To get the full experience, it was decided Catie and I would work Monday and Tuesday in the clinic and Wednesday and Thursday in the schools. After spending time in the clinic and realizing how much we were needed, our plans changed and we spent all week (except a couple of hours on Thursday) in the clinic. For me personally, this was the most life changing part of our trip.
Our clinic was located about 3 miles away from Blanchard (where we stayed) in Cite Solei, an extremely impoverished and densely populated commune located in the Port-au-Prince metropolitan area in Haiti. The area is generally regarded as one of the poorest and most dangerous areas of the Western Hemisphere and it is one of the biggest slums in the Northern Hemisphere. The area has virtually no sewers and has a poorly maintained open canal system that serves as its sewage system. It has few formal businesses but many local commercial activities and enterprises. There is sporadic but largely free electricity, a few hospitals, and two government schools. HOM operates this clinic along with a church and school on the same site.
As I mentioned in an earlier post, we were not allowed to tour Cite Solei this year as we have in the past because of violence in the city while we were there. Therefore I’m sharing some of my friend Frank Clark’s pictures from their tour of the city in 2015 in a slideshow below. (Thanks Frank!) Since I was not able to see the city for myself (beyond the clinic), here is a description from Brian Fitzpatrick and Michael Norby from as recently as 2014. (http://newint.org/features/2014/07/01/haiti-fighting-for-change/)
“At the sea’s edge, toddlers play naked among wild pigs, and people rummage across mountains of rancid trash and human feces. Most housing consists of ramshackle huts, like ovens under the Haitian sun. When it rains, an ankle-deep soup of sewage fills the interiors. Years after the earthquake, the famous mud cakes of Cité Soleil are still being sold at the side of the street: discs of baked dirt, water and salt eaten by starving families to stave off hunger.”
Our clinic was located about 3 miles away from Blanchard (where we stayed) in Cite Solei, an extremely impoverished and densely populated commune located in the Port-au-Prince metropolitan area in Haiti. The area is generally regarded as one of the poorest and most dangerous areas of the Western Hemisphere and it is one of the biggest slums in the Northern Hemisphere. The area has virtually no sewers and has a poorly maintained open canal system that serves as its sewage system. It has few formal businesses but many local commercial activities and enterprises. There is sporadic but largely free electricity, a few hospitals, and two government schools. HOM operates this clinic along with a church and school on the same site.
As I mentioned in an earlier post, we were not allowed to tour Cite Solei this year as we have in the past because of violence in the city while we were there. Therefore I’m sharing some of my friend Frank Clark’s pictures from their tour of the city in 2015 in a slideshow below. (Thanks Frank!) Since I was not able to see the city for myself (beyond the clinic), here is a description from Brian Fitzpatrick and Michael Norby from as recently as 2014. (http://newint.org/features/2014/07/01/haiti-fighting-for-change/)
“At the sea’s edge, toddlers play naked among wild pigs, and people rummage across mountains of rancid trash and human feces. Most housing consists of ramshackle huts, like ovens under the Haitian sun. When it rains, an ankle-deep soup of sewage fills the interiors. Years after the earthquake, the famous mud cakes of Cité Soleil are still being sold at the side of the street: discs of baked dirt, water and salt eaten by starving families to stave off hunger.”
We arrived at the clinic around 8:00 most mornings. Hundreds of men, women and children were already lined up waiting for us. Half of the clinic is set up for mission groups such as ours and is staffed only about 6 months a year, depending on the number of medical missions scheduled through HOM. The other half houses Haitian doctors. It is determined ahead of time who should see us and who should see the Haitian doctor, but I witnessed many examples of teamwork between both sides as thoughtful decisions were made on behalf of the patients. Our side of the clinic was set up with a triage room (Amy, Jennifer, Marcia, and Catie), four exam rooms manned by our doctors (Evelyn, Karen, Christy, and Frank), a surgical room (Dr. Mike and his son Austin), Pharmacy (Kerry, Diron and me), and a Lab. Interpreters were with each person and what an important job! Our work could not be done effectively without efficient translators. Sidenote: On Monday, I actually worked surgery with Dr. Mike, but spent the rest of the week in Pharmacy, thus the stories of me in surgery!
Every patient who came in was given worm medicine and weighed. We took their blood pressure, temperature and a detailed description of their symptoms. If needed, pregnancy tests and urinalyses were given. They then waited to see a doctor. After the appointment with the doctor, they brought their prescriptions to the pharmacy window and waited for it to be filled. The entire process could take hours. The vast majority of what we saw was high blood pressure (and I mean HIGH...in very young people!), pediatric malnutrition, skin rashes, respiratory infections, asthma, GERD, abscesses and worms. But we also saw some very sick people, especially babies.
Every patient who came in was given worm medicine and weighed. We took their blood pressure, temperature and a detailed description of their symptoms. If needed, pregnancy tests and urinalyses were given. They then waited to see a doctor. After the appointment with the doctor, they brought their prescriptions to the pharmacy window and waited for it to be filled. The entire process could take hours. The vast majority of what we saw was high blood pressure (and I mean HIGH...in very young people!), pediatric malnutrition, skin rashes, respiratory infections, asthma, GERD, abscesses and worms. But we also saw some very sick people, especially babies.
