In aftermath of quake, illnesses emerge

Fourteen-month-old Abigail Charlot survived Haiti's cataclysmic earthquake but not its miserable aftermath. Brought into the capital's General Hospital with fever and diarrhea, little Abigail literally dried up.

"Sometimes, they arrive too late," said Dr. Adrien Colimon, the chief of pediatrics, shaking her head.

The second stage of Haiti's medical emergency has begun, with diarrheal illnesses, acute respiratory infections and malnutrition beginning to claim lives by the dozen.

And while the thousands jammed into germ-breeding makeshift camps have so far been spared an outbreak of contagious disease, health officials fear epidemics. They are rushing to vaccinate 530,000 children against measles, diphtheria, tetanus and whooping cough.

"It's still tough," said Chris Lewis, the emergency-health coordinator for Save the Children, which by yesterday had treated 11,000 people at 14 mobile clinics in Port-au-Prince, Jacmel and Leogane. "At the moment, we're providing lifesaving services. What we'd like to do is to move to provide quality, longer-term care, but we're not there yet."

Haiti's government has raised the death toll for the Jan. 12 earthquake to 230,000 from 212,000, and says that more bodies remain uncounted. Communications Minister Marie-Laurence Jocelyn Lassegue said yesterday that the new figure does not include bodies buried by private funeral homes in private cemeteries or the dead buried by their own families.

The new figure gives the quake the same death toll as the 2004 Asian tsunami.

The number of deaths indirectly caused by the quake is unclear; the United Nations is only now beginning to survey the more than 200 international medical-aid groups working out of 91 hospitals -- most of them just collections of tents -- to compile the data. About 300,000 people were injured in the quake. At Port-au-Prince's General Hospital, patients continue arriving with infections in wounds they can't keep clean because their home is the street. The number of amputees, estimated at 2,000 to 4,000 by Handicap International, keeps rising as people reach Port-au-Prince with untreated fractures.

Violence bred of food shortages and inadequate security is also producing casualties. Dr. Santiago Arraffat of Evansville, Ind., said he treats several gunshot wounds a day at General Hospital.

"People are just shooting each other," he said. "There are fights over food. People are so desperate."

Nearly a month after the quake, respiratory infections, malnutrition, diarrhea from waterborne diseases and a lack of appropriate food for young children may be the biggest killers, health workers say.

Part of the problem is ignorance. Abigail's mother, 20-year-old Simone Bess, waited a week after her child fell ill to bring her in, Colimon said.

Colimon ushered Bess into an adjacent tent when it became clear that the Swiss doctors trying to hydrate and keep her child breathing would fail. Bess screamed in agony and crumpled to the paving stones when she heard.

"Please give me my child!" she wailed. "My one and only child. Tell them to do something for her! Tell them to wake her up!"

Twenty yards away, the child's father, James Charlot, curled up against a wall, shaking with grief.

A shortage of medical equipment and spotty electrical power -- service has been restored to about 20 percent of Port-au-Prince -- have worsened the medical emergency.

A respirator might have saved Abigail, Colimon said. But the hospital has none. Nor does it have electrocardiogram machines. The sweltering heat inside the pediatric tent may also have been a factor.

"This whole tent -- all (the infants inside) are dried up because it's so hot in there," said Willow Walsh-Hughes, of Draper, Utah, a nurse who hugged and stroked Bess as her child's life slipped away.

The wire-thin Bess had stopped lactating after the quake, Walsh-Hughes said. Because breast-feeding is the best way to avoid infant diarrhea, a mother's ability to lactate can determine a baby's survival.

Acute child malnutrition is expected to only worsen until the summer harvest in August, said Mija Ververs, a UNICEF expert in child nutrition.

Forty-seven percent of Haiti's population of more than 9 million is under age 18. It has the Western Hemisphere's highest birth rate and its highest child and maternal mortality rates.

Haiti also has the hemisphere's highest malnutrition rate -- with about 17,500 children under age 5 acutely malnourished even before the quake, according to UNICEF.

An official from a major field hospital said that the case of 10 American Baptists charged with kidnapping for trying to take 33 children out of Haiti without permission was impeding the evacuation of critically injured youngsters to the U.S.

"Pilots are very reluctant to take ... back children without the proper papers," said Elizabeth Greig, the chief administrative officer for the University of Miami-Medishare Foundation.

Prosecutors in the kidnapping case are to make their final argument today on whether to pursue the charges.