Saturday, November 27, 2010

Cholera in Cabaret

On Sunday night, I received a summons to go back to Cabaret to help at the Samaritan's Purse cholera treatment center (CTC). They were losing a lot of their volunteers at the beginning of the week and were going to be short-staffed. Could I come and help out for a few days?

I went out on Monday morning and was promptly handed the triage tent again. It was a similar picture: lots of children on the verge of collapse, lots of adults able to hold the rehydration fluids until they started vomiting, and lots of elderly folk who were either very feisty or very close to death. My favorites were the people who came and, after a little questioning, turned out to be suffering from a normal diarrhea and could be sent home with just a dose of cipro. My least favorites were the ones who got rushed in by taptap or moto-taxi and literally collapsed in my arms, no radial pulse, partially conscious, and so dehydrated that if you pinched their skin, it stayed exactly as you pinched it.

I was very fortunate this time around to have an emergency room doctor floating between triage and admit, so when those severe cases arrived, he was generally on hand to receive them while 2 wonderfully skilled nurses got IVs into the patients. A Haitian nurse worked with me in triage, refilling ORS cups and handling some of the discharges. Two young Haitian men helped with paperwork, handwashing, filling cups, and shoveling dirt over all the vomit and diarrhea.

One afternoon, a few of the staff had to leave to prepare for a flight so I was transferred to a tent of 13 hospitalized patients, adult and child. A few of them were quite sick and 6 of them were spiking fevers, possibly due to malaria, so it was a busy evening. I have never worked as a nurse in a hospital setting - this was the closest experience I've ever had! My patients all did well though, and I was very gratified to see that several of them did so well overnight that they were discharged when I returned in the morning.

Overall, rates are dropping in the Cabaret area. Last week, the CTC had about 200 inpatients. This week, it had closer to 100. And instead of receiving about 150 new patients through triage every day, we were receiving approximately 90. Although we were short-staffed and therefore working very hard, there was a general sense of relief at the downward trend. Of course, rates are now climbing in Cite Soleil so when Samaritan's Purse opens the site there this weekend, I may be called upon to help there as well.

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