The clinic staff has been working non-stop. If you or someone you know is a medical professional interested in volunteering at the clinic during this crisis, please contact Dr. Kenneth Kornetsy, kkornetsky@msn.com. Our two service year doctors finish their term on the 22nd, leaving Dr. Casseus as the sole doctor; we are already feeling under-staffed, so this additional loss is very concerning.
We have separated off the normal clinic from the new wing extension, designating the area as the cholera ward (pictured at right; in the last couple of hours since we took this picture, the central area has been filled with more cots to accomodate patients arriving tonight). The extension is not quite finished (it has no electricity, running water, or room dividers), but is a good space for cholera treatment. We are working to maintain a tight quarantine on this space to avoid contaminating the rest of the clinic or staff house and have hired additional cleaning staff. Normal consultations are closed, but we continue to take emergencies and maternity consultations.
There is a rotating schedule of nurses and doctors attending to the patients at all hours. Most cases of cholera can be treated solely with ORS, but the more severe cases also require IV fluids, and occasionally antibiotics. We are providing food for the patients. Along with medical care, we are giving preventive education, soap, water-purification packets, and instructions for preparing ORS to patients' families, because they are at a high risk of contracting the disease. The administrative staff are helping with other efforts such as education and record keeping, using a set of recently-developed cholera-specific charts and forms.
At the same time we treat patients at the clinic, it is crucial that we continue our prevention campaign. The cholera forms track each patient's address and water source; we hope that the patterns we see emerging will help us identify contaminated water sources and target our prevention campaigns. On Sunday, Dr. Hippolyte and Fidel made announcements in many local churches, and yesterday Dr. Hippolyte and Emily appeared on the radio. Today we hosted the first meeting of the Thomassique Cholera Committee (pictured at left), which we created to coordinate the efforts of our clinic, World Vision, government officials, religious leaders, school directors, and other organizations working in Thomassique. For example, this collaboration allows for supply exchange: We provided World Vision with ORS, and they gave us several boxes of water-purification packets (we are still waiting on the Klorfasil systems to arrive). The Haitian Ministry of Health is also supporting us, and sent a car full of cots, ORS, bleach and other supplies to the clinic this afternoon. The Community Health Workers continue to provide outreach and education in their communities. Bouloum has seen a couple of cases, but Dahlegran, Barank, and Savann Plat have had no reported cases.
One of the most troublesome problems facing us in this crisis is that we are still without a good source of water. The pipe brining water to Thomassique was reportedly repaired yesterday (after nearly 2 weeks), but we still do not have running water at the clinic or staff house. It is incredibly difficult to adequately clean a cholera ward without sufficient water, so Brian has been traveling half an hour to Dahlegran each morning to collect several large bottles full of water from their local water source. We sincerely hope the water will be back soon.
**To volunteer at the clinic during this crisis, please contact Dr. Kenneth Kornetsy, kkornetsky@msn.com.**
