CDC Cholera Prevention Materials for Haiti

The CDC has just published cholera prevention manuals for use by local community health workers in Haiti.  The manual is available in English, French and Haitian Creole and is on-line at www.cdc.gov/cholera/materials.html. Direct links to the English and Creole versions can also be found at the end of this posting.

The manual covers prevention topics such as hand-washing, oral rehydration solution and safe drinking water.  It also features decisions related to caring for those who are stricken.  There is a section of community education cards and low literacy posters.  An optional power-point presentation is available, if needed.

http://www.cdc.gov/cholera/pdf/chw_trainingmaterialsforcholera_v2.pdf
http://www.cdc.gov/cholera/pdf/chw_trainingmaterialsforcholera_creole_v2.pdf

Lenten Reflection by Paulette West, Executive Director UMVIM, SEJ

United Methodist Volunteers in Mission April 22, 2011

It is finished...A reflection upon returning home from Haiti  I find Haiti one of the most difficult places to serve.  It was hard for me to be there again.  Perhaps for me, part of the difficulty lies in facing and acknowledging my own shortcomings, weaknesses and sin.  When Jesus spoke those words, "It is finished" -   I think to myself, "But it is not finished; just the beginning."  Perhaps what was finished was the suffering and death required for new life.   I realize that whatever I struggle with, sacrifice or give is nothing when compared to the struggles and sacrifice of Jesus.  His mission to show us the depth of God's love and mercy wasn't finished but just the beginning of what He expects of us.      As I reflect back on the week serving in Haiti (April 1-8) and think about Easter approaching, I realize that the only hope for Haiti is resurrection- new life.    In the year since I was in Haiti following the earthquake, there is still devastation and rubble in many places, still tent cities, and still the poor masses; but there are also many glimpses of new life taking place. As I think about last week, I am reminded of the places where resurrection is taking place.  Life continues around and despite of the destruction.  Security walls are being rebuilt; schools and churches repaired.   Returning to College Bird, no longer is there a structure ravaged and fractured - the rubble has been removed and temporary classrooms give students an opportunity to learn.  A year ago at Grace Hospital, a malnourished infant boy lay in a crib in a military tent because the buildings were crumbling and unsafe.  His face remained with me as I worried and wondered if he died.  During our tour of the new temporary structures, Roberson shared that he too thought Paulo would not survive; but was thrilled to share that his health improved and the mother that had abandoned him returned to take him back three months later.   New life and hope for a future.  On Tuesday with the announcement of the new president, you could see the sense of hope in the celebration of the people in the community.  A chance for changes where corruption and oppression end and new opportunities and hope may exist for the Haitian people.  Our mission in Haiti was finished; but it is not finished for Haiti as it is not finished for us.  When He said "It is finished", Jesus may have only been referring to the fact that his death accomplished the mission that God had sent him.  But his resurrection meant so much more - new life and hope!  The love I have can never compare to His love for the world yet I know that I am called to share His love with others.  So how do I embody and share this incredible love?  I'm afraid I don't always do it well.  But I will continue to try because I am one of the Easter people. The hope for Haiti is the resurrected Christ; the hope for all of us is found in His love.  May you continue to share the hope and love of the resurrected Christ with others in all you do. Paulette West, Executive Director UMVIM, SEJ Important Notice: Our office will be closed Friday, April 22 and Monday April 25 in observance of Easter. Should you have an immediate need, please email: sejinfo@umvim.org

UMVIM, SEJ United Methodist Volunteers in Mission www.umvim.org www.umvimsej.wordpress.com Donate to UMVIM, SEJ!

HAPI Focuses on Health and Wellness: An Advance Special Option

We can make our plans, but the LORD determines our steps. (Proverbs 16:9) We are always planning: daily, weekly, monthly, annually, the 5-year plan and the 20! Some of those best-laid plans are realized and others discarded or transformed. The one certainty: God always shows up in surprising and delightful ways, leading us on paths we hadn't imagined.


Such has been the journey of HAPI. We've laid our plans for 2011 and we step out in faith, courage and a sense of freedom and adventure that arises out of walking in the will of God, knowing the he has plans to prosper us, not harm us, to give us hope and a future!
Shalom,

Valerie Mossman-Celestin
U.S. Executive Director
Haitian Artisans for Peace International (HAPI)

Health, Healing & Wholeness - Water filters NEW!

GET INVOLVED

Health, Healing & Wholeness
Clinic

Gabriel & her baby girl would have been mortality statistics if not for assistance from HAPI's clinic to access an emergency c-section.

