notes: 12/12/10 HEAS Update From Dr. Jim Wilson: Big Paul (MMRC), Open Hands, and our team formed a convoy to go into the valley prepared for the worst but uncertain about precisely what we would find. In these verification deployments, the mantra is "you don't know if you don't go", and this was certainly the case. We headed to the "Belle Fountaine" that was mentioned by multiple sources in the Furcy area as a village experiencing "8-10 fatalities". There has been some degree of controversy in regards to what constitutes a 'team' for such deployments and what should one bring along in case you find a community in trouble. In the case of yesterday's deployment, we took 4 4WD vehicles in, 1 was unable to continue, and the other blew its clutch as we arrived in the camp after 4.5 hrs offroading to get there. Going back in to retrieve the vehicle and survey the area some more by foot. When we had initially gone, we debated how many medical personnel and RL to bring given the uncertainty of the reporting balanced with the moral and ethical considerations of arriving without an ability to help if there is a bad situation. A terribly difficult decision. We elected to go with an interim option, where we brought supplies and enough medical personnel to handle a situation for 24 hrs until help arrives. In this case, MSF graciously offered backup support. Comms were decent, but sketchy as we went deeper into the mountains. We had cell and radio contact at certain key points in the itinerary. No helo LZs were identified in immediate proximity to Belle Fountaine along the route we took, which was the approach from Croix des Bouquets, through Jong, and points south. Along the way, we passed through Tisource asking for directions. Our security detail got the phone number of the town administrator / leader who called us after we were already up the mountain to say they had "300 fatalities". We saw no evidence of this during our very brief stop but will circle back there this morning to check it out ourselves this morning. If true, there are multiple communities that wash, bathe, and drink from the same irrigation runoff ditch that passes through multiple communities. Upon arrival to the crest of the mountain ridge, we had locals acknowledging the presence of cholera pointing down to Tisource and later found locals saying they themselves saw a single fatality and then pointing to Belle Fountaine. Many hours later upon arrival in the town of Belle Fountaine, we found no evidence of cholera but there was a local claiming two fatalities in a village one hour's hike from Belle Fountaine. We don't know if locals were referring to the town of Belle Fountaine or the entire region is considered "Belle Fountaine". If the latter is true, then we have a most difficult survey to conduct and implications of dire consequences for these villages if they ever become infected with cholera. This is a VERY isolated and difficult to access region. We scratch our heads about these events because we observed multiple independent sources reporting an outbreak in "Belle Fountaine". Perhaps they are referring to Tisource. Either way, we return to the area today for an overnight mission to continue the evaluation process. Thanks for the backup support Carmen as always and special thanks to Big Paul and his crew, the folks from Open Hands, and Dutch-MSF for their assistance. -------------------------------------------- 12/11/10 Dr. Jim Wilson and MMRC Global team is doing a recon mission up in the mountains of this area. No medical facilities are indicated in this area on the Resource Finder map. There will probably be a need to set up a CTC and CTU or CTPs in area. -> 12/12/10 HEAS Update From Dr. Jim Wilson: Big Paul (MMRC), Open Hands, and our team formed a convoy to go into the valley prepared for the worst but uncertain about precisely what we would find. In these verification deployments, the mantra is "you don't know if you don't go", and this was certainly the case. We headed to the "Belle Fountaine" that was mentioned by multiple sources in the Furcy area as a village experiencing "8-10 fatalities". There has been some degree of controversy in regards to what constitutes a 'team' for such deployments and what should one bring along in case you find a community in trouble. In the case of yesterday's deployment, we took 4 4WD vehicles in, 1 was unable to continue, and the other blew its clutch as we arrived in the camp after 4.5 hrs offroading to get there. Going back in to retrieve the vehicle and survey the area some more by foot. When we had initially gone, we debated how many medical personnel and RL to bring given the uncertainty of the reporting balanced with the moral and ethical considerations of arriving without an ability to help if there is a bad situation. A terribly difficult decision. We elected to go with an interim option, where we brought supplies and enough medical personnel to handle a situation for 24 hrs until help arrives. In