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Archive for October, 2010


Project Medishare’s certified prosthetic orthotist (CPO) Davor Krchelich works to make a hand washing bucket. The Ministry of Health has asked Hospital Bernard Mevs Project Medishare (HBMPM) to make room for cholera patients should the outbreak hit Port-au-Prince. While there have been no cholera cases at HBMPM, staff are preparing for the worst. Hand washing stations will be set up at strategic points around the hospital to help patients and staff stay safe from spreading cholera should a case be admitted to the hospital. Photo by Jennifer Browning.

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Dr. Pretanville from Partners in Health's(PIH) sister organization, Zanmi Lasante, talks to Project Medishare community health agents about cholera. Photo by Jennifer Browning.

By Jennifer Browning

Fighting something like a cholera outbreak cannot be done by one organization alone. Project Medishare realizes this and the importance of working with partners who share the same ideology. In this case, it is not just treating cholera but focusing to educate on how to prevent it.

Project Medishare has been directly involved in helping stop the spread of this deadly disease by networking with the Haitian Ministry of Health,  Zanmi Lasanté, the American Red Cross and many other partnering NGOs so we can assist as much as possible.

In a meeting this week with health agents, Dr. Pretanville from PIH/Zanmi Lasante, spoke to Project Medishare community health agents about cholera. He detailed what causes the disease, how to prevent it, and how it can be treated.  Joining Dr. Pretanville were other PIH health agents joining Project Medishare in the campaign to educate the community.

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This past weekend, nine-month old Bidina Joseph received endoscopic third ventriculostomy (ETV) to treat her hydrocephalus. Today Magdala will take Bidina back to their home in Ti Goave, a two-hour drive from Port-au-Prince. Magdala said she is so thankful for the pediatric neurosurgery team who helped her daughter. Over a three-day period a pediatric neurosurgery team from Washington University School of Medicine performed 22 surgeries. Photo by Jennifer Browning.

By Jennifer Browning

Magdala Ezeve started noticing Bidina’s head was growing abnormally larger when her baby was three months old.

She brought Bidina to Bernard Mevs in February. At that time, Project Medishare’s nurse liaison Maguy Rochelin was working at the field hospital assisting medical staff with earthquake victims. After a call from a Bernard Mevs nurse stopped by the hospital on her way home, met with Magdala, retrieved all of her information and told her she would contact her when pediatric neurosurgeons arrived to do another assessment for children with hydrocephalus.

Earlier this month, Dr. Keith Rich from Washington University School of Medicine assessed Bidina and determined she was a candidate for surgery. This past weekend in spite of the cholera outbreak, Dr. Rich and his team of pediatric neurosurgeons performed an endoscopic third ventriculostomy (ETV) on Bidina.

Today Magdala will take Bidina back to their home in Ti Goave, a two-hour drive from Port-au-Prince. Magdala said she is so thankful for Dr. Rich being able to help her daughter.

“I am so very happy because before the surgery she had a crooked eye that was going to the left,” Magdala said. “I was so worried about this, but today it is already looking normal. My daughter is happy, she is playing with me and laughing.”

Over a three-day period the pediatric neurosurgery team performed 22 surgeries. Eleven of those children have already been cleared to return home, and five more, including Bidina, will be discharged from the hospital today.

For follow-up appointments parents will be able to take their children to Healing Hands, one of Project Medishare’s partners, or return to Hospital Bernard Mevs Project Medishare. For those who do their follow-up through Healing Hands, Natacha Guillaume, a clinical manager with Healing Hands, will send a report to Maguy so Project Medishare can continue to have an accurate case file of the patient.

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Event Star crews flew to Haiti yesterday to set up a Project Medishare tent in Mirebalais which will be used as a cholera treatment center. After the cholera outbreak was confirmed, the Ministry of Health asked Project Medishare for assistance particularly with providing tents and important medical supplies such as IVs, IV starting kits and cots. Photo by Jennifer Browning.

By Jennifer Browning

After the cholera outbreak was confirmed, the Ministry of Health asked Project Medishare for assistance particularly with providing tents and important medical supplies such as IVs, IV starting kits and cots. One tent, which was previously used as an operating room at the Project Medishare field hospital, was set up yesterday in Mirebalais by Miami Event Star crews.

