April 8, 2020
CCH is mobilizing and immobilizing in reaction to COVID-19 this week. I guess you could say we’re getting the message out to “stay home”!
Community Outreach
Phase 1 of our community outreach is underway. We’ve outfitted our blue truck with speakers and we’re taking it to the communities we serve to share health messages about coronavirus. Like our cholera education campaign a few years ago (and political or advertising messages in Haiti), using a “mobil” truck with loudspeakers and catchy music is a proven way to share information. We’re alerting people to stay home, avoid social contact, wash their hands, and be alert for corona symptoms.
Phase 2 of our community outreach will likely involve distributing materials like face masks, bleach, soap, and pamphlets about the disease. However, we are still figuring out the best way to get those supplies in country and distribute them safely without causing mobs.
Physical Therapy Changes
Our PT Clinic has stopped seeing patients in person, in accordance with the Haitian National Association of Physical Therapists’ recommendations. We’re transitioning to “telehealth” appointments. CCH Board Member, Dr. Michele Wiley – Professor of Physical Therapy at Shenandoah University, prepared some “telehealth” guidelines for our PT clinic staff in Haiti.
After a very productive planning meeting with PT clinic staff last week, we carefully selected patients for whom telehealth PT sessions are appropriate. Clinic Coordinator, Melissa Jean-Bart says, “Our staff are enthusiastic and shared great ideas on how we can make this work even in a low resource environment. It was amazing how committed they are to still serve the patients even if they can not come to the clinic.” CCH is also planning to make videos in Haitian Creole with targeted rehab exercises that patients and families will follow.
PT staff are still assisting with triage and patient education during the busiest hours for our Primary Care Clinic, so PT telehealth sessions will be done outside of those hours, mostly in the afternoons.
Primary Care
As we’ve said before, the CCH clinic does not have the capacity to treat coronavirus patients directly. But we are screening every patient we see for potential corona symptoms. Our primary healthcare goal is to remain open and treat patients with other ailments to help relieve the overall burden on Haiti’s healthcare system.
We recently shared this story of some adorable new CCH clinic patients on our Facebook page. Darlyns and Darla are 5 months old, and some of CCH’s newest patients. They woke up with flu symptoms last week and their parents, Victor and Nadine, took them to the local hospital, only to find it closed for outpatient services. One person at the hospital referred them to CCH. Unable to find a motorcycle taxi, they walked across town to our clinic carrying their sick babies. Our doctors and nurses took great care of the whole family. The babies were evaluated thoroughly by our loving CCH physicians; their parents were encouraged, with all their questions answered. The twins received medicine at our pharmacy and later went home to recuperate with very relieved parents! This week, Darlyns and Darla came back to our clinic for a check up. Both babies responded well to the treatments and are expected to have a full recovery. We also found out that their parents have another set of twins who are 17 years old! What an amazing family!
COVID Response Coordination
COVID-19 presents another level of challenge in Haiti. The current protocol is for our clinic staff to contact the MSPP (Haiti’s National Ministry of Health) hotline if a suspected patient presents. The national protocol intends to have regional isolation centers set up where patients can be treated. The problem is that there aren’t established centers ready to receive patients yet. So there is a national protocol but the infrastructure and capacity is largely not there to support it.
On March 30th, CCH Clinic Coordinator Melissa Jean-Bart attended a “Haiti Health Network” round-table call in COVID-19. This network is an affiliation of clinics like ours. The network reached the following consensuses:
- There are not cases being seen yet at outlying clinics.
- There is an overall drop in patient volume across all clinics, indicating that educational efforts to stay home are taking hold to some extent.
- Some options are being considered to get more PPE to clinics. The supply is low now. However, shipping does not seem to be affected so far; it’s just a supply and price problem. There are grassroots efforts to make PPE in Haiti.
- Treatment options for COVID may include adjusted use of CPAP machines, inhalers (ideally with spacers), which would be better than nebulizers for administering medicines like albuterol so as not to blow the virus everywhere in aerosol form. High flow oxygen systems may be apropos now and are sold in Haiti. Bag valve mask ventilation and other skills learned in life support courses will be put into use soon. Chloroquine is being promoted very strongly. We still advise trying to be supplied with it, careful of counterfeits, awaiting proper validation at this time. We will be following additional medical data closely.
- The network encourages everyone’s contributions of knowledge and connections with MSPP (Haitian Ministry of Health) and health care leaders in Haiti so we can support each other’s efforts.
CCH has some ventilators in our surgical clinic and our medical leadership is discussing best ways to deploy ventilators if/when needed. We will be working with other healthcare entities in Haiti to share our ventilators, train personnel, and use them for the greatest public good.
Grassroots Efforts
Haiti’s hard-fought battles with cholera in the past decade are bearing fruit in this new coronavirus challenge. People are aware of the importance of hand-washing and disinfection to slow the spread of the disease. This past week, many business owners around Jacmel set up hand-washing stations outside their doors, requiring shoppers to wash before entering.
These grassroots efforts give us hope that everyone is taking this seriously and trying to do their part to keep their communities safe. And we know you are too! We’re all in this together.
If you’d like to help us do more in Haiti, you can click here to donate to CCH. Thank you, Coalition members!!