this case, MSF graciously offered backup support. Comms were decent, but sketchy as we went deeper into the mountains. We had cell and radio contact at certain key points in the itinerary. No helo LZs were identified in immediate proximity to Belle Fountaine along the route we took, which was the approach from Croix des Bouquets, through Jong, and points south. Along the way, we passed through Tisource asking for directions. Our security detail got the phone number of the town administrator / leader who called us after we were already up the mountain to say they had "300 fatalities". We saw no evidence of this during our very brief stop but will circle back there this morning to check it out ourselves this morning. If true, there are multiple communities that wash, bathe, and drink from the same irrigation runoff ditch that passes through multiple communities. Upon arrival to the crest of the mountain ridge, we had locals acknowledging the presence of cholera pointing down to Tisource and later found locals saying they themselves saw a single fatality and then pointing to Belle Fountaine. Many hours later upon arrival in the town of Belle Fountaine, we found no evidence of cholera but there was a local claiming two fatalities in a village one hour's hike from Belle Fountaine. We don't know if locals were referring to the town of Belle Fountaine or the entire region is considered "Belle Fountaine". If the latter is true, then we have a most difficult survey to conduct and implications of dire consequences for these villages if they ever become infected with cholera. This is a VERY isolated and difficult to access region. We scratch our heads about these events because we observed multiple independent sources reporting an outbreak in "Belle Fountaine". Perhaps they are referring to Tisource. Either way, we return to the area today for an overnight mission to continue the evaluation process. Thanks for the backup support Carmen as always and special thanks to Big Paul and his crew, the folks from Open Hands, and Dutch-MSF for their assistance. -------------------------------------------- Re: Results From Kenscoff and Mountain Villages South Survey Saturday, December 11, 2010 2:27 PM From: "Haiti Cholera" To: "James Wilson" Cc: haiti-epidemic-advisory-system@googlegroups.com Dear Jim, I am waiting for the assesment of this mission and ready to support if needed. Paul contacted me last night but too late and we need first verifiaction of the alert in order to support. Please keep me posted on situation ASAP Best, Carmen On 11 December 2010 06:52, James Wilson wrote: Thank you for the kind offer. We are moving quickly now to intercept and evaluate reporting we discovered in the Obleon - Furcy corridor by multiple locals of roughly ten fatalities each in the communities of Bel Fountaine and Mohotiere Brouette. Infection believed to have been acquired after travel to the Sequin area as opposed to PaP, however we will investigate this further. Brief stop at the Baptist Mission located between Kenscoff and Fermante indicates they've seen 8 patients total, none from these communities, no fatalities with two discharges. No patient surge noted, and the staff had not heard about the abovementioned communities. We have teamed up with MMRC Global's Paul Sebring and the good folks from Open Hands to get on-site quickly. It is a long off-road drive with possible on-foot hiking into these areas. We have been told by locals there is zero medical support. If true, we expect to see a very bad situation, and one for which we may not be prepared with our recon team. With the multiple days of lockdown we've all experienced thanks to the demonstrations, we believe the disruption in NGO activity has contributed to a bad situation. We hope we are wrong. I am copying PAHO ARO for their awareness of the possibility we may need immediate assistance for rapid mobilization of a CTC/CTU capability. We estimate we will be able to last 24-48 hrs on-site without support, however there is a great deal of uncertainly what we will truly find. All helo's are grounded last time we checked, so again we hope the situation is not as bad as what the locals claim. Cheers, Jim On Dec 10, 2010, at 5:37 PM, jame0330 @ metnet.edu wrote: Jim, please let me know what you find out about activity in Kenscoff. I have a guest house there and a group of medical people and access to supplies. We could be there tomorrow. Our group is currently in PAP and ready to work. My phone number is 651 592 7607 please text me. My folks are antsy to get back work, we just got back from setting up a CTC in La Gonave. On Dec 10 2010, Jim Wilson, MD wrote: Will report upon return what we find. Jim -------------------------------------------- 12/11/10 Dr. Jim Wilson and MMRC Global team is doing a recon mission up in the mountains of this area. No medical facilities are indicated in this area on the Resource Finder map. There will probably be a need to set up a CTC and CTU or CTPs in area.