Annual budget: $7000*

Suggested contribution: $100

*Includes nurse & benevolence fund. Pharmaceuticals are contributed by medical teams.

Long-Term Health Volunteers Needed

Hôpital Albert Schweitzer Haiti Saving lives, changing lives for more than 50 years... Check out our new Website! QUICK LINKS Blog Dear HAS Alumni:     Hopital Albert Schweitzer Haiti has made great progress in its long-term goal of ensuring that the core permanent medical and nursing staff is composed primarily of Haitian clinicians, with support being provided by international clinicians to fill in gaps in specialties or vacation coverage. Due to the challenges to the Haitian medical system since the earthquake and the cholera epidemic, many physicians and critical nursing staff have left for Europe and the United States, or to large international NGOs in Haiti. Therefore, this model cannot be sustained at the present time, and HAS finds itself in need of several core staff volunteers willing to commit to a minimum of one year of service. These include, on a high priority basis, the following positions: Anesthesia, either nurse-anesthetist or anesthesiologist. The shortage in this service is a rate-limiting variable for the provision of full-time surgical coverage.  Surgery with capabilities in orthopedics, to support the needs of a large number of trauma victims.  This physician should be versatile, and also capable of supporting the demands from general surgery patients. Long-term physicians will find that fluency in French is of great benefit, as is a willingness to learn functional Kreyol. Translators will be provided as necessary, but somewhat impede the direct communications between medical professionals. As usual, HAS will continue to need the support of short-term specialists in plastic surgery, pediatric surgery, gastroenterology,and other disciplines.  Questions and expressions of interest should be directed to:  Dr. John Judson drjudson@aol.com 717-877-0871 (US)

CHOLERA IN HAITI: IMPLICATIONS FOR HEALTH CARE VOLUNTEERS

In late October of 2010 the unthinkable happened. Only 9 short months before, Haiti had undergone a devastating earthquake that destroyed much of the country’s infrastructure, and left many thousand dead and a million people homeless. Now cholera, which had not been seen in the country for many decades, swept through the countryside and the refugee camps. By the end of the year more than 170,000 cases had been reported, with 3600 deaths, and no end is in sight. The outbreak appears to have originated from a single source, possibly from a member of a Nepalese peacekeeping force, as the specific serotype is endemic to the same area of Asia.
Cholera is an acute bacterial infection of the intestines, caused by Vibrio cholerae. A toxin that the bacterium produces causes acute watery diarrhea and subsequent dehydration. The disease usually results from drinking water contaminated by human feces, less often from poorly cooked food. Person to person transmission is rare. For a cholera epidemic to occur there usually must be a significant breakdown in water supply, sanitation, and personal hygiene. Infection is most often inapparent or produces only mild symptoms. Only 5% have a severe disease with massive diarrhea and rapid dehydration, leading to death in 50% of cases if untreated. Mild to moderate infection can be treated with Oral Rehydration Therapy, (ORT). More severe infection, and/or the presence of intractable vomiting, usually requires the use of intravenous fluids. Ringer’s Lactate is preferred. Antibiotic therapy with doxycycline or azithromycin may shorten the course and prevent spread, and is recommended by WHO for moderate or severe infection. The CDC and WHO are not currently recommending the cholera vaccine, either for travelers to Haiti, health workers in epidemic or endemic countries, or in Haiti populations at risk during the epidemic.

In an article from Lancet, Partners in Health, who have worked extensively in Haiti for many years, and have provided exemplary care during both the earthquake and the cholera epidemic, propose five complementary interventions that may slow the current epidemic in Haiti:

1. Identify and treat all those with symptomatic cholera: consider all modes of therapy, including antibiotics. Antibiotics are currently being used only in severe infections. Wider use would shorten the duration of infection and the carriage of the bacterium.

2. Make oral cholera vaccines available in Haiti and elsewhere. Current recommendations from WHO do not recommend routine use during the current epidemic. This decision is based on cost and logistical considerations which, in Partners in Health estimation, are not insurmountable.

The widespread use of vaccines could save thousands of lives.

3. Remedy Haiti’s water insecurity and improve sanitation, emphasizing separation of the water supply from fecal contamination, a measure that has not been sufficiently emphasized by aid organizations This step will have an additional benefit by improving the overall health of communities.

