients spilled out in the open areas sheltered by tarp and many more lined the corridors. They followed us with their eyes that seemed to ask for our help. IVs hanging from poles but more often than not from nails or hooks sticking out from the rafters. There were seven of us, one nurse and six doctors. There was a more urgent need for doctors in the Mission clinic in St. Louis du Nord and apparently the death toll was greater there; five or six deaths a day by reports. Patients traveled long distances and upon arrival many were quite ill. So Tom our leader decided to leave Don and Ian, both doctors at La Puente where there were already some doctors and nurses working there while the rest of us traveled to St. Louis the same evening.
After another forty-five minutes of bumpy ride, we arrived at the Northeast Haitian Christian Mission, there we were greeted by glittering Christmas lights. It was quite heart-warming after a long day of travels.
The cholera treatment area was divided into three areas: the ready-to-discharge unit (patients on ORS, ready to be discharged), the step-down unit where patients were discharged from the "ICU", they still had diarrhea and some vomiting but were taking ORS and then the "ICU" where the sickest patients were and all were on IVs and were encouraged to take ORS.
In the less serious units, patients and relatives were bedded on mats on the floor. There were about twenty odd patients. In the "ICU" there were about twenty-five patients lying on cots, some of which were diarrheal cots with holes in the centers for the diarrheal output. The ward was surprisingly free from strong stench. Many of the patients had the classic glazed look, sunken and listless eyes and were either restless or motionless. We were told that the patient census had decreased by half. It was close to seven in the evening.
The only resident doctor in the cholera clinic had left for Port-au-Prince and we were essentially the team for the cholera unit. After dinner, Tom, Sherry and I decided that we would round in the evening with Geselin and Mark our interpreters, there were several patients; a man in bed 1 and a few toddlers that needed attention being dehydrated and listless. We worked steadily till mid-night, checking pulses and turning up IVs. Sleep came quickly and even the roosters and Duke, the mission dog, a black lab which came crashing in one of the bunk beds did not disturb me.
Allan and Mary took the early morning round at four am.