Wednesday, November 10, 2010
Battle Rages in Cite Soleil
Photo by John Carroll, M.D.
St. Catherine Laboure Hospital
Cite Soleil, Haiti
Posted on Wed, Nov. 10, 2010
Battle rages in slum, this time against a disease
By JONATHAN M. KATZ
A wooden wheelbarrow is pushed to the high green gates of a slum hospital, carrying an unconscious woman, her lips white and cracked with dehydration. She is 22, and two days ago she was healthy.
The concrete passageway leading to the hospital is filled with victims of the cholera epidemic that has entered Haiti's capital. Three weeks after it was confirmed for the first time ever in the Caribbean nation, the waterborne sickness has claimed at least 643 lives, mostly in the countryside.
If Wednesday's traffic is any indication, cholera is growing fast in the seething slum of Cite Soleil and perhaps all of Port-au-Prince, a city of more than 2.5 million.
A taxi truck known as a "tap-tap," painted with green and yellow hearts, backs in to the hospital to unload an elderly woman. An unemployed father carries his limp daughter, wrapped in a yellow blanket.
Two-year-old Clercilia Regis had been sick since Sunday, when she lost control of her bowels during church and had to be carried out by her worried parents to their dark, one-room concrete home on a side street nearby.
Since the rumors of the sickness arrived in the capital they had taken their pastor's advice and mixed their water with bleach and some lime juice. Clercilia got sick anyway, but her father, Jedson Regis, says she didn't seem too bad off at first. Then came Tuesday.
"Last night around seven, the worst started," he said Wednesday. Clercilia was producing water at a terrifying rate. But at night in a lawless slum, he couldn't do anything.
When the sun broke, Regis put on a gray T-shirt reading "Turkey Run State Park, Indiana," and walked his daughter to Hospital Saint Catherine Laboure. Along the way he passed the canals that make perfect breeding grounds for the disease, green-brown soups of floating plastic bottles and human waste, with chickens pecking at the surface.
The aid group Doctors Without Borders and the health ministry have set up tents inside the hospital. The sick are lined up in beds with clear IV tubes in their arms. Those too weak to turn their bodies get beds with holes and buckets in the center. The woman carted in by wheelbarrow - actually a gray, 10-foot contraption known as a "bouret" - was transferred to another facility for the most extreme cases.
Nearly 10,000 people have been hospitalized for cholera across Haiti with symptoms including serious diarrhea, vomiting and fever. The deaths usually come from the extreme shock brought on by dehydration.
Nobody knows how cholera came to Haiti. An outbreak of some sort was expected in the wake of the Jan. 12 earthquake, but this came out of the blue - there had never been a case of cholera confirmed in the island nation. So far nobody is investigating the cause; suspicions are high that the South Asian strain was carried by U.N. peacekeepers from Nepal, but the case is politically sensitive and health organizations who might investigate say they are currently focused on controlling its spread.
Port-au-Prince officially has had 1 death and 175 people hospitalized, but those figures are based on two-day-old reports, and were out of date before they were announced. There are reports all over Port-au-Prince of infections, in earthquake camps, slums and neighborhoods.
At the hospital in Cite Soleil, worried families wait on benches. Pans of bleach-laced water are placed at the doorways inside and out, to kill the bacteria being tracked in.
"If we were in hygienic conditions, maybe we would be able to say we were in control of the situation," said Dr. Juliet Olivier, a Haitian physician on the Doctors Without Borders team working there. "The disease is easy to treat, but the patients take a long time before coming to see a doctor."
Outside, the traffic is nonstop. The concrete passageway painted in hospital green and cream is sprayed with slogans from the planned Nov. 28 election - long live this candidate, vote for that. One excited scrawl reads, "Viv MSF nan Site Soley" - long live Doctors Without Borders in the City of the Sun. Market women selling fried plantains and spaghetti are doing a good business, and so are they boys selling plastic bags of water that may or may not have the disease.
"Dlodlodlo," they rattle. It means "waterwaterwater."
Clercilia Regis and her family got theirs from a tap when they couldn't afford the water their church sells from a donated machine for 15 gourdes, or about 38 cents, a gallon.
As the young girl grew sicker, she did her business on the floor, leaving her parents to clean it up with a bucket. There are few latrines on the street, and those are for adults.
The buckets were emptied across the alley, seven feet from the family's door, into an empty home abandoned by former neighbors in the 2000s when the local threats were bullets from gang wars and clashes with U.N. peacekeepers.
As Wednesday morning becomes afternoon, Regis walks out of the hospital. Clercilia is again in his arms.
Her stiff body is wrapped in a plastic bag. A death certificate is in her father's right hand.
"It was night, I couldn't take her until the morning," he said. With no money to bury her, he wasn't sure what he would do with her body. He straightened it in his arms and walked his daughter home, still draped in the yellow blanket.
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