Event Star crew member explains what else will be needed to complete the tent with Project Medishare's Country Director Marie Chery and Zanmi Lasante's Dr. David Walton. A tent previously used as an operating room at the Project Medishare field hospital after the earthquake was set up in Mirebalais by Miami Event Star crews. The tent will provide a place for a cholera treatment center, which will collaboratively be set up by Project Medishare and Partners in Health’s(PIH) Zanmi Lasante (ZL). Photo by Jennifer Browning.

The tent will provide a place to set up a cholera treatment center which will collaboratively be set up by Project Medishare and Partners in Health’s(PIH) Zanmi Lasante (ZL).

Today both organizations are working together to see that wooden floors are secured in the tent and that cots are in place so that patients can be transferred as soon as possible.

PIH’s Dr. David Walker said cholera patients currently receiving care at the hospital in Mirebalais and the clinic in Las Cahobas should begin being transferred to the cholera treatment center by tomorrow at the latest.

A Ministry of Health community nurse is in charge of arranging the staffing needs at the cholera treatment center. Project Medishare staff and volunteers are standing by should the need arise.

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Project Medishare medical and office staff go out into the community to get the message out about cholera. Without community health programs like this one, it would be almost impossible to spread the word about prevention to keep people safe. Photo by Jennifer Browning.

By Jennifer Browning

In NPR’s Health Experts Keep Close Eye on Cholera in Haiti, Christopher Joyce discusses Haiti’s health worker’s focus on prevention and education and how it is vital to keep cholera at bay. Epidemiologists working with the International Organization for Migration have begun to do this by tracking those from the Artibonite region where the outbreak started. Officials are using cell phone records to track people who are leaving the area for fear that these people may possibly be infected. Epidemiologists are sending these people text messages providing a free number to call. Those who do call learn not only how to avoid spreading the disease, but also what to do if they get infected.
Project Medishare has joined forces with the Haitian Ministry of Health as well as other partnering organizations such as Partners in Health’s Zanmi Lasante, American Red Cross, and other NGOs to get the message out about cholera, including how to prevent it and how it is treated.

In Joyce’s article, Sabrina Pourmand-Nolan, local director for World Vision, advocates that in order for Haiti to prevent cholera from becoming a permanent plague, it will take more than proper sewage to keep the Caribbean country out of the woods.

Project Medishare community health nurse Wiseline Celestine uses a megaphone to make people aware about cholera and the ways to prevent contracting the disease. Photo by Jennifer Browning.

“It’s not just about getting proper sewage,” Pourmand-Nolan told NPR, “it’s about getting proper educational facilities, proper health facilities. That’s how we are going to protect the people over the long term.”

Project Medishare began working in rural Haiti in 1994 with a focus on empowering the people to support a community health program. Today, based in Thomonde, in Haiti’s Central Plateau, the organization continues its mission to improve access to healthcare in Haiti.

When the word got out that cholera was raging across the nearby Artibonite area, Project Medishare mobilized 82 community health agents who immediately began getting the message out to their communities. They were joined by 20 other community health doctors and nurses and office staff.

And while, the organization’s doctors, nurses, pharmacists and health agents are out in the community each day, it is times like these that provide a reminder regarding the importance of this community health program in Haiti’s Central Plateau.  Without programs like this one, it would be almost impossible to spread the word about prevention to keep people safe.

Project Medishare’s community health and development program exists on private donations. If you would like to make a donation to keep these programs in action click here to make a secure online donation today.

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RADIO TALK: Community health nurse Wiseline Celestine and staff member Ronel Marcellus go live on the airvaves at a Thomonde radio station talking about cholera and how to prevent the disease. The Project Medishare staff created a skit which discusses the importance of hand washing, boiling drinking water, cooking food thoroughly, avoiding fish from the Artibonite River along with raw fruit, and using regular and pit latrines appropriately as to limit exposure of disease. Photo by Jennifer Browning.

By Jennifer Browning

As part of Project Medishare’s Cholera Prevention and Education campaign, community health nurse Wiseline Celestine and Ronel Marcellus, Project Medishare’s bookkeeper, in Thomonde created a skit, which is airing on three radio stations that have far reach in the upper region of the Central Plateau. The radio skit discusses the importance of hand washing, boiling drinking water, cooking food thoroughly, avoiding fish from the Artibonite River along with raw fruit, and using regular and pit latrines appropriately as to limit exposure of disease.

