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We were able to drive up to our clinic on Tuesday this week, finding the road very slippery and gutted out, but passable.  We had to put our jeep into 4-wheel drive “low” position, that gives the most power, so we could make it up some of the steep, slippery hills.  Our patients were grateful for our presence and we expect a large crowd on Thursday as well.  They walk for hours on very slippery, muddy paths to reach us, and we’re glad to be able to help meet their health needs.

Major losses from the hurricane in our area are mostly agricultural, with the loss of banana trees, coconuts and recently planted bean seeds.  One of the nearby Protestant churches had significant damage, as well as the pastor’s house, and some schools had damage to their roofs.  We’re working with local leaders to assess the extent of damage in the areas around our clinic site and will see how we can most help these communities.

At this point, the road between Cayes and Jérémie is closed to all traffic due to mudslides in the area around Beaumont.  We’ve seen the Port-au-Prince buses sitting in their stations in Jérémie for the past few days and now have an explanation as to why!

The cholera epidemic has now reached Port-au-Prince, according to Haitian government health officials.  Over 70 cases have been identified in people who live in Port-au-Prince, but contracted the disease while visiting outside the capital.  Several cases have been reported in patients who have not left the capital city, which means that it was acquired there, rather than in the area where the epidemic began.  This is a serious development, because it means that the bacteria causing cholera is now in Port-au-Prince itself.  Officials are setting up cholera centers throughout the city and clinics and hospitals are gearing up to handle the epidemic.  Flooding from the recent hurricane, Tomas, will only add to the risk of spread of the disease.

At this time, there are no reported cases of cholera in the Grand’Anse department where we are located.  We’re taking the epidemic seriously, however, and are augmenting our own stock of antibiotics, oral rehydration packets and IV fluids in preparation.  Each time we go up to our clinic, we do health teaching with our patients, instructing them to be careful about the water they drink and to practice good hygiene and hand-washing.  We also have several hundred “hygiene kits” that we will distribute in our area, if needed.  We appreciate your prayers as we attempt to deal with this new crisis.

As I write this blog (2:00pm CT on Friday, November 5th), the worst of Hurricane Tomas seems to be over. Warnings about the storm had been disseminated throughout the country all week and we watched the storm’s path on the internet several times a day.  Around midnight last night, heavy rains and fierce winds began, bending the coconut trees and snapping off branches of other, less flexible trees. Porch chairs were blown
over and the rain struck the house from all directions. From 6:00 – 8:00am, there was a bit of a lull, with calming of the winds and very little rain. But, then it began again with a vengeance, the wind knocking down most of the banana trees in the yard and the rains battering our closed windows. Here are some scenes from our house:

The latest news from Port-au-Prince is that it is raining heavily there also, with strong winds and areas of flooding. We are uncertain as to whether any of the tent camps have been flooded, as was feared. We are grateful that the storm did not hit the main part of the country directly, although it appears that there will be certain loss of crops, and possibly some lives as well. We expect to go up to our clinic on Monday and will assess the damage to the communities up there. We appreciate your prayers and your support as we seek to assist those in need here in Haiti.

I’m sure you are all aware from the news channels that there has been an outbreak of cholera in Haiti.  Cholera is a very deadly disease, causing severe diarrhea that leads quickly to dehydration and death.  This is the first time it has been reported in Haiti and is a very serious situation on top of all the other problems here related to the January earthquake.  It was first reported on October 20th in the town of St. Marc, which is located north of Port-au-Prince.  Since then, cases have been reported in the Artibonite, Central and North departments of the country (Haiti is divided into 10 departments, which are like states.  The department Jeremie is in is called the Grand’Anse).  Between October 20 and 27th, the Haitian Ministry of Health has reported 4649 confirmed cases of the disease and 305 deaths.

The Haitian government, UN, and other non-profit organizations already working in Haiti after the earthquake have now begun to respond to this new crisis.  Cholera treatment centers are being set up in affected areas, and water purification tablets and oral rehydration salts are being distributed, especially in camps where IDP’s (internally displaced persons) are living.  In addition, many organizations are mobilizing community health workers and other personnel to do community education and teach about prevention, especially emphasizing water purification and hand washing.

On Friday, October 29th, there were reports of demonstrations against Nepal UN forces who are stationed at a base near the Artibonite River.  Many feel that the Nepal soldiers are responsible for bringing the disease, which is endemic in their country, to Haiti, contaminating the Artibonite River, leading to spread of the disease.

Thus far, no cases have been reported in the Grand’Anse department and Jeremie.  We have been spending time during each of our clinic sessions, though, discussing the outbreak and teaching our patients basic prevention techniques.  We receive reports from the UN every 1-2 days and are keeping up with the progress being made in containing the outbreak.  Everyone here is hoping that the disease can be prevented from reaching Port-au-Prince, in which case, it would likely spread to the entire rest of the country.

We will keep you updated from time to time on this blog.  Please continue to pray for this country and its people.