notes: 12/9/10: HEAS POST- posted from "HEAS partner" Nine new cases of cholera have occurred in the village of Petite Paradise. Up until this time, there were no known cases of cholera in the areas that used water from the Living Water Ministries well, but this outbreak puts everyone on guard of all water sources. (Lpar- this is a community just up the roard from Anse Rouge) -------------------------------- 12/3/10 Email from Dr. Grazia Caleo, PAHO Gonavies I am based in Gonaive for PAHO/OMS. I am following the allert situation in the Haut Artibonite. Reganding the situation in Anse Rouge I contacted MSF France they told me that in Source Chaude they set up a UTC in Anse Rouge a points ORS. Also they regularly provide support and supply. ------------------------------------------ 12/2/10 HEAS post from Amber The clinic was still closed yesterday. However, Dr. Carlo, in his meeting with our coordinator today, announced that the Town of Anse Rouge clinic would reopen to cholera patients as early as tomorrow. The "clinic" is actually at the site of the burned down hospital and to our knowledge has not seen cholera patients since the epidemic began. Other clinics in Commune Anse Rouge remain closed to cholera patients. Some clinics had closed completely when the cholera numbers peaked. THose clinics have now re-opened but refer cholera patients to La Source Chaude or Gonaives. Article 29 Organization is gathering daily and bi-weekly information on the cholera situation in the Commune and coordinating with MSPP and other organizations who can help with supplies for the clinics. If your organization has information to add to this report, or can provide training materials, personnel, or supplies, please contact Amber Munger via email or telephone for more information (English and Kreyol only). If your organization is on the ground in Haiti and can provide direct assistance in Anse Rouge please contact Hebert Pierre (kreyol only) at 3820-9678. ----------------------------------- 12/2/10 Email from Amber n terms of the Town of Anse Rouge, as I mentioned before, Hebert said that that clinic is closed. When he went to the clinic again on Tuesday to get information there was only a guardian there who could not provide him with any information. He is hoping to establish more formalised lines of communication today and tomorrow as he meets with CARE - who contacted him yesterday - and MSPP on Friday at the community meeting 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives. -> 12/16/10 HEAS post by Amber Munger Although the numbers have stabilized and even decreased in Communes Anse Rouge and Terre Neuve, we still have preventable cholera deaths on a regular, daily basis, due to a lack of education about cholera prevention and treatment. A29 is supporting a house to house community education campaign in 22 hard to reach villages in the region. We are seeking partnership with a health based NGO who has medical staff that can give a two day training for 30 cholera agents, supported by A29. We also seek support in the form of informative leaflets that can be left with each household, aqua-tab and soap. If other health based NGOs are able to provide other forms of support to the region, A29 would be happy to facilitate the implementation of health based programs in the region. We have a good relationship with an extensive community network of peasant groups that reach every corner of Communes Anse Rouge and third section Terre Neuve. ----------------------------------------- 12/9/10: HEAS POST- posted from "HEAS partner" Nine new cases of cholera have occurred in the village of Petite Paradise. Up until this time, there were no known cases of cholera in the areas that used water from the Living Water Ministries well, but this outbreak puts everyone on guard of all water sources. (Lpar- this is a community just up the roard from Anse Rouge) -------------------------------- 12/3/10 Email from Dr. Grazia Caleo, PAHO Gonavies I am based in Gonaive for PAHO/OMS. I am following the allert situation in the Haut Artibonite. Reganding the situation in Anse Rouge I contacted MSF France they told me that in Source Chaude they set up a UTC in Anse Rouge a points ORS. Also they regularly provide support and supply. ------------------------------------------ 12/2/10 HEAS post from Amber The clinic was still closed yesterday. However, Dr. Carlo, in his meeting with our coordinator today, announced that the Town of Anse Rouge clinic would reopen to cholera patients as early as tomorrow. The "clinic" is actually at the site of the burned down hospital and to our knowledge has not seen cholera patients since the epidemic began. Other clinics in Commune Anse Rouge remain closed to cholera patients. Some clinics had closed completely when the cholera numbers peaked. THose clinics have now re-opened but refer cholera patients to La Source Chaude or Gonaives. Article 29 Organization is gathering daily and bi-weekly information on the cholera situation in the Commune and coordinating with MSPP and other organizations who can help with supplies for the clinics. If your organization has information to add to this report, or can provide training materials, personnel, or supplies, please contact Amber Munger via email or telephone for more information (English and Kreyol only). If your organization is on the ground in Haiti and can provide direct assistance in Anse Rouge please contact Hebert Pierre (kreyol only) at 3820-9678. ----------------------------------- 12/2/10 Email from Amber n terms of the Town of Anse Rouge, as I mentioned before, Hebert said that that clinic is closed. When he went to the clinic again on Tuesday to get information there was only a guardian there who could not provide him with any information. He is hoping to establish more formalised lines of communication today and tomorrow as he meets with CARE - who contacted him yesterday - and MSPP on Friday at the community meeting 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives.

