A word that gives the chills. In my mind it is associated with middle age and plague and scary history lessons from primary school. At the latest you could associate it with the 19th century if you read Les Misérables, or El amor en los tiempos de cólera.
If you google it the first quote is from WHO: Cholera is an acute diarrhoeal disease that can kill within hours if left untreated. Researchers have estimated that there are 1.4 to 4.3 million cases, and 28 000 to 142 000 deaths worldwide every year.
Unfortunately you have to associate cholera also to a small caribbean country in the 21st century.
There was a cholera outbreak in 2010 in Haiti after the earthquake. You probably read on the news last week that the UN admited their role in the reintroduction of cholera in Haiti: poor sanitation sent sewage from some peacekeepers camp into local waterways.
Since then, Haiti is struggling to eradicate the disease.
Last week casually I heard this UN public excuses in the car going to our field trip to Marchand-Dessalines, a small town in the Artibonite department where the cholera outbreak started in 2010. Dessalines is one of the most vulnerable communities, a rural area with a river and many rice fields, thus waters that facilitate the propagation. GSK is working together with Save the Children to fight the disease and support Haiti’s National Plan for the Elimination of Cholera, facilitating access to basic lifesaving interventions for treatment and prevention of cholera: educational sessions to the people, health frontline workers trainings, essential equipment to health centers.
Thanks to this help and the effort of the nurses and medical team, Dessalines is now the department with less cholera cases.
But there is still a lot to do. Dr Savain gave us a tour of the Bois Mary cholera treatment unit. Few miles away from the town, difficult access via a bumpy road that gets flooded during the rainy season (highest incidence of cholera), no light at night, the state does not provide the center with anything but 6 nurses who I had the privilege to meet. It was a surprise meeting for me, and intense, as I asked the genuine question “what can be done better?”…
It would be too long to report the whole conversation here. But a few points really broke my heart:
- The nurses and the maintenance man who has to clean the beds and the room and embalm the bodies when the worst happens are not vaccinated. The state so far has prioritized other places to start the vaccination campaign as Dessalines has done so well. What a reward!!…
- The nurses claim a physical separation between them and the patients, just a thin partition and a door to knock so they always have time to get prepared and put gloves on and avoid unprotected physical contact with a patient. Because some patients panic and sometimes just rush on them.
- Some nurses refuse to be on duty at night, they are scared as the center and surroundings are so dark and there’s been some robbery before (water pump for example) – not mentioning they have to use their small mobile phone light to see where to inject a patient, they’re used to that and it is secondary issue!!
I didn’t want to raise too much expectation as I was not prepared and thus was not sure what we’d be able to achieve on the top of what we already do, but I left with the hope to come back soon with good news for these 6 fantastic nurses and some more improvements of their work conditions.