HAITI: Day 7 -- PIH and some R&R

06-25-11

We packed up said goodbye to our modest little home of the last week and headed back to Port au Prince for a day of rest and relaxation with a stop at Partners in Health (PIH) along the way. When you enter the gates of PIH, you feel as if you’re entering a major compound. The driveway winds up to rows of concrete buildings. Some of the buildings serving as the hospital, others as homes for the patients, and other as community centers where women are taught skills to start local businesses. One of the community healthcare workers started us off on a walking tour of the outside of the compound.

At one point, we ran into a little boy who called himself Anyo. As he saw me, he asked me “Kreole? English?,” and I tried to explain to him that I only spoke a little Kreole…could he speak English? He told me yes and then proceeded to tell me “My name is Anyo” in perfect English. He was so friendly and outgoing, and the first child I met that could speak any English.

As we continued the tour of the compound, spiraling higher and higher (the compound is built on a mountain/hill), the views kept getting more and more beautiful. We finally reached the peak where you could see “mountains beyond mountains” (the appropriate name of the book about Paul Farmer and PIH in Haiti). After enjoying the view, we headed back down to tour parts of the hospital. We toured the internal medicine ward, the surgery ward, the maternity ward, and the TB ward. By “toured” I mean we would go to the entrance of the ward and a hospital worker would tell us some facts about the logistics of that specific ward. It was interesting to see in the maternity ward, posters of the treatment protocol for raped women as well as promotional material for the contraceptive injection. The hospital is the best medical facility I have seen in Haiti, and overall, PIH impressed me.

After a very bumpy (think huge potholes and crazy,/no rules, traffic), we arrived to our hotel in Port au Prince—Karibe. It was such a strange feeling going from working in makeshift clinics in the dirt where finding clean water was a huge problem to a five star hotel with a massive pool containing a built in bar. It very much typified the contrasts of Haiti—the huge disparity between the wealthy and the poor, the beautiful scenery dotted with makeshift shacks for housing, the smiling baby covered with a festering skin infection.

We enjoyed our time at the hotel, taking advantage of the pool and everything else the hotel had to offer—a celebratory ending of our trip to Haiti.

Overall, I enjoyed my trip to Haiti. It was fulfilling, frustrating, heart breaking, heartwarming, educational, and incredibly fun. The country has countless problems, but the people are resilient, and that gives me hope.

HAITI: Day 5 & 6 --working in clinics

06-23-11 -- Clinic in La Hoyt

Today was market day in Thomonde. The local women had put out all of their homemade goods to sell -- beautiful embroidered tablecloths and colorfully embroidered scrub tops and dish towels. They also had all kinds of carved wooden bowls and other decorative items. I ended up getting a great tablecloth with "Haiti" embroidered in the center.

After the market, we again made good use of our rented landrovers as we crossed rough terrain to reach a rural clinic. At one point, the drivers even stopped to evaluate if they could even travel further on the "road." When we arrived at the clinic site, we saw it was a local's house. They gave us use of their kitchen for our pharmacy and 2 other bedrooms for our other clinic rooms. One of the local doctors from the nearby town, Casse, joined us -- Dr. Jean Baptiste. At times there was some tension working with him, but having him there helped us see a lot more patients.

I was assigned to the adult clinic in the morning and the pediatrics clinic in the afternoon. My first patient was the sweetest 80 year old lady who was complaining of generalized pain (abdominal, knees, hips). We ended up giving her some pain medication and antacids. Another one of my patients was a 40 year old man who had his 10 year old son with him. As we were talking, he kept coughing, and when I listened to his lungs you could hear crackles/wheezes in all of his lung fields. As we continued talking, he admitted to smoking cigars everyday for as long as he could remember. I suspected he had COPD complicated with an infection and Dr. M agreed, so we gave him an antibiotic and an inhaler.

In the afternoon, I saw the healthiest/happiest baby I've seen in all the clinics. She giggled as pulled my stethoscope out to listen to her heart. She turned out to be perfectly healthy, but as we were wrapping things up, Lenny, the translator, suggested that I have a sexual history discussion with the mom since she looked VERY young. I agreed, and although she seemed a bit embarrassed, she ended up deciding to get an HIV test at the clinic.

I ended clinic feeling hot, tired, but happy about the patients I got to see that day.

06-24-11

Our last day in clinic...it came so fast.

The night before, as Sameer was confirming our clinic day with TonTon (another medishare liaison), we discovered there had been some kind of miscommunication and there was no clinic scheduled for our last day. After Sameer talked to TonTon to see if there was any way we could still do clinic, Tonton agreed to see what he could set up for us.

Thus, our hopes weren't very high as set out for our last clinic day thinking we were just going to be helping out Dr. Jean Baptiste (the Haitian doctor from the day before) in his clinic. As seems to be the case in Haiti though, you never get what you expect. We were pleasantly surprised as our drivers dropped us off at a school building with about 50 moms with babies waiting for us, so we could set up clinic as we had the days before.

Wet set up clinic in the concrete school classrooms with windows cut out from the wall that the local children peered through all morning and afternoon.

I started off the morning in the peds clinic working with Allison (one of the peds docs). I saw a lot of healthy, happy babies, which was fun and uplifting. There was one 4 month old in particular that just kept smiling at me in the most adorable way. The rest of the kids mostly had minor illnesses -- sinusitis, URIs, and abdominal pain.

I spent my afternoon in the adult clinic with David (our internal medicine doc). There were a few patients that had the same complaints we had been hearing all week -- URI, headache, generalized pain, but I also had some other, more unusual, patients. The patient that touched me the most was an elderly man who presented with generalized pain, but Youseff (who was triaging patients that afternoon) said that something seemed off about him, and when I started asking him questions, he was barely able to respond. His wife then described how he had been acting bizarrely for the last week or so...almost going into hysterics at times. When we asked if anything in his life had changed recently, his wife revealed that their son had been in horrible traffic accident, and that's when the husband's bizarre behavior had started. David thought he might have the beginning stages of dementia and referred him to the nearest hospital for evaluation. Afterwards, Youseff was telling me how often times, elderly patients can get something called post traumatic dementia after a particularly distressing experience. I can't even imagine what that poor man must have been going through, and there was nothing we could really do to help him except refer him to a hospital for more testing.