HAITI: Day 4 -- Clinic near Marmot

As we set out for our second day of clinic, we stopped by the newly finished Marmot Maternity Center. Staff includes 3 ambulatory nurses and support staff. They are still looking for a doctor and a midwife, but Marie said they were currently talking to a midwife who would most likely fill the position. The clinic had 2 NICU beds, and observation room, and a maternity ward. It's definitely progress and will fill a huge need in the community.

We then continued on to our clinic site. Rough roads again, but not quite as bad as the previous day. Looking out my window and seeing all the little kids -- on horses, carrying water, waving at the passing car-- I felt hopeless. Haiti/Medishare is making progress -- the maternity clinic and the nutrition factory, but the way these happy, outgoing kids were living just made my heart ache.

I spent the morning in the pediatrics clinic with Susan. It was so hot (no air flow) that I was trying my best just to not sweat on our patients. We even had a few students who were sweating so much that they soaked through their scrubs. Our patients had a lot of non specific abdominal pain (most likely due to worms) and some upper respiratory infections. We also had a girl with rectal prolapse. Apparently she had an operation for it a few months ago, but it had reoccurred. The mom was very worried about it, and said every time it happened, she had to push it back in. There was very little we could do for her, so we just suggested she returns to the surgeons who did the operation.

In the afternoon, I worked on pediatric triage with a local nurse. This included height and weight measurements, temperature, and arm circumference. The local nurse was invaluable -- she could communicate with the mothers and children to get the most accurate weight and height measurements. Triage also provided some down time to just play with the adorable little kids. There was one 3 year old wearing her mom's wide brimmed hat who came over and decided to play peek-a-boo with me --so adorable :)

It turns out we got done with the pediatric patients before the adults, so I moved outside to try and triage the adults since we probably wouldn't have time to see them all. I started off taking vital signs and sent in patients with extremely high blood pressures. We then realized we had time to see even fewer patients than we though, so I started going around with a translator to get the patient's chief complaint. While we were walking around, Woon Cho came out and spotted a sickly looking man and looked at his health record where it stated he might have HIV. Woon Cho immediately took him inside. One of our doctors, David, works at the AIDS clinic in Atlanta, so we took the patient to see him. Since we have no HIV medication, David wanted our patient to go to the nearest hospital to receive treatment. After finding out the man could not afford transportation to the nearest hospital, David collected money and gave it to the man.

While I was triaging, there was another woman complaining of an eye problem. I unfortunately had to tell her that we had no eye medication we could give her. On the ride home, we discussed how it would be really helpful to bring an opthalmologist on the next trip since so many of our patients had eye complaints related to working out in the bright sun without any eye protection.

On the second day of clinic there were quite a few interesting cases in the adult clinic where we could either provide treatment or refer the patients to a center where they could receive care. Overall, it was starting to feel like were having some kind of impact.