notes: 12/12/10 Big Paul (MMRC), Open Hands, and our team formed a convoy to go into the valley prepared for the worst but uncertain about precisely what we would find. In these verification deployments, the mantra is "you don't know if you don't go", and this was certainly the case. We headed to the "Belle Fountaine" that was mentioned by multiple sources in the Furcy area as a village experiencing "8-10 fatalities". There has been some degree of controversy in regards to what constitutes a 'team' for such deployments and what should one bring along in case you find a community in trouble. In the case of yesterday's deployment, we took 4 4WD vehicles in, 1 was unable to continue, and the other blew its clutch as we arrived in the camp after 4.5 hrs offroading to get there. Going back in to retrieve the vehicle and survey the area some more by foot. When we had initially gone, we debated how many medical personnel and RL to bring given the uncertainty of the reporting balanced with the moral and ethical considerations of arriving without an ability to help if there is a bad situation. A terribly difficult decision. We elected to go with an interim option, where we brought supplies and enough medical personnel to handle a situation for 24 hrs until help arrives. In this case, MSF graciously offered backup support. Comms were decent, but sketchy as we went deeper into the mountains. We had cell and radio contact at certain key points in the itinerary. No helo LZs were identified in immediate proximity to Belle Fountaine along the route we took, which was the approach from Croix des Bouquets, through Jong, and points south. Along the way, we passed through Tisource asking for directions. Our security detail got the phone number of the town administrator / leader who called us after we were already up the mountain to say they had "300 fatalities". We saw no evidence of this during our very brief stop but will circle back there this morning to check it out ourselves this morning. If true, there are multiple communities that wash, bathe, and drink from the same irrigation runoff ditch that passes through multiple communities. Upon arrival to the crest of the mountain ridge, we had locals acknowledging the presence of cholera pointing down to Tisource and later found locals saying they themselves saw a single fatality and then pointing to Belle Fountaine. Many hours later upon arrival in the town of Belle Fountaine, we found no evidence of cholera but there was a local claiming two fatalities in a village one hour's hike from Belle Fountaine. We don't know if locals were referring to the town of Belle Fountaine or the entire region is considered "Belle Fountaine". If the latter is true, then we have a most difficult survey to conduct and implications of dire consequences for these villages if they ever become infected with cholera. This is a VERY isolated and difficult to access region. We scratch our heads about these events because we observed multiple independent sources reporting an outbreak in "Belle Fountaine". Perhaps they are referring to Tisource. Either way, we return to the area today for an overnight mission to continue the evaluation process. Thanks for the backup support Carmen as always and special thanks to Big Paul and his crew, the folks from Open Hands, and Dutch-MSF for their assistance. -------------------------------------------- 12/11/10 Dr. Jim Wilson and MMRC Global team is doing a recon mission up in the mountains of this area. No medical facilities are indicated in this area on the Resource Finder map. There will probably be a need to set up a CTC and CTU or CTPs in area. -> 12/12/10 HEAS Update From Dr. Jim Wilson: Big Paul (MMRC), Open Hands, and our team formed a convoy to go into the valley prepared for the worst but uncertain about precisely what we would find. In these verification deployments, the mantra is "you don't know if you don't go", and this was certainly the case. We headed to the "Belle Fountaine" that was mentioned by multiple sources in the Furcy area as a village experiencing "8-10 fatalities". There has been some degree of controversy in regards to what constitutes a 'team' for such deployments and what should one bring along in case you find a community in trouble. In the case of yesterday's deployment, we took 4 4WD vehicles in, 1 was unable to continue, and the other blew its clutch as we arrived in the camp after 4.5 hrs offroading to get there. Going back in to retrieve the vehicle and survey the area some more by foot. When we had initially gone, we debated how many medical personnel and RL to bring given the uncertainty of the reporting balanced with the moral and ethical considerations of arriving without an ability to help if there is a bad situation. A terribly difficult decision. We elected to go with an interim option, where we brought supplies and enough medical personnel to handle a situation for 24 hrs until help arrives. In this case, MSF graciously offered backup support. Comms were decent, but sketchy as we went deeper into the mountains. We had cell and radio contact at certain key points in the itinerary. No helo LZs were identified in immediate proximity to Belle Fountaine along the route we took, which was the approach from Croix des Bouquets, through Jong, and points south. Along the way, we passed through Tisource asking for directions. Our security detail got the phone number of the town administrator / leader who called us after we were already up the mountain to say they had "300 fatalities". We saw no evidence of this during our very brief stop but will circle back there this morning to check it out ourselves this morning. If true, there are multiple communities that wash, bathe, and drink from the same irrigation runoff ditch that passes through multiple communities. Upon arrival to the crest of the mountain ridge, we had locals acknowledging the presence of cholera pointing down to Tisource and later found locals saying they themselves saw a single fatality and then pointing to Belle Fountaine. Many hours later upon arrival in the town of Belle Fountaine, we found no evidence of cholera but there was a local claiming two fatalities in a village one hour's hike from Belle Fountaine. We don't know if locals were referring to the town of Belle Fountaine or the entire region is considered "Belle Fountaine". If the latter is true, then we have a most difficult survey to conduct and implications of dire consequences for these villages if they ever become infected with cholera. This is a VERY isolated and difficult to access region. We scratch our heads about these events because we observed multiple independent sources reporting an outbreak in "Belle Fountaine". Perhaps they are referring to Tisource. Either way, we return to the area today for an overnight mission to continue the evaluation process. Thanks for the backup support Carmen as always and special thanks to Big Paul and his crew, the folks from Open Hands, and Dutch-MSF for their assistance. -------------------------------------------- 12/11/10 Dr. Jim Wilson and MMRC Global team is doing a recon mission up in the mountains of this area. No medical facilities are indicated in this area on the Resource Finder map. There will probably be a need to set up a CTC and CTU or CTPs in area.

