Friday, July 10, 2020

Pandemic Notes from a Rural Haitian Hospital(1)

Alma Mater Hospital in Gros Morne, Haiti

Since March 19th, when the first case of COVID-19 was reported in Haiti, the Haitian Ministry of Public Health and Population has attributed a total of 6,371 confirmed cases and 113 deaths to the virus infection. These statistics are flawed because Haiti’s two virus testing sites are overwhelmed, and they are in sharp contrast to the troubling data from neighboring Dominican Republic (reporting 38,432 cases and 821 deaths). At this point in the pandemic, it seems clear that the government has grossly underestimated incidence and mortality rates and have minimized the terrible risk that this virus poses to its vulnerable population.


Initially, the Haitian government’s response was swift and effective. They closed down the country in March, and social distancing, mask wearing, and frequent hand washing was common – particularly in Port-au-Prince. However, as the pandemic continues, preventive measures have waned in the cities and are near nonexistent in the countryside.


In Gros Morne, a mountain town of 34,000 residents and the health center for the northern Artibinite region (164,000 people), hardly any precautions are being taken. The realities of poverty and the need to eke out a living to put a daily meal on the table impose overcrowding and the need for close personal interactions. As such, there is a great deal of “fever” in town, but few will admit to COVID-19 symptoms because of the stigma. Only a handful of very ill patients have come to the Alma Mater Hospital. Still, the virus takes its toll: there were thirteen funerals on Saturday and five on Sunday, far more than usual.


The Haitian government plans to allow churches to hold services starting next week and will open schools again in August. With no countrywide COVID-19 response plan and limited access to testing kits, we are bracing for an onslaught. Meanwhile, our public health workers are attempting to destigmatize the disease, educate the public on its symptoms, promote mask wearing, and encourage sick patients to come to the hospital.


Brittany Galvin, RN NP

Michael Viola, MD