Posted by: calloftheandes | October 29, 2010

Medical Team in Cité Soleil; Cholera Suspected There Also

Sources: HCJB Global, Haiti Libre, Samaritan’s Purse, Everyday Christian, BBC

Photos by Hermann Schirmacher
Story by Ralph Kurtenbach and Harold Goerzen

HCJB Global physicians treated a patient on Wednesday, believed to be the first confirmed cholera case in the city Cité Soleil, Haiti.

“The diagnosis of cholera was established by a doctor experienced in tropical medicine,” reported the newspaper, Haiti Libre. The patient was ordered hospitalized, whereas rehydration was ordered for another patient who may have cholera.

Dr. Mark Nelson with patients

HCJB Global Hands physician Mark Nelson described cholera as producing a “quiet” diarrhea. He traveled from Texas to rendezvous with the team that had flown in from Ecuador. Nelson, who has served with HCJB Global in Ecuador’s Amazon region, said cholera “dehydrates patients to the point of shock quickly and without the usual associated abdominal discomfort and fever that most diarrheal illnesses produce.”

“It’s really sinister how quickly and quietly patients go down,” he said, “The volume of fluid lost is really fast.”

Unlike five cholera cases reported by Doctors Without Borders, in Haiti’s capital, the Cité Soleil victim is not from the Artibonite district and had not traveled to an infected area, reported Haiti Libre. Artibonite is the most affected area, with the disease believed to be carried by waters of the Artibonite River.

“It is established that such person has not been out of Cité Soleil and it is a local case of disease transmission inside Cité Soleil,” the newspaper said. “If this case is confirmed by government health authorities, this will confirm the existence of an outbreak of infection independently, anywhere in the country’s largest slum, the worst scenario envisaged.”

Hermann Schirmacher with Haitian child

”We have not seen the two patients again,” said the HCJB Global Hands team leader, Hermann Schirmacher, “but it is known that if rehydration is employed, the patient is not in danger and almost always recuperates.”

At a rehydration center, 130 patients per day were treated earlier this week, but Nelson wrote that those numbers have decreased with effective intervention in the cholera epidemic. “Today there were “only” 36 patients, of whom 3 or 4 were critically ill,” Nelson said. “The efforts by the international relief community, much of it done by Samaritan’s Purse, have been largely effective in containing the cholera epidemic, but those that are sick are really, really sick.”

Dr. Francisco Nina examines a child.


Nelson asked for prayer as he and Bolivian physician, Francisco Nina, travel to Villard, some two hours outside of the capital, Port-au-Prince. A good road is accompanied by higher speeds and imprudent driving and Nelson considers bad accidents a constant threat.

On Tuesday team members Nelson, Schirmacher, Nina and Ian McFarland responded with Samaritan’s Purse staff to serious traffic accident on just 2½ miles from the Samaritan’s Purse (SP) base. “We left everything and went to the site of the accident where two large trucks had collided head-on, resulting in several deaths and leaving others injured,” Schirmacher wrote. “The injured were taken to the Mission of Hope base where the most serious were cared for. They were stabilized before being taken to a hospital.”

Ian McFarland assists with an intravenous drip.

Earlier this week SP’s country director, Matt Ellingson, said areas of Haiti report no cholera at all “yet the U.N.’s perspective from today is to treat this as a serious outbreak, and it matches what our epidemiologists and medical people here in the country are saying.”

The Ecuador team has been assigned to a rehydration center where SP teams are seeing more than 100 patients a day needing intensive oral and intravenous rehydration.

The center is in an area where a large “tent city” was set up after the quake and where SP staff members and volunteers have been visiting regularly.

This makes the third trip to Haiti for Nelson; McFarland and Schirmacher are there for a second time. It is the first time for Francisco Nina, a third year resident at Hospital Vozandes-Quito.

“This is a team that surpasses the wildest imagination with its international mix. It reflects the reality of the multicultural family of HCJB Global,” wrote Schirmacher. He then detailed how Nelson had lived in Venezuela as the son of U.S. missionaries. McFarland grew up in Northern Ireland and has raised his own family in Spain and Ecuador, whereas Dr. Nina is Bolivian. Schirmacher himself is a Paraguay-born descendent of German Mennonites who migrated to South America.

Even as Haitians wait for clean water at hydration stations, a pastor preaches the good news of salvation concerning the living water that satisfies eternal thirst, according to Schirmacher. “Six people who were waiting in the line for water—or to be seen as patients—accepted that invitation. They will know someday in heaven that this crisis that Haiti is experiencing was the day of their salvation!” he wrote.

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