notes: 12/3/10 Email from Dr. Grazia Caleo, PAHO Gonavies I am based in Gonaive for PAHO/OMS. I am following the allert situation in the Haut Artibonite. Reganding the situation in Anse Rouge I contacted MSF France they told me that in Source Chaude they set up a UTC in Anse Rouge a points ORS. Also they regularly provide support and supply. ------------------------------------------ 12/2/10 HEAS post from Amber The clinic was still closed yesterday. However, Dr. Carlo, in his meeting with our coordinator today, announced that the Town of Anse Rouge clinic would reopen to cholera patients as early as tomorrow. The "clinic" is actually at the site of the burned down hospital and to our knowledge has not seen cholera patients since the epidemic began. Other clinics in Commune Anse Rouge remain closed to cholera patients. Some clinics had closed completely when the cholera numbers peaked. THose clinics have now re-opened but refer cholera patients to La Source Chaude or Gonaives. Article 29 Organization is gathering daily and bi-weekly information on the cholera situation in the Commune and coordinating with MSPP and other organizations who can help with supplies for the clinics. If your organization has information to add to this report, or can provide training materials, personnel, or supplies, please contact Amber Munger via email or telephone for more information (English and Kreyol only). If your organization is on the ground in Haiti and can provide direct assistance in Anse Rouge please contact Hebert Pierre (kreyol only) at 3820-9678. ----------------------------------- 12/2/10 Email from Amber n terms of the Town of Anse Rouge, as I mentioned before, Hebert said that that clinic is closed. When he went to the clinic again on Tuesday to get information there was only a guardian there who could not provide him with any information. He is hoping to establish more formalised lines of communication today and tomorrow as he meets with CARE - who contacted him yesterday - and MSPP on Friday at the community meeting 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives. -> 12/9/10: HEAS POST- posted from "HEAS partner" Nine new cases of cholera have occurred in the village of Petite Paradise. Up until this time, there were no known cases of cholera in the areas that used water from the Living Water Ministries well, but this outbreak puts everyone on guard of all water sources. (Lpar- this is a community just up the roard from Anse Rouge) -------------------------------- 12/3/10 Email from Dr. Grazia Caleo, PAHO Gonavies I am based in Gonaive for PAHO/OMS. I am following the allert situation in the Haut Artibonite. Reganding the situation in Anse Rouge I contacted MSF France they told me that in Source Chaude they set up a UTC in Anse Rouge a points ORS. Also they regularly provide support and supply. ------------------------------------------ 12/2/10 HEAS post from Amber The clinic was still closed yesterday. However, Dr. Carlo, in his meeting with our coordinator today, announced that the Town of Anse Rouge clinic would reopen to cholera patients as early as tomorrow. The "clinic" is actually at the site of the burned down hospital and to our knowledge has not seen cholera patients since the epidemic began. Other clinics in Commune Anse Rouge remain closed to cholera patients. Some clinics had closed completely when the cholera numbers peaked. THose clinics have now re-opened but refer cholera patients to La Source Chaude or Gonaives. Article 29 Organization is gathering daily and bi-weekly information on the cholera situation in the Commune and coordinating with MSPP and other organizations who can help with supplies for the clinics. If your organization has information to add to this report, or can provide training materials, personnel, or supplies, please contact Amber Munger via email or telephone for more information (English and Kreyol only). If your organization is on the ground in Haiti and can provide direct assistance in Anse Rouge please contact Hebert Pierre (kreyol only) at 3820-9678. ----------------------------------- 12/2/10 Email from Amber n terms of the Town of Anse Rouge, as I mentioned before, Hebert said that that clinic is closed. When he went to the clinic again on Tuesday to get information there was only a guardian there who could not provide him with any information. He is hoping to establish more formalised lines of communication today and tomorrow as he meets with CARE - who contacted him yesterday - and MSPP on Friday at the community meeting 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives.