4. All health projects must be dedicated to improving Haiti’s overall health system.

This important step has often been ignored by aid organizations

5. Cholera demands a global health policy, one not based on gross domestic product. “The goals of responding to cholera in Haiti should look the same as the goals of responding to cholera in the Dominican Republic or Florida. No epidemic of cholera is local for long. In this dire emergency we can accept nothing less than complementary prevention and care” 3

References

1. Haiti Cholera Outbreak: Information for Health Providers. cdc.gov. 2010

2. Frieden et al: Public Health in Haiti—Challenges and Progress. NEJM.org, 1056, 2010

3. Ivers, Farmer et al: Five Complementary Interventions to Slow Cholera in Haiti: Lancet 376, 2048-51, 2010

Submitted by Roger Boe MD

UMCOR Featured on Dec. 5th CBS-TV Special on Haiti

NEW YORK (UMNS) — Relief efforts after the Jan. 12 earthquake are highlighted in a CBS-TV religion special, “Haiti: Religion’s Response to Disaster,” which will begin broadcast on Sunday, Dec. 5. Check local television listings for times. Members of the United Methodist Committee on Relief, Church World Service, Catholic Relief Services and the Jewish Distribution Committee will share stories about their work with viewers. Melissa Crutchfield of UMCOR talks about the Haitian people’s struggle for survival and her agency’s renewed efforts and commitment in Haiti.

Creole Cholera Handout for Health Volunteers in Haiti

 I just wanted to share the information from the health book I've compiled concerning diarrhea, rehydration and [added today] Cholera. With hydration the death rate can be dropped from 50% to under 1%. Please feel free to share with anyone who can be helped. [E-mail, or print hard copies]. If you know folks who talk on the radio please share this information with them as well. With knowledge --hand washing, careful food and water choices, and RAPID/aggressive hydration many lives can be saved. Praying. Dr. Kris

Kolera: Kolera ka bay dyaré sévè. Bakteri kolera ka kontaminé sa n’ap bwè ak manjé n’ap manjé. Si kolera kapab léjé, men 10% vin grav é kabap tiyé moun tre vit. Moun [possib san sentòm] kontajyé pou 7 a 14 jou. Pi fò ka gen ti dyaré koz chimik toksik bakteri fè, 1 a 5 jou apré ékspozé. [Dyaré # 242-249]

Sentòm Sévè Kolera: Dyaré sévè tankou dlo, kapab gin glè, kapab sanblé koulé lèt. Dyaré kapab grav paské kèk moun pèdi 0.95 L likid chak é. Vomisman é dyaré kapab grav paské li kapab kòz yo dévni dézidraté, yo vin dézidraté lè yo pèdi twòp likid nan kò yo. Lòt sentòm enkli: nozé, vomi, kranp mis, dézidratasyon [rapid, fo], é chòk. Timoun fé mim sentòm é kapab gin fatig, koma, fyèv é kriz [#18]

Ris & Konplicasyon Kolera: Moun avèk malnitrisyon, asid mank nan vant, bay swen moun avèk kolera, sistèm iminité fèb, oubyen pa pran asé atansyon ijenn. Konplicasyon: rapid dézidraté kapab touyé nan 2 a 3 é. San trètman, moun ki pat grav vit kapab mouri apwé 1 a 7 jou.

Anpéche Kolera: Pran gwo prékosyon: lavé men avèk anpil atansyon souvan [avèk savon]. Apwé ou fin touché moun nan oubyen touché nenpòt likid kò moun malad la oubyen watè li. Lavé men avèk savon chak fwa yo watè ou pipi. Bwè dlo trété. Manjé kuit, byen cho. Bwe lèt bouyi.

Trètman Kolera: RANPLASE LIKID!!! Bay SRO souvan jiska moun pipi byen. Si li ka selma bwè kek kiyè pa fwa, by chak 3 ou 4 minit. San ranplase likid, mwatye moun grav va mouri men avek asé likid pi piti pase 1% va mouri. Si li vomi oubyen pa ka bwe asé, pa pwan anpil tan, alé tousuit nan klinik! Li possib moun va bezwen séwòm nan venn. Antibyotik é zin kapab diminyé dyaré é vomisman. Trèzenpòtan pou konmansé trètman rapid paské moun kapab vin grav vit.

Dyaré
Dyaré Lakòz Yo: Viris, mikwòb, parazit, maladi malmanjé [malnitrisyon], dlo pa trété, manjé gaté, fyèv malarya, SIDA, alèji, moun lèt bay konplikasyon, éfè ségondè akoz de rémèd, pwazon, twòp manjé fri, twòp manjé avèk grès.