Project Medishare and its community health agents hope that this education campaign will prevent the spread of cholera in the communities we serve, however should the outbreak reach our area, we have a treatment plan to activate immediately.

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Linda Mondesir, a bookkeeper at Project Medishare's Thomonde office, assists medical staff and community health agents distribute life saving water purification tablets. Staff and health agents go out into the community each day to spread the message regarding preventing cholera. The distribution is in combination with the current cholera education and prevention campaign. Photo by Jennifer Browning.

By Jennifer Browning

Community health agents and staff spread out among the community again today to continue raising awareness about the cholera outbreak that has devastated the Artibonite region, which is west of Thomonde and other communities Project Medihare serves. In addition to reinforcing their prevention message, the health agents also distributed water purification tablets.

In Thomonde, medical and office staff used a small generator to hook up a sound system to attract attention. At certain points in town, the truck stopped and as people gathered the team would begin talking about the cholera outbreak and how cases had been confirmed in nearby Mirebalais. They also talked about ways to prevent acquiring the disease.

Some people had questions such as why they couldn’t eat raw fruit and vegetables, or why was it no longer safe to eat fish from the nearby river. The Medishare staff patiently answered all questions and then began to explain how to use the water purification tablets before distributing them to all who gathered.

Due to the rapid progression of the illness along with concerns that many patients may be remaining at home when symptoms become present, Project Medishare is working actively within the communities in the Central Plateau. Project Medishare’s

People gather to listen to Project Medishare staff discuss the cholera outbreak happening in the Artibonite area and nearby Mirebalais. Medical staff and community health agents are teaming together to spread the word so that people understand hand washing and drinking clean water can prevent a cholera infection. Photo by Jennifer Browning.

community health agents are actively participating in our education and prevention campaign. They have not only spread out through our communities, but have also penetrated areas in nearby Hinche.

These health agents are using motorcycles to reach the most rural areas we serve and are equipped with megaphones to gather attention of the people. At these community meetings they are distributing items to help keep the community safe such as chlorine tablets, liquid bleach and oral rehydration kits.

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Project Medishare community health nurse Wiseline Celestine hands a box of oral rehydration packets to a community health agent. Project Medishare's health agents are working feverishly to educate the people in order to prevent cholera in their communities. Photo by Jennifer Browning.

By Jennifer Browning

Forty community health agents gathered at the Project Medishare office in Thomonde today to meet with Country Director Marie Chery, Dr. Serge Pintro, Zanmi Lasante doctors and Project Medishare medical staff. After the meeting the staff handed out water purification tablets and oral rehydration solution to community health agents. The health agents will distribute these items to those in their community reminding them how important it is they follow specific prevention guidelines.

Project Medishare  medical staff reinforced the prevention guidelines.

Federick Fanel, a health agent with Partners In Health’s sister organization, Zanmi Lasante, was also invited to attend to help spread the word in the community. Fanel, who is also a teacher in Thomonde, said he learned much at the meeting.

“They not only reinforced the importance of boiling and treating water, but also how important it is to disinfect the latrines. In rural Haiti, there are many people without latrines, so it is important that we instruct them how to properly build a pit latrine by digging a deep hole, and more importantly covering it properly after use.”

Each community health agent received a large box full of bottles of water purification tablets to distribute in their communities. They also received oral rehydration packets to have on hand in case they encountered anyone with cholera symptoms. Photo by Jennifer Browning.

Fanel said that he also learned how to instruct others on how to make their own oral rehydration solution, if they did not have any of the ready-made packets on hand.

During the meeting Dr. Malou Phanord also stressed to the health agents how important home visits were at this time.

“Home visits are even more important today, because there may be some who have symptoms and stay at home,” she said.

Should a health agent notice a person with cholera symptoms, Project Medishare community health nurse Wiseline Celestine also gave specific instructions on what the health agent should do. Because cholera severely dehydrates its victim, it can kill within hours.

“If someone has diarrhea as a symptom, before you take them to the hospital, it is important to immediately start giving them the rehydration solution,” Celestine told the health agents. “This will help them stay hydrated on their way to the hospital. Many of the deaths in Artibonite were on the way to the hospital, because they were not able to hydrate before leaving for the hospital.”

She then talked about how it was necessary for all the water people used to be purified.

“It is important to tell them to use these purification tablets to not only purify the water they drink, but all water,” she said. “They must treat the water they bathe in, the water where they wash their dishes and their clothes. It is a lot of effort, but it is very necessary!”

