The CLM residence in Bay Tourib is right next door to a cholera clinic.

That’s not a coincidence. Our presence in Bay Tourib depends on a close collaboration with Partners in Health, the NGO through which the Haitian health ministry operates in central Haiti. The joint Fonkoze-Partners in Health project, financed by a Canadian foundation called “Kanpe”, includes CLM, the cholera center, and a small hospital, and it stands an excellent chance of dramatically improving life in Bay Tourib.

Before we started, the nearest cholera treatment center was in Tomonn, a hike of five hours or more down the hill from Bay Tourib. Neighbors and family members would put victims in beds that they would carry down the hill, but many died before they could get treatment. When the Bay Tourib center first opened, it was receiving ten, twenty or even thirty cases per day. It was packed. Victims were being carried there from more than two hours away because it was so much closer than anything else. Hundreds of lives were saved.

As the rainy season draws to a close, and as our CLM team spreads water filters, latrines, and information throughout the region, the cholera count has been diminishing. Three cases are now enough to make for a very busy day, and it is now rare for the center to have more than three patients at a time.

But the cholera threat has not disappeared. Wednesday morning, when I arrived in Bay Tourib, I learned that Mona, one of our CLM members, was there with her child, who had been stricken a couple of days earlier. Mona is from Anba So, a secluded ravine about halfway down towards Tomonn, but well off the road. We spoke to Mona several times during the day to share our concern and to talk to her about preventing further occurrences, and were glad to see the child’s condition improve quickly. Usually, that’s what happens to cholera patients. They recover quickly as they take in intravenous fluid. Cholera, after all, kills through dehydration. Meanwhile, the cholera medication generally kills the microbe without too much trouble. As long as patients get the care before they are too far-gone.

We were, then, both saddened and alarmed when one of Mona’s neighbors arrived in Bay Tourib late Wednesday afternoon and told us that another one of Mona’s kids had died of cholera that same day. Even as Mona was worrying about one child, she lost another one. Mona herself hadn’t yet heard the terrible news.

And as we spoke with Mona’s neighbor, we learned that things were worse they we had initially imagined. Mona lives with her children in a cluster of four houses, three of which are part of our program. It is a terribly poor little neighborhood. The houses are made of thin, crooked wooden posts, their walls woven out of sticks, and their roofs of palm-seed pods. It’s hard to see how such structures can provide any protection at all. And those houses had somehow attracted a small cholera epidemic. Three of them produced four cases and one death in just a few days.

Rony, one of the Bay Tourib case managers, and I knew we had to do more than just talk to Mona. The other case managers were already on their way back to our base in Mibalè , but he and I weren’t scheduled to return until he was finished seeing the families he serves on Thursdays. Rony’s not strong on a motorcycle yet, so our truck would be coming up the mountain to get us. When the pick-up truck arrived, we threw in our pump sprayer and a half-gallon of bleach. We would stop the truck halfway down the road, and hike into Anba So. While our driver waited with the truck, we’d do what we could to disinfect the neighborhood.

Mona’s neighbor rode with us back down the road, and led us to their houses. When we got there, we covered the three infected houses as well as we could, and left the families instructions for additional cleaning they’d need to do. When we got back down the hill we arranged for the neighborhood’s own case manager, Aunondieu, to disinfect the houses again when he returned on Wednesday.

We didn’t get to Anba So any too soon. Before our eyes, Mona’s neighbors were loading another little girl onto a horse for a ride up to Bay Tourib. She had contracted cholera, and was already weak. There had been a slight delay while they prepared some oral rehydration fluid to help her survive the trip, but the neighbors were anxious to make it to the cholera center as quickly as they could.

When we were finished, Rony and I rushed back to the truck. We were in a hurry because the path we had taken was so steep that it would be dangerous once darkness descended. As it was, we spent a good deal of time picking our way back up the hill to the main road climbing on all fours.

We’ll do what we can to help Mona and her neighbors put an end to the cholera threat. They need further training to ensure they’re using the water filters we’ve given them correctly. They should have their latrines within a few weeks.

The visit to Anba So made for grim work, but it was not without its moment of hope. While Rony was spraying, one of Mona’s nephews called me aside. He showed me a goat and its newborn kid. His mother is a CLM member, and the goat was her goat, which she lets him take care of. As far as I know, it’s the first of the roughly 800 goats we have distributed in Bay Tourib to give birth. It thus can stand as an emblem of the first steps out of poverty for the region’s extreme poor, even as the family it belongs to mourns.