A Day in the Haiti Cholera Zone's Health Facilities (II)

A Day in the Haiti Cholera Zone's Health Facilities (II)

(Read Part I)

A Children's Ward Set Up in the Drouin Health Center

On Wednesday we met with a group of some 15 community health agents from the surrounding villages. Our discussions revealed the ironies of Haiti. In a country where almost everyone has a relative who lives in the United States or Canada, and where remittances from overseas far surpass the total amount of international assistance coming into the country, the only source of drinking water in their villages, they told us, was the river. There were no latrines. We had arrived with a representative of the MSH partner organization Pure Water for the World to propose the installation of biosand filters which would permit families to purify the river water. The health agents initially wanted water storage tanks with generators and pumps like the one in front of the health facility so they would not have to hand carry water from the river. It was a fair request but not one we could respond to. They said they were afraid of infection from the water splashing out of the buckets used to carry the river water. We tried to reassure them that cholera is not transmitted through the skin. They needed to make sure they washed their hands regularly with soap…but soap and the means to buy it is in short supply in many villages. And a long time ago they had received some sand filters and now everyone was afraid to use them. But how will you pay for fuel to keep the generator running, we asked? No easy answers. In the end they agreed that we should send a team of educators and trainers to talk to them some more about the newer biosand filters we were proposing.

And then there were the health agents themselves. Although I understand nearly everything, my spoken Haitian Creole is not good so I was prepared to work through a translator. No, they said, they understood my French just fine. Dr. Conille did a presentation on cholera, its causes, its prevention, what to do if someone got sick. It was a simplified presentation to meet the needs of village health workers. During the question and answer session at the end, one young man pulled out a medical book. "Why were we not using preventive tetracycline?" he asked. After the meeting I went up to him to offer to send him some additional literature on cholera treatment and prevention.

We returned to Port-au-Prince Wednesday night. Thursday flew by with staff updates, responding to urgent e-mails, preparing some brief proposals for funding, dealing with the on-going issues of project management, because our regular activities have to continue despite the emergency, and participating in a two-hour meeting with USAID during which the USAID strategy for support to government of Haiti initiatives to strengthen clinical care and community outreach was presented. MSH was asked to lead community education activities throughout the country in its 147 health facilities. Hopefully today there will be time to process the information gathered during our visit to the Artibonite and start to find some solutions to the needs presented to us there.

Agma Prins is Chief of Party of the Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project, led by Management Sciences for Health and funded by USAID.

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Great blog, by swain that wrote so often. The power reaction that writes to-date knowledge :)

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