Benet Joacime, a supervisor for health agents stationed in very rural Baille Touribe said he appreciates meetings like the one today because it allows for good communication between the Project Medishare medical staff and the health agents.

“When we learned that cholera had started in the Artibonite, we immediately went out to our sections and started educating about preventing cholera,” Joacime said.

For Joacime, he said it was important to make sure all of the community health agents in his area were organized and understood how to educate each area about prevention.

“It is a big responsibility because I have to make sure my community is safe,” he said, “so I have to put more leadership out to my agents, and be really organized to make sure everyone understand how important this is.”

He continued to explain how the health agents are using all of Project Medishare’s resources to spread the word. Health agents who oversee hard to reach areas are given motorcycles and all agents are given megaphones to speak to large groups and community education rallies.

At these community cholera prevention meetings, Benet said people listen closely.

“From what we see, people are very afraid of this disease,” he said. “They listen on the radio and they hear how bad things are in the Artibonite, so they really know how important it is to follow our instructions.”

When we were notified of the outbreak, the purification tablets and disinfectants weren’t available for us to distribute to the communities,” Joacime said. “People were worried. We continually heard ‘how can I protect my family?’ ‘How do we purify the water?’”

Without the purification tablets to distribute, Joacime said that health agents stressed the importance of boiling water, cooking food thoroughly and steering clear of raw fruits and vegetables. However, now they can help the people in their community go one step further in making sure the water they use is clean.

“Now that we have these important items to hand out to the people. We can go back to our communities and as we distribute the purification tablets and rehydration solution, we can reinforce the message,” he said. “We are so grateful that we have these to give to the people in our community to keep them safe.”

*Laurene Leger contributed to this story.

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Pediatrician Dr. Heidi Sandige and neurology resident Suzanne Schindler measure 9-month-old Shaina Shirley Vil’s head to asses the child's condition before recommending surgery. Dr. Sandige and Schindler are part of a pediatric neurosurgical team led by Dr. Keith Rich from Washington University School of Medicine. Photo by Jennifer Browning.

By Jennifer Browning

A pediatric neurosurgical team is working this week at Hospital Bernard Mevs Project Medishare. Last weekend Dr. Keith Rich was at the hospital participating in a neurological assessment of prospective surgical patients, as well as providing follow-up care to others.

Pediatric neurosurgery teams have been coming to Haiti since 2003 to provide surgeries to children with hydrocephalus. Those surgeries in the past have been primarily performed by neurologist Dr. John Ragheb and his team from the University of Miami Miller School of Medicine. While Dr. Rich and some of his team have participated in Project Medishare’s specialty surgical trips with Dr. Ragheb, this is the first time Washington University School of Medicine has organized their own pediatric neurosurgical trip to Haiti.

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Project Medishare volunteers Dave Bompart and Sam Perales help organize supplies donated by Hospital Bernard Mevs Project Medishare (HBMPM). The supplies will be sent to St. Nicholas Hospital in Saint-Marc. The Ministry of Health has asked Project Medishare for assistance particularly with providing tents and important medical supplies such as IVs, IV starting kits and cots. Photo by PJ Pitts.

By Jennifer Browning

Project Medishare is on the front lines in Haiti responding to the deadly cholera outbreak that has infected thousands of people.

Project Medishare has been directly involved in helping stop the spread of this deadly disease by networking with the Haitian Ministry of Health, Partners in Health–through their sister organization Zanmi Lasanté, the American Red Cross and many other partnering NGOs so we can assist as much as possible.

The Ministry of Health has asked Project Medishare for assistance particularly with providing tents and important medical supplies such as IVs, IV starting kits and cots. We are making the large tents that were used at the field hospital available to be used as cholera treatment centers. One of those tents will go to Mirebalais, which is halfway between Port-au-Prince and our community health program in Thomonde.

Cholera cases have been confirmed in Port-au-Prince, however it is believed that these cases were contracted in communities outside the capital. Currently, Hospital Bernard Mevs Project Medishare has made room available for patients suffering from cholera.

This weekend several of our staff traveled to Saint-Marc to assist doctors at St. Nicholas Hospital.

Project Medishare’s efforts are sustained by individual donations. If you would like to help us continue our efforts in assisting Haiti through this grim time, please click here to make a secure online donation today.

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