notes: 12/2/10 HEAS post from Amber The clinic was still closed yesterday. However, Dr. Carlo, in his meeting with our coordinator today, announced that the Town of Anse Rouge clinic would reopen to cholera patients as early as tomorrow. The "clinic" is actually at the site of the burned down hospital and to our knowledge has not seen cholera patients since the epidemic began. Other clinics in Commune Anse Rouge remain closed to cholera patients. Some clinics had closed completely when the cholera numbers peaked. THose clinics have now re-opened but refer cholera patients to La Source Chaude or Gonaives. Article 29 Organization is gathering daily and bi-weekly information on the cholera situation in the Commune and coordinating with MSPP and other organizations who can help with supplies for the clinics. If your organization has information to add to this report, or can provide training materials, personnel, or supplies, please contact Amber Munger via email or telephone for more information (English and Kreyol only). If your organization is on the ground in Haiti and can provide direct assistance in Anse Rouge please contact Hebert Pierre (kreyol only) at 3820-9678. ----------------------------------- 12/2/10 Email from Amber n terms of the Town of Anse Rouge, as I mentioned before, Hebert said that that clinic is closed. When he went to the clinic again on Tuesday to get information there was only a guardian there who could not provide him with any information. He is hoping to establish more formalised lines of communication today and tomorrow as he meets with CARE - who contacted him yesterday - and MSPP on Friday at the community meeting 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives. -> 12/3/10 Email from Dr. Grazia Caleo, PAHO Gonavies I am based in Gonaive for PAHO/OMS. I am following the allert situation in the Haut Artibonite. Reganding the situation in Anse Rouge I contacted MSF France they told me that in Source Chaude they set up a UTC in Anse Rouge a points ORS. Also they regularly provide support and supply. ------------------------------------------ 12/2/10 HEAS post from Amber The clinic was still closed yesterday. However, Dr. Carlo, in his meeting with our coordinator today, announced that the Town of Anse Rouge clinic would reopen to cholera patients as early as tomorrow. The "clinic" is actually at the site of the burned down hospital and to our knowledge has not seen cholera patients since the epidemic began. Other clinics in Commune Anse Rouge remain closed to cholera patients. Some clinics had closed completely when the cholera numbers peaked. THose clinics have now re-opened but refer cholera patients to La Source Chaude or Gonaives. Article 29 Organization is gathering daily and bi-weekly information on the cholera situation in the Commune and coordinating with MSPP and other organizations who can help with supplies for the clinics. If your organization has information to add to this report, or can provide training materials, personnel, or supplies, please contact Amber Munger via email or telephone for more information (English and Kreyol only). If your organization is on the ground in Haiti and can provide direct assistance in Anse Rouge please contact Hebert Pierre (kreyol only) at 3820-9678. ----------------------------------- 12/2/10 Email from Amber n terms of the Town of Anse Rouge, as I mentioned before, Hebert said that that clinic is closed. When he went to the clinic again on Tuesday to get information there was only a guardian there who could not provide him with any information. He is hoping to establish more formalised lines of communication today and tomorrow as he meets with CARE - who contacted him yesterday - and MSPP on Friday at the community meeting 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives.

