Haiti, round 6: water, water everywhere, and not a drop to drink

 

 Cholera treatment is gratifyingly discrete- in sick, hose 'em down, send them home well- An American solution.

 We went back Jan 7th. 

 Cameron King worked out the details- that child has a remarkable Haitian rolodex in her head.

 I stopped at Jim Tucker's Medmission (Walmart for NG tubes, IV sets, Ringer's Lactate), Jim loaded me up again.

Kelly and Joe Nelson sent down a load of arm boards and med supplies form Asheville, and I was ready to go.

Of course, if the water was any good, I'd be out of business. 

 SIFAT ( service in faith and technology), a South Alabama Christian Technology outfit, has a plan for that. 

They created a light weight, solar powered, electrolytic Chlorine extractor, uses table salt, and contracted with Bahamas Habitat to deliver the water purification systems to Haiti, and place them in remote villages.

 The idea of heading cholera off at the pass that way is appealing, so I hooked up with them to tote some water systems. 

 We picked them up in Lineville, a little southeast Alabama town 90 min from everywhere, (watch the tele wires on short final), and  carried them down to the Banyan FBO, at FXE in Ft Lauderdale, site of the jump-off for BH's  great air bridge after the quake. 

We dropped them there for Dan Pace to pick up. 

 We swapped for a big ole generator, couldn't fit much of it in the 22 what with all the med supplies, but took the circuit breakers, the gas tank and various heavy bits. I lumbered into Port au Prince without incident, and met up with the dread(ed) Sam Bloch, stayed in the presidential suite at Grassroots.  Still with bucket showers, no running water, but living large.

Who says there's no progress in Haiti?

They put up a basketball goal since I was there last, and I wheezed through a couple of 2 on 2 games under the lights- proud to say these hippies'll still fall for a head fake, the pick and roll works in the tropics. Played a game called fire ball- like ultimate frisbee, which I like, but played with a gasoline soaked kevlar ball, the rules of engagement very lax- rugby alight- who needs voodoo?

 Went back to St Damien's, where much more progress was evident- in 6 weeks, 9 tents went to 18, then two prefab 32 bed units were built- one for adults with cholera, one for kids- I couldn't recognize where we'd worked last time.

 Only the sickest get to the prefabs, most treated with ORS in the triage tents, and the whole system pretty well organized. Their 1.5% death rate not too shabby, and the dead primarily have co-morbidities- TB, HIV, senescence. Among them the biphasic nature of the illness is more apparent- sick as hell, huge volume treatment, improvement, followed by a relapse in the diarrhea, and rehydration the second time leading to congestive heart failure, and there was no catching them up. 

 So I think antibiotics early in the rehydration of the elderly, and the otherwise sick may save them the relapse…the lessons we learn, and at whose cost…

But things are better.

Helped unload a container of supplies into the St Damien's warehouse- took all day and some advil, but quality time with Fr Rick Freschette- I insist my latter day saints be facile with a forklift.

No shortages of stuff in Port…though Kelly's armboards were new, and better.

We flew up to Cap Haitien, where I was met by Cameron's pal, Gregory, and we visited his friend Tabitha's orphanage- 26 kids otherwise bereft.

 

Gregory made Christmas for the kids, and the layout was pretty basic- pigs at the well, I doubt Dr Snow would approve. Eating and sleeping quarters are tight.

 

 

 

 

 

Shook hands with famous COPAN Dan Pace, but on the run, didn't get to talk to him even a little bit.

I did see his plane- prettier than mine, but together taking over the Cap Haitien ramp, that was nice, with the shape of Christmas past in the background.

 Met a dynamo, Dr Tiffany Keenan, first of Brunswick, lately an ER doc in Bermuda, but in her spare time runs HaitiVillageHealth in Bas Limbe, northwest of Cap. Here with the Leftenant and Trey and his Chloride pump.

 Met her in a beautiful hotel, Roi Christophe, great looking tropical decor, lousy food ill served at a glacial pace and temp…something very Haitian in that.

  was accompanied by a retired Leftenant colonel in British Military Intelligence, Richard Garrity, now a bobby in Bermuda- my kind of knucklehead, unapologetically politically incorrect, deeply imbued by his Republican father with an outsized disdain for British royalty (I wonder how that went over among her majesty's finest), full of witty understatement, appalled at the dirt and filth on his first look at Haiti. Makes Tiff rolled her eyes, but I think he's just the thing for her.

 Took a truck to Labidi, with instructions to find Josie there for the boat ride across the bay to the clinic. Saw 6 water taxies, with 6 eager captains,

and made a mistake- still clunking along with the language, I said "Ou gen Josie" are you Josie?-? First one said- "Oui, m'wen Josie!" second one also said "I am Josie", third and then all, the same…finally one stuck his face in mine and said- "Really- I am Josie!", and off we went.  Should have asked koman rele ou- what is your name...

 Cause he wasn't Josie, and he lit out for Labidi village instead of Ba Limbe. The Royal Carib cruise ship rose up- an apparition, their kayakers huddled like goslings taking instruction.

I finally asked his name (Felix), turned him around, ultimately Josie showed up, and we took the whaler over open water- South Pacific set views- Haiti can be spectacular.

Ba Limbe is a fishing village- not too bad, food enough, the fields tended, fishermen tend to their nets- feels pretty normal.

 

On the way over, we circled a piece of styrofoam trash turned out to be Josie's trot line, reeled in a nice white fish he called beaujevare. 

The clinic is is run by visiting volunteers- mostly Canadian, mostly Newfoundlanders, a couple from Calgary. One, Johanna Rocco, is a nurse who works above the arctic circle with the Inuit- very interesting. At night we talk about Robertson Davies, Atwood, and Munro, gun control (for), and drug legalization (against). They think we're odd in the States…it was fun to hear about why. The clinic is well stocked, and efficiently run- three of us can see 100 or so from 8-2:30, leaves time to visit the local cholera treatment center

 

They've treated 2000 patients since November 1st, but only 14 now, and not so very sick. There's  time to read the MSF (docs without borders) protocols, which are stuffy and bureaucratic- too slow to place an IV or NG, as though we were running out of supplies (we are not). They've gotten too big to be any fun, I think.

 It's more like a regular job, not so much drama.

 We met with local midwives, talked too long about clean water- they'll be our ayervedic foot doctors in the villages. One of them caught me dozing, we discovered both our youngest are both named Benjamin, got along famously

 

 

but I failed to get her number.

Saw a man with an incarcerated hernia, scrotum big as a grapefruit, could not get it reduced, and packed him off to Cap in a pickup

truck. Ambulances are something i've taken for granted.

 

 

 

 We met up with Trey Reid and Cameron, did a water chlorinator installation at the Bas Limbe clinic site. Trey is an Alabama country boy- easy to underestimate til he starts talking about Chloride diffusion rates, particulate counts, and Bernoulli comes up here too. 

The way it works is, Trey talks to the village literati about using the chlorinator, demonstrates the solar panel and the setup, and Cameron makes everybody glad they're there.

 

 

We drove back over rough roads to Cap Haitien, through well tended rice patties, hopeful country.

Still cooking with charcoal, gathered daily:

 

An altogether different looking Haiti...makes you feel better about things.