Vomisman é Dyaré [Vant Pase]: Vomisman é dyaré kapab rézilta viris, mikwòb, parazit yo, manjé ki mal dijéré [kòm twòp manjé dous] é lòt bagay yo. Vomisman é dyaré kapab nwizib pou timoun yo paské li kapab kòz yo dévni dézidraté, yo vin dézidraté lè yo pèdi twòp likid nan kò yo. Ti bébé yo kapab dézidraté byen vit. Men dézidratasyon kapab rivé yon moun a nenpòt laj.

Siy dézidratasyon:

• rechiya

• pa manjé byen ké nòmal

• pèdi pwa

• pa pipi souvan ké nòmal

• pipi pi fonsé ké nòmal

• kè ap bat vit

• bouch sèch

• swaf [bébé yo kapab montré ké yo swaf lè yo ap kriyé é yo rechiya é yo gen gran dezi pou bwè lè moun ofri yo]

• jé yo vin fon

• pa gen dlo nan jé li, lè li kriyé

• platon tèt vin ba [koté nan tèt ki toujou mou paské zo pankò fémen] nan bébé yo ki mwens ké 18 mwa

Ranplase Likid: Si pitit ou gen tan vomi ou gen dyaré pou plizyè è de tan li va bézwen bwè likid pou ranplase sa li té pèdi. Ankouragé timoun bwè dlo é lòt likid klè. Mandé doktè konsénan SRO solisyon pou bébé ou ka anfòm. Lè gen bon mélanj sèl, sik, potasyóm é lòt éléman pou ranplasé sa ki te pèdi nankò a.

Séwòm Nan Bouch, Trètman Dézidratasyon: SRO. Yon lit [twa boutèy kola] + 4 gwo kiyè san tiyon sik [ou 2 gwo kiyè tiyon] + 1 ti kiyè san tiyon sèl. Bay moun pou dyaré oubyen vomi ki pa grav. Bwè ti kras chak 15-20 minit. Si moun bwè asé li va bézwen pipi 4 ou 5 fwa pa jou. Si pipi fò sa kapab di moun bézwen bwè plis, si pipi vin pal sa vlé di moun bwè asé. Pou Kolera kék moun bezwen bwe chak 2-5 minit.

SRO: Si pitit ou gen dyaré men li pa vomi, bay li SRO libréman. Doktè a kapab mandé ou règle ki kantité pitit ou bwè. Ou kapab sèvi ak yon konngout, yon kiyè ou yon ti vé kòm yo sèvi pou bay rémèd.

Pitit Vomi: Si pitit ou ap vomi [avèk ou san dyaré] éséyé bay li ti kras SRO souvan kòm yon ti kiyè chak minit. Lè pitit ou kòmansé kenbé sa ou bay li san vomi, kòmansé ogmanté kantité ou bay li. Si pitit ou kontinyé vomi, tann 30-40 minit apwé li té vomi dènye fwa é bay li kèk sisin SRO. Ti kantité de tan zan tan kapab rété anba pi byen pasé si ou bay li anpil a la fwa.

Disantri, Gwo Dyaré Avèk San: Doulè, vant tranché avèk dyaré an jénéral avèk san. Nòmalman kalité dyaré sa bézwen rémèd é bézwen konsiltasyon épi swiv nan yon kilinik.

Joe & Pastor Shirley Edgerton

KEC-VIM / GBGM Long Term Volunteers

La Gonave, Haiti

USA: 001-785-979-4494

web: http://www.centralumclawrence.org/                                                                                                            

Borgmans Lead Haiti Medical Team: Excerpt from NCJ Site

Ron and Gloria Borgman, Spearfish UMC recently led one of the first medical teams to work with the E'glise Methodiste d'Haiti (EMH) Church since the earthquake.  Many of the construction teams are taking a medical component wherever they are working but this was a medical team only.  Gloria, UMVIM Coordinator for the Dakotas, was invited to bring a medical team to the Carrefour Church, EMH, last fall while serving on a Solar Oven team.  Little did she know that the earthquake would intervene and that the logistics of such a venture would be magnified several fold.  Here is part of their story! For more information, contact Ron and Gloria. Introduction The United Methodist Dakotas Conference Volunteer in Mission medical team that worked in Haiti June 25-July 5, 2010 have returned.  Words (and pictures) can't quite explain the sights and sounds of the experience.  Acres of tents, many of them makeshift, some inches from the busy road.  Streets teeming with people, vehicles, bicycles, carts, animals. The ever present piles-and odor- of garbage because there is no place else to put the trash.  Television pictures have depicted what to expect but it is still hard to comprehend several story buildings collapsed to only a few feet tall or whole hillsides of homes changed to rubble in seconds.