notes: 12/2/10 Email from Amber n terms of the Town of Anse Rouge, as I mentioned before, Hebert said that that clinic is closed. When he went to the clinic again on Tuesday to get information there was only a guardian there who could not provide him with any information. He is hoping to establish more formalised lines of communication today and tomorrow as he meets with CARE - who contacted him yesterday - and MSPP on Friday at the community meeting 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives. -> 12/2/10 HEAS post from Amber The clinic was still closed yesterday. However, Dr. Carlo, in his meeting with our coordinator today, announced that the Town of Anse Rouge clinic would reopen to cholera patients as early as tomorrow. The "clinic" is actually at the site of the burned down hospital and to our knowledge has not seen cholera patients since the epidemic began. Other clinics in Commune Anse Rouge remain closed to cholera patients. Some clinics had closed completely when the cholera numbers peaked. THose clinics have now re-opened but refer cholera patients to La Source Chaude or Gonaives. Article 29 Organization is gathering daily and bi-weekly information on the cholera situation in the Commune and coordinating with MSPP and other organizations who can help with supplies for the clinics. If your organization has information to add to this report, or can provide training materials, personnel, or supplies, please contact Amber Munger via email or telephone for more information (English and Kreyol only). If your organization is on the ground in Haiti and can provide direct assistance in Anse Rouge please contact Hebert Pierre (kreyol only) at 3820-9678. ----------------------------------- 12/2/10 Email from Amber n terms of the Town of Anse Rouge, as I mentioned before, Hebert said that that clinic is closed. When he went to the clinic again on Tuesday to get information there was only a guardian there who could not provide him with any information. He is hoping to establish more formalised lines of communication today and tomorrow as he meets with CARE - who contacted him yesterday - and MSPP on Friday at the community meeting 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives.

notes: 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives. -> 12/2/10 Email from Amber n terms of the Town of Anse Rouge, as I mentioned before, Hebert said that that clinic is closed. When he went to the clinic again on Tuesday to get information there was only a guardian there who could not provide him with any information. He is hoping to establish more formalised lines of communication today and tomorrow as he meets with CARE - who contacted him yesterday - and MSPP on Friday at the community meeting 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives.

notes: 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still ahve to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives. -> 11/27/10 In general, we found very limited supplies in PAP and are still in need of all of the basics. The same is true for the Clinic in the Town of Anse Rouge. 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still have to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives.

notes: 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives. -> 11/22/10 Notes from Amber Hebert has not yet even met with the organization in PAP to know what supplies we will get . That appointment is at 10:00 today. The we still ahve to figure out transport for the supplies. As soon as we receive supplies I will let you know. These supplies will be for the La SOurce Chaude clinic FIRST and anything we can spare we will give to teh CIty Clinic. The City Clinic is on Route National One and patients can more easily find transport to Gonaives from that Center. That is not the case where we are in La SOurce Chaude. We need to have supplies at the La SOurce Chaude clinic because those people will not be able to make it to another location easily. It was a blessing that MSPP had a truck available to send to La Source last time. I dont think our luck wil be the same next time around. Water - the La Source Chaude clinic has water as we have hot springs in la Source Chaude (which means, in French, "hot spring"). The nurse auxillary who works there is highly incompetent and does not use the water filter that was set up for the clinic because he does not like the person who installed it. If he decided to use it again it has to be reinstalled and will be at least a few weeks before it is up and running. So we need aquatab or other water disinfectant for the clinic (as well as for the population in general). ---------------------------- 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives.

notes: 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives. -> 11/21/10 Email from Amber The City Clinic in Anse Rouge most definitely needs support as well. It is not practical to transport patients back and forth - and the City Clinic is along Route National One so it may get more patients coming through Anse Rouge. However, the Source Chaude Clinic has access to the mountains and it is the major central point where the other villages come for help. Both are important to support - I would say that the City clinic (which, as I mentioned, used to be a hospital, but burnt down) services about 20,000 and the La Source Chaude clinic would service the other half of the population while other clinics remain closed. Hebert did not seem to think that MSPP will be providing more supplies to either clinic in the near term. MSPP is currently completely overwhelmed in Gonaives. ---------------------------------------- 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives.
dc_population: 40 -> 20

