Saturday, January 01, 2011

Haiti: Again…

It’s an odd thing getting a glimpse of something you know well from a time somewhere in the distant past. That distant past for me was 32 years ago, when I spent several months in a refugee camp in Cambodia as medical director of pediatrics. I was a senior resident in pediatrics and had 6 months to go before I started my fellowship in critical care at Johns Hopkins. And here I was in Cambodia. How I got there, and how I got to finish my residency in a refugee camp is a whole different story. But happen it did. image

I look more or less the same after 32 years (“more” round, and “less” hair), and have been traveling the world doing third world medicine ever since. But what does all that have to do with the fact that tomorrow, a team of 14 of us leave for Haiti? Again? It’s the cholera thing. We had 2 epidemics in the Cambodian refugee camp while I was there: measles and cholera. I actually got measles encephalitis and was evacuated to Bangkok where I was in the  ICU for a week, comatose with cerebral measles. I woke up, had lost 15 pounds (it’s all back now thank you very much), and went right back to the refugee camp to keep working. That aside, it was the deaths that we saw. On day one of the refugee camp opening (around Christmas day 1980), I lost over 100 children. Every day was the same as waves and waves of refugees came over a mountain range being chased by communist insurgents. It finally slowed down, then the epidemics hit. Measles first. Hundreds of deaths from measles pneumonia, never seen here in the US. Then it was the cholera. Close quarters, hygiene issues (150,000 refugees cramped into about 10 acres), and poor control. I learned about cholera quickly, and how to treat it. I’ve never had to use that knowledge again until a few months ago. Haiti brought back the memories. The glimpses of those times, offer a valuable reminder that things sometimes don’t change. Poor sanitation, hygiene and dirty water, brings cholera to the forefront and with it its devastation. And that’s why we’re going. After my assessment trip a few weeks ago, it became clear that we needed to go back and reinforce the education and prevention programs we put into place. We’ll be doing that, examining all the children again, and doing a nutritional assessment on all of them. We’ll put those who are moderately or severely malnourished into a comprehensive nutritional ruse program using Medika Mamba (a peanut butter paste). We’ll go to 15 projects and see about 1700 children.

Glimpsing the past does change the way you look at things in the present. I know what needs to be done. I’ve seen it and have lived it. The team is ready, and we are off to face the battle. Bring it!

In all things give thanks,