Haiti

So I know it's been a long time since I've posted but I was back on the road again this Christmas break. It's sort of long but there was a lot to write about! Enjoy!

Our medical team (minus Rohini whose passport was denied in Miami for water damage) arrived in Port-au-Prince mid-morning and after a long search for our bags (which yielded all except one) headed to the smaller airport down the road. We weighed in, split into smaller groups and crammed into the 5-passenger plane for the 24-minute ride over to Pignon. Gabi met us at the airport and brought us to the mission house in Jacsonville.

We unpacked the pharmacy that night, combining the meds we brought with us with those stored from previous trips. We spent the rest of the night hanging out on the roof watching for shooting stars.

The next day we opened up the doors of our clinic to the community. Min, a fellow first year medical student, and I took over the vitals station where I learned the Kreyol basics such as bonjou and kouma ou ye? I also learned the phrases for sit here, stand there, lift your tongue and close your mouth. After spending an extra night in Miami and sorting out her passport issues, Rohini was able to fly into Port-au-Prince, pick up the missing bag and join us.

After the patients were done with vitals, they went to the next station where their histories would be taken and physicals would be performed. If the case was more severe or the patient needed something looked at we took them into one of the rooms in the back. When they were done we gave them their medication and sent them over to Christina, our high school student and one very cool girl, who gave them an eye exam and found them some glasses.

That night after we closed up shop and retired to the upstairs for dinner, a man was brought in with a laceration on his leg from a motorcycle accident. The medical team set to work and, using our headlamps for light, we were able to stitch him back up. Afterwards we went upstairs to celebrate Gabi’s sons Garel’s and second-year med student Thomas’s birthdays. They provided rum, coke, Prestige (the local beer) and Clarin (moonshine) and played an ecliptic mix of Caribbean and American music.

The next day our A team, Dr. Graham, Dr. Weis, Alison and Chris, did a home visit to see a patient who has been very sick. He had edema below the waist and had been sick for many months. His family had moved him to the floor signifying that they were expecting him to die soon. The medical team couldn’t figure out what was wrong and came back to the mission house to discuss the case. Alison went back later that afternoon and convinced the family to move him back into the bed. Unfortunately shortly after the move he coded. Alison started CPR and the motorcycle was sent back to pick up Dr. Graham and Chris. About half an hour later they pronounced him dead.

One of the hardest parts about seeing patients in the clinic was the language barrier. Many of us do not speak any Kreyol or French and things often got lost in translation. Alex, one of the other medical students had a patient that was complaining of blood in the stool. He did a fecal smear to test, aka, sticking his finger in the guy’s anus to get a sample. The test came back negative because, as he later found out, the bleeding had stopped two weeks earlier. Stephanie, a fourth year, had a patient that was complaining of a bump on her clitoris. She had gone to the clinic and was given a shot, which caused her to miss her period. Stephanie did a pelvic exam and could not for the life of her find the mysterious bump. After much frustration another translator overheard the conversation and informed Stephanie that her patient actually had a cyst on her ovary and the shot was a treatment for that.

We had some other really interesting cases too. One guy came in with the complaint of sores on his legs. I took him into the back room to have a look. Turns out it was actually a large mass (think the size of a cantaloupe) on his inner upper thigh. It had been there for 10 years but we weren’t able to tell if it was a femoral hernia or a lipoma. We told him that he should go to the hospital to get it checked out and return in March when the surgery team would be here.

I was also able to see a case of pancreatic cancer. The patient was very jaundiced with bright yellow eyes and had a palpable tumor in the epigastric region. After discussing it with Gabi it was decided that it would be best to tell the head of the household and to keep the diagnosis from the patient and the women. Another case of mine was a woman who had lost a leg to diabetes. Her blood pressure and blood glucose readings were extremely high. We gave her three months worth of medications and told her to come back a few days later to see if they were working. Thankfully when she came back her blood pressure was already improving.

New Years Eve brought more excitement. We started out the evening with a very sick woman. She had a very high fever and was dehydrated. We put in an IV and transported her to the hospital. The team got back around 9 pm that night and we started celebrating. Two hours later a baby was brought in. His twin brother had already died and the parents had come to us to try to save him. Thankfully the people that needed to be sober were while the rest of us ran around finding the things that they needed. We started him on a nebulized albuterol treatment, among other things and after about an hour transported him to the hospital for further treatment.

The New Years had rolled in without anyone taking notice. Instead we celebrated an hour later on the roof under the stars in a small village in Haiti. A friend of mine used to say that how you spend New Years is indicative of how the rest of your year will go. If that is true then I have one hell of a year in front me.

We ended the week with some exciting animal run-ins. We were warned before we showed up that there was a family of bats that made themselves a home inside of the mission house. Luckily they seemed to have moved out but did visit us on a couple of occasions. There were also a couple of mice that liked to rummage around our rooms at night. They also enjoyed running around on the roof and jumping off into the trees. I was sitting up there by myself when one of the mice ran full speed into my back and apparently threw something at me in the process before running off. I guess they don’t like guests. On the last clinic day we also had a visit from a tarantula. I almost stepped on it when walking to the pharmacy. I thought maybe it was someone’s pet so I didn’t think much about it but I guess it was just a wild tarantula that had wandered in. One of the locals stepped on it and killed it.

The last night the local high school students put on a show for us. They did a couple of skits including one about cholera. They also sang a couple songs for us and their band played a few tunes. Dr. Weis then presented the students with three trumpets and a trombone to help them expand their ensemble.

I think this is a good time to go back and talk about what the long-term goals of this project are and where your money is going. Jacsonville does not have much of a healthcare system. There is a clinic and hospital in nearby Pignon but it is poorly staffed and lacks a lot of equipment and training. For now a medical team will be going to Jacsonville every 3 months in order to ensure continuity of care. Patients will be given three months worth of medication for chronic illnesses. If they have any problems they can talk to Gabi or go to the hospital. Every time a group goes down we will bring more supplies and medications with us in order to make the clinic as fully functioning as possible. On occasion surgeons, dentists and other specialists will join us and offer their services. In the meanwhile the extra money raised will go towards a fund to build a permanent clinic and hospital in Jacsonville staffed by Haitians. Our goals at the moment are to establish a good healthcare system that we can pass over to them in the future.

What was interesting to me is that the community seems to be putting a lot of faith in us as healthcare providers. In some ways this is a really good thing. It means that we are doing a good job and that they trust us to give them medications and treatments that will help them. However, We are not in a facility that can accommodate much in terms of trauma and serious illness and we are definitely not a facility that has beds for people to stay.

We packed up the pharmacy after the last clinic day and headed to the airport in shifts the next morning. When we were all in Port-au-Prince they took us around the city to show us what it is like. The devastation was immense with buildings in shambles and tent cities set up everywhere. We stopped at the hospital and walked around but didn’t have a chance to go inside. Alison had worked here for a while after the earthquake and told us where all of the different wards were.

After the tour we went back to the airport and headed home. It really was a great trip. I learned a lot about medicine and got to see some really interesting cases. I also got to see first-hand what the earthquake has done to this already ravaged country. I am hoping to go back again someday and continue to support this project. Thanks again to everyone that donated money. It really does help!