Interview with Dr Irmgard Harms in Haiti: “The situation has improved, but is not easing yet”

by Ruth Bücker,  2010/11/02

The cholera outbreak surprised her just as much as many of the affected persons in the Haiti. With her long years of experience, Dr Irmgard Harms from Bad Hindelang was supposed to assist the re-opening of the “Hospital of Hope” in Port-au-Prince; however, things turned out differently. Ruth Bücker has talked to Irmgard Harms.

Irmgard, what was the reason for you going to Haiti?

I was to travel back to Haiti in order to assist the re-opening of the “Hospital of Hope”. I had already had the opportunity of helping to set up the humedica hospital in Niger. And since I had already been to Port-au-Prince as a member of the first mission team immediately after the earthquake in January, it just seemed right to return there once more.

What does your work look like now?

The day I arrived, we received news of cases of cholera having been confirmed in the regions north of Port-au-Prince. Over the following day, a cholera outbreak was confirmed for the region surrounding the city of St Marc.

Therefore, my current work has hardly anything to do with what I was planned to do. Now I am treating patients suffering from cholera and instead of handling matters of organisation, I am now taking care of infected patients together with the medical team of humedica.

In contrast to other missions you took part in, this time you did not have to travel from Germany to the emergency region first, but you already were in situ. What was it like, and what did your work look like until further medical colleagues from Germany arrived.

First, humedica coordinator Caroline and I made an assessment of where and how the arriving team could help most effectively. That meant for the coordinator that she had to visit numerous authorities, in order for us to be able to assess the mission location and the situation appropriately.

Dr Irmgard Harms had already been a member of the first mission team after the earthquake in Haiti; now she has been fighting the cholera epidemic spreading in the country for more than a week. Photo: humedica/archive January 2010

Thanks to the long-time and excellent cooperation with various health authorities and other organisations such as e.g. UNICEF, we were able to oversee and assist work at a small hospital right in the centre of the outbreak of the epidemic which is accompanied by severe diarrhoea.

However, being the only professional medic there, I was unfortunately not able to take all the measures I wished in order to deal with the situation. There were too many patients coming to the hospital who were already too severely dehydrated due to diarrhoea. Although I could of course offer some assistance in my position as humedica doctor, I could not take all the measures I am usually used to taking during missions with a whole team of medics.

Therefore, the short time between the outbreak and the arrival of the first humedica team in Haiti seemed to be very long to me and I was actually wishing for them to arrive soon. In the meantime we have arranged everything in a way appropriate to the situation.

What did the team have to cope with after arriving in the cholera region?

At first we had to arrange the hospital according to our standards. That meant we had to clean it, set up various treatment rooms and bedrooms in a way that patients suffering from cholera could be separated from others.

When the number of cholera cases was still increasing at the beginning of the mission, about 400 patients per day visited our hospital. In the meantime, the number of patients who ask us for help has luckily become much lower. I consider this to be a very good sign, although we must not judge prematurely and have to wait some time before clearing-off the warning.

Above all if more heavy rainfalls come down on Drouin, the river Artibonite could once more burst its banks and flood houses and latrines and the temporary drinking water systems. I am pleased about the improvement we are experiencing right now, but we still cannot relax completely.

What can you do for the patients?

Cholera is a disease accompanied by severe attacks of diarrhoea, with the germs in the patients’ intestines leading to an extreme loss of water caused by vomiting and egestion. For children and already weakened persons in particular, this loss of liquid can cause death. Therefore the first thing we need to do for patients who are suspected to suffer from cholera is to isolate them from other persons and to rehydrate them as soon as possible.

In the worst cases this is achieved by means of intravenous rehydration; patients who do not bring up everything, are given as much fluid as possible to drink. The liquid contains electrolytes which are to help the patients’ dehydrated bodies to re-establish a normal fluid balance.

Furthermore, we were able to distribute hygiene articles, chlorine tablets and special food to our patients.

Have there been sad moments in the last days?

Well, the second-worst thing for me certainly was the feeling to be forced to wait for the team from Germany and not being able to do as much as I am used to.

The worst thing, however, was that we were not able to save all the people. When despite intensive medical care we were unable to help a patient and had to watch some of the die.

And what kind of situations contributed to building up and motivating the team?

On one of the first days, an old man brought us his grandson. The boy was lying limply in his arms and seemed to be more dead than alive. The boy did not react when we addressed him and was severely dehydrated. We put him on the drip and when I came to the hospital in the morning two days later, the little patient was sitting upright in his bed, was laughing and wanted to eat and drink.

His grandfather told us that the family was immensely happy and that the boy’s mother would soon bear another child.

I have one more question: you have already been to Haiti with the first mission team in January. What has changed over the past nine months and how do you assess the current situation in Haiti apart from the cholera outbreak?

Sometime this year I read a headline in a German magazine saying: “Haiti – a dying country.” I think that it would be realistic to say: “Haiti – a suffering country.” I personally can see so many signs of hope, such as for example the supply with prosthetics, and the clearing and reconstruction works that are progressing very well; also the construction of roads.

But what I consider to be most important is the fact that the Haitians do not give up. This is an important step towards the country’s future.

Dear Irmgard, thank you very much for your commitment and for the time you have taken out for this interview. We wish you and the team all the best.

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