Tuesday, December 21, 2010


Local people can make a difference for those suffering in Haiti

An outbreak of cholera that began in October is the latest disaster to strike Haiti.

There is a large Haitian-American community here in Norwich. Almost all will know someone who is infected with this potentially deadly bacterium before the outbreak is over.

Haiti, the poorest nation in the Western Hemisphere, has been recovering from a major earthquake in January that took the lives of approximately 250,000 people.

Vibrio cholerae is the bacterium responsible for cholera. It produces a toxin that causes diarrhea and vomiting so severe that it can completely dehydrate a young child or elderly person in hours. Unless fluid is rapidly replaced, the infected person will lose enough volume to cause cardiac shock and death.

In a dehydrated patient, venous access for fluid replacement is often difficult, if not impossible. Specially designed needles can be carefully drilled into large bones allowing fluid to be infused directly into the bone. This is an expensive option since the cost of these needles is $100 each.

Once cholera has been introduced into a community, as it is now in Haiti, it doesn’t leave quickly. After reaching an initial peak, the number of cases slowly declines over a period of years. Current projections of 200,000 infected people and 17,000 deaths are being considered. Given the remote villages affected in a country where no adequate census can be carried out, these numbers are estimates at best.

Cholera is transmitted among humans through fecal-oral contact. Typically, this involves tainted food or drinking water. In Haiti, the Arbonite River that provides the only clean drinking water for many villages has been contaminated.

The most effective way to prevent cholera is through improved sanitation and the provision of clean drinking water. Once contracted, rehydration with fluid and electrolytes must begin immediately.

There is currently an urgent need in Haiti for medical professionals who can skillfully start IVs and provide nursing care. Nurses, doctors and other staff from The William W. Backus Hospital, and paramedics from the Norwich area, have volunteered to go to Haiti in January. They are doing this on their own time and at risk of becoming ill themselves. The physician members of the Backus Medical Staff have agreed to provide financial support for transportation.

This effort to help those in need defines the term “community” both locally and internationally.

Anthony G. Alessi, MD, is a neurologist and Medical Director of the Primary Stroke Center
at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Alessi or any of the Healthy Living columnists at healthyliving@wwbh.org

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