140 Cholera beds extendable to 280 per PAHO list dated 12/6/10
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As publicly stated by MSF
[http://www.doctorswithoutborders.org/news/article.cfm?
id=4849&cat=voice-from-the-field]
Since a cholera epidemic was first confirmed in October in Haiti’s
Artibonite region, Médecins Sans Frontières teams have treated more
than 10,000 suspected cases nationwide. In addition to MSF’s 3,000
staff members in Haiti, more than 100 international staff and more
than 400 national staff are working on cholera intervention
activities. MSF is supporting two Haitian Ministry of Health hospitals
in the Artibonite Region, where the cholera outbreak originated.
To bolster health clinics in some of the more outlying areas in the
north and center of the country—in places such as Gros Morne—MSF is
supplying IV solution, oral rehydration salts, IV sets, and hygiene
materials. Supplies have also been provided to the hospital in the
town of Port de Paix in the country’s far north and another MSF team
is working as far north as Cap Haitien to treat suspected cases there.
MSF is supporting cholera treatment centers in Gonaives and Gros
Morne. A 20-bed cholera treatment center has also been set up in
Leogane, where MSF already runs a hospital.
The epidemic has taken grip in Port-au-Prince, and while MSF teams are
scaling up capacity to 1,000-beds in locations throughout the city,
the numbers of cases is already overwhelming MSF and public medical
facilities.
Stefano Zannini is the Head of Mission for MSF in Haiti. Here he gives
a first-person account of the situation on the ground for MSF teams
responding to the spread of the outbreak in Port-au-Prince.
It’s a really worrying situation for us at the moment. All of the
hospitals in Port-au-Prince are overflowing with patients and we’re
seeing seven times the total amount of cases we had three days ago.
In the slum of Cite Soleil, located in the north of the city,
yesterday we recorded 216 separate cases of cholera arriving at the
hospital, while the total number recorded just 5 days ago was 30.
Patients are coming from everywhere, throughout the city, slums and
wealthier areas. At the moment we have 400 beds set aside for the
stabilization and rehabilitation of patients and we’re hoping to get
that up to 1,000 by the end of the week.
But we are really worried about space. If the number of cases
continues to increase at the same rate, then we’re going to have to
adopt some drastic measures to be able to treat people. We’re going to
have to use public spaces and even streets. I can easily see this
situation deteriorating to the point where patients are lying in the
street, waiting for treatment. At the moment, we just don’t have that
many options.
We’re looking for alternative spaces, but you have to remember what
the situation in Port-au-Prince is like. Since the earthquake, every
available space that wasn’t damaged has been filled by camps where
people are living in extremely precarious conditions. Just to find an
empty area in this city is a major logistical challenge, so for us to
find room to treat people is very complicated.
At the moment we have more than 100 international staff and more than
400 Haitian staff working in the cholera treatment centers throughout
the country, but it’s just not enough. More medical staff are
arriving, but there’s a chronic lack of personnel here in Haiti and we
are close to being overwhelmed. Our teams are working 24 hours a day
and tiredness is becoming an issue. Our teams are already stretched
and are very stressed from the workload. Working inside a cholera
treatment centre with the smell, the noise and the pressure of so many
patients is not easy. But we will keep on providing treatment.
As the MSF head of mission, I am extremely proud of the passion and
commitment my teams are currently showing in Port-au-Prince and in
Haiti. But we’re at critical point. There is no cholera in living
memory in Haiti and thus little knowledge of the disease. This means
there are a lot of misconceptions and rumors flying around which has
caused panic in the population. Some people are staying away from the
cholera treatment centers or are afraid to have them in their
neighborhoods because they think they help spread the disease. We’ve
been trying to explain that the opposite is true: the closer a centre
is to a population, the better.
We’re trying to explain that cholera can kill, but at the same time,
it’s a disease that you can treat quite easily. It’s extremely
important that the patient arrives as soon as possible to the medical
facility in order to be treated.
Cholera treatment centers, where patients can be isolated, are
critical for effective treatment. The access points are controlled so
that whoever enters or leaves is sprayed with chlorine to disinfect
properly and prevent further spread of infection. Depending on the
number of beds, each treatment center can take up from 50 meters to
one hectare of space. Each patient is given a bed and usually does not
stay for longer than two days.
But another problem is that when people have finished their treatment
and they leave the centers, they go back to what is potentially a
cholera infected area. Here in Port-au-Prince, 1.4 million people are
still living in camps and within the camps, hygiene, sanitation and
clean water are scarce. These 1.4 million people depend entirely on
humanitarian aid groups for clean water. Infrastructure is weak and
it’s very difficult to get medical aid and water to all of these
people.
Two weeks ago I was in Petite Riviere in the Artibonite region where
the cholera outbreak originated, and I visited our hospital and
cholera treatment centre in Cite Soleil this morning. People are
brought to our facilities, many crying and some screaming. Panic has
spread throughout the city because cholera is completely new to these
people. One of the saddest moments that sticks in my mind is a 10- or
12-year-old child who I saw bringing her mother to our cholera
treatment centre and sitting with her, waiting for her to be treated.
Usually, it’s mothers and fathers who bring their children to
hospital, but here it is the kids who help their parents to the
treatment centers.