notes: 12/11/10 Dr. Jim Wilson and MMRC Global team is doing a recon mission up in the mountains of this area. No medical facilities are indicated in this area on the Resource Finder map. There will probably be a need to set up a CTC and CTU or CTPs in area. -> 12/12/10 Big Paul (MMRC), Open Hands, and our team formed a convoy to go into the valley prepared for the worst but uncertain about precisely what we would find. In these verification deployments, the mantra is "you don't know if you don't go", and this was certainly the case. We headed to the "Belle Fountaine" that was mentioned by multiple sources in the Furcy area as a village experiencing "8-10 fatalities". There has been some degree of controversy in regards to what constitutes a 'team' for such deployments and what should one bring along in case you find a community in trouble. In the case of yesterday's deployment, we took 4 4WD vehicles in, 1 was unable to continue, and the other blew its clutch as we arrived in the camp after 4.5 hrs offroading to get there. Going back in to retrieve the vehicle and survey the area some more by foot. When we had initially gone, we debated how many medical personnel and RL to bring given the uncertainty of the reporting balanced with the moral and ethical considerations of arriving without an ability to help if there is a bad situation. A terribly difficult decision. We elected to go with an interim option, where we brought supplies and enough medical personnel to handle a situation for 24 hrs until help arrives. In this case, MSF graciously offered backup support. Comms were decent, but sketchy as we went deeper into the mountains. We had cell and radio contact at certain key points in the itinerary. No helo LZs were identified in immediate proximity to Belle Fountaine along the route we took, which was the approach from Croix des Bouquets, through Jong, and points south. Along the way, we passed through Tisource asking for directions. Our security detail got the phone number of the town administrator / leader who called us after we were already up the mountain to say they had "300 fatalities". We saw no evidence of this during our very brief stop but will circle back there this morning to check it out ourselves this morning. If true, there are multiple communities that wash, bathe, and drink from the same irrigation runoff ditch that passes through multiple communities. Upon arrival to the crest of the mountain ridge, we had locals acknowledging the presence of cholera pointing down to Tisource and later found locals saying they themselves saw a single fatality and then pointing to Belle Fountaine. Many hours later upon arrival in the town of Belle Fountaine, we found no evidence of cholera but there was a local claiming two fatalities in a village one hour's hike from Belle Fountaine. We don't know if locals were referring to the town of Belle Fountaine or the entire region is considered "Belle Fountaine". If the latter is true, then we have a most difficult survey to conduct and implications of dire consequences for these villages if they ever become infected with cholera. This is a VERY isolated and difficult to access region. We scratch our heads about these events because we observed multiple independent sources reporting an outbreak in "Belle Fountaine". Perhaps they are referring to Tisource. Either way, we return to the area today for an overnight mission to continue the evaluation process. Thanks for the backup support Carmen as always and special thanks to Big Paul and his crew, the folks from Open Hands, and Dutch-MSF for their assistance. -------------------------------------------- 12/11/10 Dr. Jim Wilson and MMRC Global team is doing a recon mission up in the mountains of this area. No medical facilities are indicated in this area on the Resource Finder map. There will probably be a need to set up a CTC and CTU or CTPs in area.