notes: I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives. -> 11/21/10 Email from Amber Hi folks - Just a quick update on this. Yesterday 63 patients showed up at the La Sources Chaude clinic after noon because all other clinics in Commune Anse Rouge (except for the one in the City of Anse Rouge) closed their doors to cholera patients. A29 Coordinator lobbied MSPP in Gonaives for help. In response, MSPP sent a truck to La Source Chaude to transport the 63 patients to Gonaives. Our coordinator said there were only a few patients who came to the La Source Clinic this morning before he left for PAP to try to seek medical supplies. MSPP sent us some fluid and IVs as well as a tent to set up a CTC in the lakou of the La Sous Clinic. The supplies will not last long. Hebert is in PAP meeting with Americare to see if they would be willing to give us free antibiotics, fluids, clorox for disinfecting the center, and aquatab. As I mentioned before, there are no qualified medical personnel in second section Commune Anse Rouge, and I am not sure that there are any either in the first section either (other than the regional director, who is helping to coordinate rather than see patients). ----------------------------------------- 11/21/10 Email from Amber I am on a call until 8:00 when I will get back to this but for now I wanted to make clear that A29 does not represent the ILODEP clinic. A29 is trying to find support for the community clinics - not the private clinic run by a private organization. I just received word that even the ILODEP clinic closed, just as all of the other private clinics. The private clinics will not accept cholera patients. Since I last wrote you yesterday, the La SOurce Chaude clinic received 63 patients - because all of the other clinics in the entire commune closed except for the City of Anse Rouge clinic which has no materials. Since the La SOurce Chaude clinic also had no materials, our coordinator Hebert Pierre worked with the Ministry of Health to try to find transport to Gonaives for all 63 of the patients. Gonaives is a treacherous two hour drive from La Source Chaude, and not many vehicles make the voyage. I will fill out the information on the sheet that you sent me just as soon as I am off the call with my board. Thanks for your help! ------------------------------------------- 11/21/10 Have requested Assesment information from Amber for clinic. lpar ------------------------------------------- Email from Amber Munger of Article 29 Organization 11/21/10 Commune Anse Rouge has approximately 37,000 residents but also services parts of Terre Neuve, raising the number to about 42,000. Article 29 Organization's base is in Second Section Commune Anse Rouge, which has four physical health clinics. One is the ILODEP clinic sponsored by Parole et Action, the other three are community clinics which have no paid staff and have not received supplies since July, the last time that A29 secured supplies for distribution to the clinics. There is no doctor or nurse in second section Commune Anse Rouge. There is rumored to be a doctor present in the City of Anse Rouge at the tent clinic (in first section Commune Anse Rouge) at the site of the old hospital that burnt down last year. This clinic is between a 2 to 8 hour walk for people in Second Section Commune Anse Rouge and there are virtually no taptaps or cars in the region. Cholera first entered Second Section Commune Anse Rouge about two weeks ago with cases coming in from people who had been in Gonaives. In second Section Commune Anse Rouge, we had five cases last week. The La Source Chaude clinic, which is the main clinic for the second section and is run by a volunteer nurse auxillary, closed its doors for fear of cholera. All five cholera victims died. A29's coordinator lobbied regional MSPP to re-open the clinic, which the volunteer nurse auxillary has now done, but there are currently no supplies (IV's, hydration fluids, antibiotics) to treat patients. Thus, more patients have arrived at the clinic, receive a cholera diagnosis, and then die. By the time the patients arrive at the clinic they have been too far along to respond to ORS, so IVs are needed. There are very few cars in the region so it is difficult to get patients to the City of Anse Rouge clinic, which as of yesterday was also out of IVs and rehydration fluids. As of yesterday, at least five more cholera patients found transport from SEcond Section Commune Anse Rouge to the City of Anse Rouge clinic in the first section. Two more died at the La Source Chaude clinic in Second Section. Five new patients had arrived at the La Source Clinic yesterday. A29 launched a public education and prevention campaign two weeks ago at teh regions two largest public markets (the City of Anse Rouge and the La Source Chaude markets). Information is spread by megaphone regarding prevention of cholera, treatment and how and when to make ORS. As a result of the outbreak in Gonaives, people are afraid to go to Gonaives for fear of contracting cholera. This puts the entire region in a precarious position as most of the region's supplies are procured in Gonaives (rice, oil, gas, everything). Commune Anse Rouge produces shallot and sourghum and pwa congo but no other crops in sufficient quantity to meet people's basic dietary needs - everything comes from Gonaives. There have been reports that one of the first two cholera victims in the region, when being shut out by the clinic and the community, deliberately polluted the drinking water source in Kay Felip, causing the other three people (of the initial five people) to contract cholera. There is a lot of panic and fear as a result, which could all easily be assuaged with the presence of a qualified doctor or nurse and some cholera medical supplies. A29 is currently engaged in efforts to secure supplies and transport for cholera treatment from PAP but has met with great challenges thus far. A29 is also attempting to engage medical teams to bring support to the region, which almost never receives such assistance because of its isolated location NW of Gonaives.

dc_population: -> 40