Medical Team Story by Gloria It was a sobering start to our week at the Methodist Church in Carrefour, which is the western section of Port-au-Prince and near the center of the earthquake. This small congregation experienced many deaths and injuries, but still welcomed our team so local people could get medical care.   Our tents in the compound joined the tents of others who still could not return to their homes.  The school and church survived the earthquake, but the children are going to school in the courtyard as their parents are still afraid to let their children inside the school.   We were able to set up "clinics" in the church building with waiting areas under the trees outside. "Triage" and the dental station were set up outside in the shade also. At the request of church and school officials, we were able to do "school physicals on all the children in the school.   The fluoride team was able to distribute toothbrushes, toothpaste, parasite treatment, pencils, and fluoride the teeth of over 1000 people, mostly children.  Our 4 medical providers were able to see over 1000 patients in our time at Carrefour.  Many patients had "minor" illnesses or requests, and nearly all received vitamins, acetaminophen or ibuprofen, and other medications appropriate to their illness.  Many patients and church people had stories to tell of the earthquake and still show the physical or mental effects of that experience.  We were able to treat a few more serious cases, such as a baby with a huge neck abscess that was treated daily during our time in Haiti and a number of people with acute malaria, burns, asthma or pneumonia.  The number of people with exceptionally high blood pressure was discouraging, as we knew that many would be untreated again after our little gift of medicine was gone.  At times we needed to remind ourselves that we were not sent to cure everyone but to reach out and do what we were capable of.  There were many bright memories and blessings also.  The school children with their yellow checked outfits and smiling faces, eager to interact with the team.   The patient interpreters and our hosts who worked many hours to provide for our comfort and safety.  The quiet young mother who traveled early every morning so we could treat her son.  The wonderful meals of Haitian food prepared by our cooks.  And it is always such a joy to work with dedicated team members who keep smiling and working and laughing despite heat and humidity and crowds of people and marginal living conditions. We were also blessed with enough donations that we were able to leave large quantities of medicine and supplies to be used by the Carrefour church and at other Methodist clinics around Port-au-Prince.  Working in Haiti takes a little extra effort these days, but the need is immense and there are tasks for whatever skills and time you can offer to our brothers and sisters in Haiti.

Update for Haiti Urgent Request

Dear Friends,
Regarding the urgent call for a team in Haiti September 21-30, 2010, Bob Jeppson, a Pastor in the Heartland South District of the Missouri Conference, has offered to lead or co-lead a mission if we can pull together enough team members. If you are interested in assisting with this urgent need please contact Bob at bjeppson@embarqmail.com as soon as possible. Thank you again for your desire to serve our Haitian friends.

Blessings,

Audrey Phelps
Volunteers in Mission
phelps@umocm.com

UMVIM HAITI UPDATE

(COPIED FROM NORTH CENTRAL JURISDICTION WEBSITE)

What UMVIM teams are doing for the Eglise Methodiste d’Haiti (EMH) earthquake priority projects can only be considered second and third and fourth mile giving! Each team of ten persons is asked to raise $3500 in project money which is then matched with $3500 from the money given to UMCOR for Haiti. Each team member is assessed $350 in project funds and all the trip costs associated with the teams …food, lodging, interpreters, transportation, etc... or $1400. This comes to an ~$1750 cost per team member, differences lying in the plane fare. At least half of this is spent while in Haiti, thus adding to their weakened economy. And UMVIM’ers donate 8 days of their time! And they work! And all the while they smile and thank God for the opportunity to serve!

SUSAN MEISTER, US-Haiti Volunteer Coordinator, has summarized the first 3 months of UMVIM activity for EMH earthquake projects. From May through July, 26 teams of 235 volunteers from around the country and one Caribbean team have donated their time and money to work on EMH earthquake priority projects. This comes to a combined volunteer donation of $411,250 for their efforts! Add the $80,500 incentive grant and the UMVIM Program has contributed $491,750 for EMH recovery through July!

All this does not include the many teams that continue to work on ongoing EMH projects across Haiti not affected by the earthquake area, and therefore not eligible for matching grants.

Between Feb. and July, at least 12 of these teams from the North Central Jurisdiction have served in Haiti. There are 2 more such teams ready to serve through 2010 and there are two Individual Volunteers scheduled to serve starting this fall.

We continue to give thanks for the dedication of these many men and women willing to serve through the UMVIM program in Haiti. The effort of each UMVIM team is of great importance to the overall recovery of the Eglise Methodiste d’Haiti (EMH).