Nurse at the Haiti floods

"A week ago, I saw a 15 year old boy, who had a horrible wound. His hand was rotten, swollen. I thought that it might have to be amputated. Since then, he has been receiving antibiotics and ... his hand is already much better, thanks to the medical care." "What is amazing is how long it takes for the water to go away." Karlien Stroeykens Nurse

Previous mission

Primary health care project in a remote district, Sierra Leone "The first thing I saw of Gonaives was this enormous lake totally created by the storm, just before entering the city. It was shocking to see cars and trucks crashed in the middle of this water. When we arrived in the city itself, I was surprised to see the state of houses; full of water with people still living inside.

"MSF was amongst the very first organizations to arrive in Gonaives and provide medical care. Only three days after the storm, we had identified a location where we could give consultations. Two weeks later, we had some 500 patients a day. MSF has put up a system where people can get consultations for orthopedic, pediatric, obstetric, and internal care.

"All the activities of the center are free of charge and include medication, dressings, vaccinations (as cut wounds can cause tetanus), sutures, short observations, and re-hydration of children. We have had already some eight births. Our center is more than a place where medical care is being provided. It is also a place of hope, where people can gather and meet others who experienced the same trauma. "Mental health is also an part of our activities. In addition we have a mobile clinic in another area of Gonaives affected by the disaster.

"The main health problems for the population are cut wounds due to the fact that people are walking in the mud and they can't see sharp objects hidden in it. These wounds get quickly infected because of the mud and the polluted water, which is a big source of bacteria. "A week ago, I saw a 15 year old boy, who had a horrible wound. His hand was rotten, swollen and smelt really bad. I thought that it might have to be amputated. Since then, he has been receiving antibiotics and we have had to do a painful dressing every day. His hand is already much better, thanks to the medical care.

"Besides infected wounds which create the risk of sepsis and tetanus, the first visible health problems are diarrhoea, lung infections and skin diseases. We also see an increase of malaria cases. Stagnated water means there are many more mosquitoes. We always have to be prepared in case of possible epidemics of cholera or other waterborne diseases. "15 days after the floods, people in Gonaives are still living in the mud, although they clean their houses every day. What is amazing is how long it takes for the water to go away. And still people try to pick up with their life; they look for food, clean water, health care, and other basic things to survive. Nothing is functioning yet. There is no electricity, no running water, and no education as the schools have been completely damaged. It will take months and months to clean the roads, and start rebuilding houses."

Psychologist at the Haiti floods

"What they are doing - taking care of the children, cleaning their houses, or helping out neighbors - is already something. In the current conditions, this is, in fact, a lot." "The population in Gonaives is showing enormous mental strength." Ilse Casteels Psychologist

Previous missions

Sierra Leone and Rwanda "The most difficult thing for the population is to start over again. They are completely hopeless. They have lost everything: houses, belongings, jobs. Some do not even know where they are. Others have lost family members. They just can't see how they are going to survive. From a mental health point of view, what they need to do above all is to be able to grieve.

"Victims need to recount what happened to them. Our mental health team is trying to show them that they have resources, and that what they are doing - taking care of the children, cleaning their houses, or helping out neighbors - is already something. In the current conditions, this is, in fact, a lot. "15 days after the floods, I am very impressed to see some people setting up small businesses and selling products with their feet in the mud.

Women are plaiting their hair on street corners in the middle of dirty water. Others constantly clean their clothes. And there are always people stopping next to the larger pools of water to clean their motorcycles. "This means that they are able to pick up their daily life, though they went through a disaster which destroyed everything. "According to our staff who was in Mapou, another part of Haiti which was flooded in May-June, people there were crying ten days after the disaster. This is not the case here yet. The population in Gonaives is showing enormous mental strength.

"People are in charge of picking up dead bodies (there are some estimated 1,500 dead and 1,500 missing). We have organised a first meeting with these people, who are not undertakers but simple municipal staff, unpaid for the last five months. They have experienced the same difficulties and trauma as the rest of the population. But in addition, they are working day and night in extreme conditions, with their feet in the water, without any specific equipment. These people also need to clean their houses and go to food distributions but can not make it. "Most are physically affected. They have nausea, heart problems, itching, skin problems, and nightmares. These physical pains express how this extremely harsh work is affecting them. As we realized how bad their situation was, we decided to hold sessions for them twice a week, on Mondays and Fridays."

Patient at the Haiti floods

"Water was coming up to my hips and I was so scared because I cannot swim. We formed a human chain to cross the street and reach the church." "The roof was the only thing we could see of our house from the church, the rest of it was under water."

MSF patient 28 year old ne lost her house. She now lives with her father and an eight-year old girl (not her daughter) in one of the many churches transformed into refugee centers for the victims of the floods. Some 15 days after the disaster, she comes for a consultation at the MSF health Center in Raboteau.

"We had a small shop where my father was selling food. I studied as a secretary, but I had no job. I was selling clothes and shoes. The day it rained (September 18), my father was at the shop. It had been raining all day, and the level of water was raising. Late afternoon, we had water up to our knees. Dad told me to leave, but I refused because I had books which I didn't wanted to lose. Our neighbor, his wife and his 18 month old child joined us, and finally we left together at night." "Water was coming up to my hips and I was so scared because I cannot swim. We formed a human chain to cross the street and reach the church. "When we arrived, the church was full of people, women, children, babies, but no one could sleep.

People were shouting, others crying and everybody was nervous. We were staying on the first floor but with our hands, we could reach the water which had completely flooded the ground floor of the building. "The roof was the only thing we could see of our house from the church, the rest of it was under water. The day after, the water level went down. We first tested the level with a stick. Then, we formed a human chain to go up to Praville, another part of the city which was higher up.

There is a refuge there, also in a church, with lots of families. There, we sleep on the roof. There are so many people - maybe 200 to 300 -, that we can hardly breath. "When the sky is cloudy and it starts to rain, I am scared but there is nothing we can do. People are tense; they have lost all the things they have gathered over the last 10 to 20 years. There is nothing left from my house except the walls. There is mud and water everywhere. We try to remove but it comes right back over and over again. We are so tired. My father does not work anymore. He is discouraged and wonders how we are going to cope.

But I know Gonaives will make it, with the help of God. "I have come to the consultation because my entire body is itching. I have no choice but to walk in the mud. I have been given an ointment to put on my skin at the MSF health center. Even if it was far away, I had to come here because I was feeling really bad. You know, at the refuge where I am staying now, there is no doctor, no aid whatsoever."