Cholera epidemic leaves Haiti on brink of disaster once more

10 November 2010

By Joe Mozingo, Los Ange­les Times

Hun­dreds have suc­cumbed to the dis­ease in a nation all too famil­iar with death and ill-equipped to deal with disaster.

Anto­nine Fiza­mey, 47, wails as her mother, Vir­ginia Sen­cilna, 67, lies gravely ill with cholera in Gonaives, Haiti. The hos­pi­tal has filled up from a cholera epi­demic that hit the city and nearby vil­lages. (Rick Loomis / Los Ange­les Times / Novem­ber 8, 2010)

Report­ing from Gonaives, Haiti — A mother cra­dled her limp 2-year-old boy, gen­tly bounc­ing him on her knee as though she would lose him if she stopped. Her lap was soaked.

The boy’s eyes were half-open and his face was ashen. His sis­ter rubbed his with­ered feet.

Rose­mane Sain­telone could not let her youngest son die now. When they arrived at this hos­pi­tal in the sea­side slum of Raboteau on Mon­day after­noon, he was still alert , look­ing around, mov­ing a lit­tle. Only an hour later, he was uncon­scious. His chest rose and fell faintly.

The hos­pi­tal was fill­ing up as a surge in Haiti’s cholera epi­demic hit this city and the vil­lages to the north and east. A city dump truck trolled the streets pick­ing up unclaimed bod­ies to take to an empty area behind the main ceme­tery. Exca­va­tors dig­ging bur­ial pits unearthed the splin­tery gray bones of thou­sands of vic­tims of two hur­ri­canes in the last decade.

In terms of cat­a­stro­phe, Haiti’s Jan. 12 earth­quake was momen­tous in scale, killing more than 200,000 peo­ple. But the cholera epi­demic shows how many Haitians live in stark prox­im­ity to death every day.

Sain­telone, a 40-year-old mother of eight, lives in a thatch-and-clay hut on a plot of land up a muddy trail in the moun­tains north­east of here. Her fam­ily grows man­gos, bananas, papayas, sugar cane and cas­sava. Seek­ing a lit­tle more secu­rity, her hus­band left three weeks ago to cut cane in the Domini­can Repub­lic.

Their son, Sebien, came down with diar­rhea Thurs­day, but Sain­telone heard rumors of a hur­ri­cane — just as she heard rumors of a dis­ease in the water — so she stayed put until Sat­ur­day, when the storm had passed. Then she put some clothes and food in a bucket and set off down the trail, wad­ing across the high, twist­ing Marme­lade River four times before arriv­ing at the lit­tle hos­pi­tal in Ennery.

A brigade of Cuban doc­tors hooked Sebien up to an IV, and he slowly regained strength. But Mon­day they told her they didn’t have enough med­i­cine. She would have to take him to Gonaives.

Her daugh­ter and niece joined her for the five-hour jour­ney down rut­ted moun­tain roads to this tat­tered gray port city, where Haiti’s founder tri­umphantly declared inde­pen­dence from the French more than two cen­turies ago.

They arrived at 3:15 p.m. and found a seat in the crowd. At least 40 peo­ple lay on gur­neys with holes cut in the can­vas, expelling diar­rhea as clear as water into buck­ets. She waited about 20 min­utes before a doc­tor from the Cuban med­ical mis­sion came to hook up an IV. He strug­gled to find a vein in Sebien’s wrist — dehy­dra­tion can col­lapse blood ves­sels — and instead put the IV in the side of his neck.

A woman down the hall erupted in scream­ing spasms when she found her hus­band dead. Patients lying around him gazed off with the same empty expressions.

A tall, hard-looking man in bas­ket­ball shorts blasted into the room, car­ry­ing a with­ered old woman. “Move, move!” he yelled.

He found a gur­ney in front of Sain­telone. “Grandma,” he said, “don’t worry, you’re not going to die.” He laid her down and put a rag next to her mouth.

Sain­telone, a slight woman with high cheek­bones, looked up briefly, then cooed and rocked Sebien, watch­ing in des­per­a­tion as his eye­lids fell lower.

Nobody knows how many peo­ple have died of cholera in this city in the last few days.

The offi­cial death toll nation­ally Tues­day was 538, but peo­ple appeared to be dying at a rapid pace. In Port-au-Prince there were at least 73 cases, and health offi­cials said they feared the dis­ease could afflict hun­dreds of thou­sands over sev­eral years.

At the Gonaives hos­pi­tal, the med­ical direc­tor said eight peo­ple had died between Nov. 1 and Mon­day after­noon. But in the next hour alone, three peo­ple died. Neigh­bors said more than a dozen bod­ies had been hauled off in a dump truck that morning.

Down the road, work­ers at the main ceme­tery said 10 bod­ies had arrived that night. They guided a reporter and pho­tog­ra­pher to them, laid on the ground or on top of tombs. A few were in body bags, oth­ers were cov­ered with sheets, two were in rough-cut coffins.

They said they dumped 48 bod­ies into pits the day before. They showed the jour­nal­ists the pits, filled with bod­ies, but it was impos­si­ble to tell how many.

The ceme­tery direc­tor, who didn’t want to give his name, said a total of 73 bod­ies had been dropped off since Sat­ur­day. It was unclear whether any of these were included in the offi­cial count attrib­uted to the epi­demic that began last month.

An Amer­i­can aid group, the Inter­na­tional Med­ical Corps, had tried unsuc­cess­fully to get the med­ical direc­tor to let them set up a triage tent to orga­nize the intake of patients. Such an effort by relief work­ers else­where had been met with fierce resis­tance by res­i­dents, who burned the tents down because they feared the clinic would only bring more disease.

Sain­telone wouldn’t stop bounc­ing her boy long enough to see whether his chest still moved.

About 4:15 p.m., a stocky doc­tor in a mask and scrubs came by. He abruptly pinched the boy on the speck of his left nip­ple. There was no response. He opened one of the Sebien’s eyes wide with his thumb and fore­fin­ger. He gave the pupil a glance, then motioned for the nurse to remove the IV.

Sain­telone watched, still rock­ing him for a moment, before she under­stood what this meant.

She clutched him tight, leaned over and sobbed silently.

Saintelone’s daugh­ter helped her put the lit­tle boy’s T-shirt on, and they put a towel over his face. The mother held him against her chest and car­ried him out the same way she had car­ried him in an hour before.

Out­side, they stood in the rut­ted street, aim­less and lost. They didn’t know how they would get home. They’d spent most of the money in their pock­ets, about $3, for trans­porta­tion to the city.

As a cool breeze rose up, Sain­telone bun­dled her son in a towel and they walked toward the highway.

They flagged down a tap­tap — a cov­ered pickup truck with benches in the back — but the dri­ver saw the body and refused to let them in. The same for the next one.

Even­tu­ally, they found one and made it to Ennery late at night. Sain­telone trudged the eight miles back to her home in the dark. She knew the trails by feel. She and the girls took turns car­ry­ing the boy. Fam­ily mem­bers gath­ered as they criss­crossed higher into the moun­tains, where by dawn the sick would be again stream­ing down in the other direction.

They laid the boy down on a bed, cov­ered him in a sheet, and put a flower stem over him.

On Tues­day, they paid a car­pen­ter down the road to build a lit­tle white­wood cof­fin. They didn’t have enough money to have it painted. They moved the fur­ni­ture out­side and swept the house to pre­pare a voodoo cer­e­mony for spir­its to watch over him.

Sain­telone tied a rag around her waist, as women do here in such times, to hold in the grief.

This Sun­day, they will hike deep into the moun­tains and bury him in a plot among his ances­tors, a rit­ual they know well.

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