SCA magazine Shape 3 2011 English

10 QUESTIONS
What caused the cholera epidemic that struck
Haiti in the wake of the 2010 earthquake and
still persists?
The lack of sanitary infrastructure. Even
before the earthquake, Haiti didn’t possess a
widespread, well-functioning sewage system.
The situation became worse when wells and other
water supplies were contaminated by wastewater,
which facilitates the spread of cholera and other
waterborne infections like typhoid and parasites.
In the absence of latrines, people relieve themselves
in what are called “flying toilets” (plastic
bags). When deposited into a landfill, these bags
may leak and case further contamination
and pollution.
How is cholera treated?
Cholera is easily treatable. The prompt administration
of oral rehydration salts to replace lost
fluids nearly always results in a cure. In especially
severe cases, intravenous administration of fluids
may be required to save the patient’s life. Left untreated,
however, cholera can kill quickly following
the onset of symptoms. Only 1 percent of treated
cases die, whereas the fatality rate for untreated
cases is 50 percent.
What can be done following a disaster to decrease
the risk of cholera and other waterborne
infections?
Water safety is the prime concern. To distribute
drinkable water to the population, chlorinate existing
water and construct temporary latrines. It may
sound simple enough, but it actually poses a huge
logistical challenge, particularly in the wake of an
earthquake or a tsunami.
What did you do at the cholera camp?
I helped cure infected people and provided
training to local medical staff. Education is as
important as clinical work, in order to build a sus-
18 SCA SHAPE 32011
Heike Haunstetter
“ I marvel
at how
much I can
accomplish
in the field
with relatively
small
resources.”
Heike Haunstetter
tainable health-care structure that continues to
function once MSF has left.
Has your work in the Third World given you
new perspectives on health care in the Western
world?
Absolutely. Returning home isn’t always easy
when you have been reminded that there are many
different worlds within this world, where people
face a radically different set of problems. Still, it’s
not fair to compare, and I can’t very well demand
that the people at home fully share my perspective.
How does it feel to return home after having
spent several months in a disaster area?
I feel grateful over the abundance of resources
that we have to help people here. In general, I complain
less about a “lack of resources” and I don’t really
see that we have a “health-care crisis” at home.
On the other hand, I marvel at how much I can
accomplish in the field with relatively small resources,
where I can really make a difference and
help so many people. In the cholera camp, it often
struck me how many lives I helped save in a very
short time by using simple means.
Do you ever feel helpless when faced with disaster
and epidemic?
Yes, when I encounter cases that I know could
have easily been cured or helped back home in Sweden.
In such situations, the injustices and inequality
of this world become painfully apparent.
How do you combat fatigue and resignation
when working in the field?
In MSF, we have tremendous support from the
other team members — not just fellow physicians
but sanitation experts, administrators and other
professionals. We all share the same living quarters,
have the same goal and focus on the same
things. And we have all left our families and our
home countries behind us.