As mentioned earlier, I worked one day in Surgery with Dr. Mike and the other days with Diron and Kerry in Pharmacy. When you are in Pharmacy, you are doing extremely important work, but a little bit isolated from what's going on in the clinic. Therefore, I've asked Amy to share some of her stories, as she was right in the heart of it.
This is a 7 month old little girl. Her mom brought her to the clinic for fever, cough, and loss of appetite. She was so light that I had to repeatedly ask her Mom her age. She weighed only 12 pounds! I noticed also she did not interact as most 7 months would, she did not attempt to stand, and she never smiled. She had a fever, her lungs sounded full of gunk, and she was dehydrated. This little girl was sick! Dr. Christy Fagg saw the baby and ask that she get a breathing treatment, antibiotics and an IV. This 30 year OR nurse hasn’t started IVs in years so I ask Marcia Chew (great ICU nurse) to start the IV. Thankfully Marcia agreed!! It’s seeing children like this in Haiti that just rips at my heart. It also makes me pause to appreciate my own children’s health, my grandson’s health and the ready access to healthcare!
-Amy Woods
This is a 7 month old little girl. Her mom brought her to the clinic for fever, cough, and loss of appetite. She was so light that I had to repeatedly ask her Mom her age. She weighed only 12 pounds! I noticed also she did not interact as most 7 months would, she did not attempt to stand, and she never smiled. She had a fever, her lungs sounded full of gunk, and she was dehydrated. This little girl was sick! Dr. Christy Fagg saw the baby and ask that she get a breathing treatment, antibiotics and an IV. This 30 year OR nurse hasn’t started IVs in years so I ask Marcia Chew (great ICU nurse) to start the IV. Thankfully Marcia agreed!! It’s seeing children like this in Haiti that just rips at my heart. It also makes me pause to appreciate my own children’s health, my grandson’s health and the ready access to healthcare!
-Amy Woods
I absolutely fell in love with the 3 year old boy! His mom brought him in as he enjoyed swallowing pennies. This little fellow was full of personality. When he rested his elbows on my knees my heart melted. Some background- Much of Haiti's population – especially children have intestinal worms. These worms may consume as much as 20% of daily nutritional intake, causing malnutrition. In most cases individuals are infected by worms because of the presence of raw sewage, the lack of potable water, and the lack of access to health care. Hence the reason our team give children over 2, adults under 65, and non-pregnant females albendazole. The albendazole is wrapped in a tootsie roll in hopes of making the taste more palpable. This little fellow was having none of it! I knew he needed to swallow the med and quickly began to “bribe” him with tootsie rolls of the non-crunchy variety. Even then this little one would tease me acting as if he was going to spit the albendazole out. His smile and laughter during our bantering made my day. To see such a happy little boy in an area of absolute distress was a heartwarming, soul feeding, pleasure. -Amy Woods
I wish I could articulate what it was like to see the sickness that came in that could easily be prevented with any kind of access to health care. Wikipedia reports that "In terms of health care spending, Haiti ranks last in the western hemisphere. Economic instability has limited any growth in this area. Per capita, Haiti spends about US$83 annually on health care. There are 25 physicians and 11 nurses per 100,000 population. Only one-fourth of births are attended by a skilled health professional. Most rural areas have no access to health care, making residents susceptible to otherwise treatable diseases." We had twin girls come in that were so sick they needed to be taken immediately to the local hospital. One doctor described the hospital as "something from the civil war era". Because the parents couldn't pay, no service would be given to them and the only way they received any medicine was because we brought it to the hospital for them to administer. In fact, the hospital would not even release the children back to their parents until they could pay. It was very stressful and maddening for our group.
As sick of some of them were, they were the strongest people I've ever met. I did several surgeries with Dr. Mike where patients were only give a local anesthetic. They rarely whimpered or said a word and were so appreciative when it was all over. It was fascinating to watch not only the surgeries themselves, but the the way Dr. Mike made each patient feel like the most special human being he had ever met. Each of our doctors (and pharmacist) did this and it honestly brought tears to my eyes each time I witnessed it. I wish I had the medical background and memory to relay the amazing stories I heard throughout each day from our oh-so-talented medical staff. Their experiences are so unique and fascinating, they really should write a book!
As sick of some of them were, they were the strongest people I've ever met. I did several surgeries with Dr. Mike where patients were only give a local anesthetic. They rarely whimpered or said a word and were so appreciative when it was all over. It was fascinating to watch not only the surgeries themselves, but the the way Dr. Mike made each patient feel like the most special human being he had ever met. Each of our doctors (and pharmacist) did this and it honestly brought tears to my eyes each time I witnessed it. I wish I had the medical background and memory to relay the amazing stories I heard throughout each day from our oh-so-talented medical staff. Their experiences are so unique and fascinating, they really should write a book!
Up Next: Haiti...The Children
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