Jim Schermerhorn is a Physician Assistant and HOPE volunteer in Haiti. His work following Hurricane Matthew is Jim’s third medical mission with HOPE this year. He was part of the HOPE team on the hospital ship, the USNS Mercy, for two deployments in 2016. Jim is also a member of the U.S. government’s Disaster Medical Assistance Team (DMAT) that responded to the flooding in Louisiana earlier this year.
This is my third time in Haiti. I was here in 2011 for the first serious cholera outbreak in Haiti and I was also here in 2008. Haiti is a difficult place to work. There are lots of challenges for health care providers and that’s what we’re here to address.
I am part of a team that was deployed two weeks ago to help assess how Project HOPE could best address the possibility of a surge in cholera following Hurricane Matthew. I have been concentrating on working with the St. Therese Hospital in Miragoane in the Nippes region. I’m working with health authorities as part of the Project HOPE team and coordinating with other NGOs that are working in this area. We’re focused on developing an outline of a plan that would address cholera at St. Therese Hospital.
There are ongoing staff shortages and a lack of resources at the hospital and many challenges in the health system as a whole, before you add cholera into the mix. At St. Therese, there are patients that also need regular medical care.
The case definition of cholera is watery diarrhea which is identified in an area or region that has already tested positive for cholera. In this area in Nippes, they have documented cholera. This means that every case of watery diarrhea is considered suspected cholera and we have no way to determine whether it is cholera because the hospital doesn’t have the ability to test for the disease. But what the hospital is doing is separating all of those patients who have the case definition of cholera and they are staying in a separate area in a separate building within the hospital compound and they receive IV medication. But currently, the hospital does not have the medications and the antibiotics and the support services and staff to work both in the hospital and in the separate cholera area.
We have seen several people with watery diarrhea. In fact the two nurse practitioners I am working with referred one case over today for a patient to be moved to the separate area for people with suspected cholera. This is not a high cholera situation right now. What we are concerned about is that it very easily could be. So we have to come up with a plan to address the possible scenario where the hospital could go from the one or two cases of watery diarrhea to 15 or 20 or 50 or 75. If that happens, could the hospital handle it? That’s the challenge that we have and that’s what I’m trying to work on.
I have participated in international humanitarian assistance disaster response work for many years with many different organizations, including Project HOPE. I think the best way that those of us in the United States can help people in developing countries like Haiti is to work in close coordination with the health authorities and other NGOs to build the health infrastructure and capacity of health workers here.
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