So my contract is due to finish 1st October. 9 months in PNG has flown by. After being sent up to Tari to get 3 building projects moving, Lae were short staffed and asked for me to come back to sort out their clinic extension project and a few pieces of administration. It was also an ideal time to buy all the things that the Tari construction project needed.
Upon arrival I was very pleased to see that my two assistants has done an excellent job of running things without an expat logistical supervisor. I started by telling them so, and that I was only here for a short time to sort out a few things and was quite happy to leave them running things.
The next day, stories started coming in of the Cholera. The medical coordinator phoned to suggest I read the "Cholera guidelines". The guideline was an inch thick of paper, so I decided to put it off until the next day (a mistake).
The next day we knew trouble was here. Reports of people with extreme diarrhea already in the hospital came through. Some had died. The boss told me to find a tent. The biggest tent I had ever seen in PNG was an army one, and the helpful officer in charge agreed to deliver 3 the next day. I read the cholera guideline and list of contents in the standard MSF cholera emergency kit. "......buckets, chlorine powder, rope, spraying equipment....... The MSF emergency team were arriving the next day, the hospital CEO, director of medical services, director of nursing, director of finance and admin, the boss and I met first thing. Well, second thing actually, me and the army met first thing. Army early. The hospital had already decided we knew Cholera more than they did and put us in charge. The army put up 5 tents. The log team went chlorine and bucket and sprayer shopping.
The emergency team arrived and told us to get more tents. As I write this we have an isolation ward with 15 beds and tents with 21 beds and by noon tomorrow I need to have somehow 75 beds. Preferably more.
Cholera is spread by "the fecal oral route". It is avoided by washing hands after using the toilet. Cholera sufferers loose up to 40 litres of fluid per day. From the end you'd rather patients didn't loose things from. Cholera patients need hygiene and isolation. Extreme hygiene. That means Chlorine. Foot baths at the wards, hand washing at entry. Cholera doesn't smell of what you'd think it does. It smells of Chlorine. I smell of Chlorine.
The patients lie on beds with holes cut out in the middle and a bucket underneath. The come in with sunken eyes and looking frail. 50% of people will die of dehydration without medical treatment. 98% will live if they get medical treatment. The medical treatment is rehydration. A man came in looking like death yesterday. He was talking about playing football today.
Chatting to friends tonight I realised that all but one of the health posts that people come to before the hospital are closed. People are dehydrating all over the province. Tommorrow they will learn that we can treat them. They will come and we will be busy. I hope I have enough beds, enough buckets and enough chlorine.