4/15/10 - 4/15/10 94 °F
Clinic was awesome today! I got to play with some of the cutest kids, make people laugh by being the crazy white girl that I am and improve health at the same time! On the flip side we had some sad cases. One lady miscarried her child, another has a probable brain tumor that is causing an increase in intercranial pressure, we had one patient with a suspected subarachnoid bleed (with likely permanent vision loss in his left eye), more scabies, asthma patients but we were out of albuterol (rescue) inhalers and could only provide slow acting inhalers…
Infant mortality is a huge concern here in Haiti. I was told that one in two children do not make it to the age of 5. Malnutrition is a large culprit, one that we have seen in the clinic and do not have a solution for. We refer them to the Red Cross but have not heard if they accept our referrals. When I am able to upload movies and pics you will see that the line to get humanitarian aid (food) from the UN is about .75-1 miles in length. UN soldiers holding AK-47s are the line monitors. Men are not allowed to wait in line, only women due to corruption. It was the only line that was longer than the bank, immigration, and gas lines (all which were substantial).
Yesterday our drivers had more trouble than usual finding gasoline. The shortage has grown so severe that each station is empty and cars just pile into the area causing complete chaos, horns blaring and yelling can be heard for a few blocks.
With piles of rubble filling every corner, dust from cement has filled the air mimicking an LA smog appearance, but lighter. This haze is thicker than smog and coats you head to toe. Bye the time I return from clinic I have a protective layer of cement coating my skin, and globs collected in my elbows. Attempting to practice good hygiene for those that do not have a clean home to return to, is all but impossible, resulting in hundreds of site-specific infections. I would say it is the number one problem that we are treating currently.
Our everyday clinic operations begin before we arrive. Our security / ushers if you will open the doors, a couple of hundred people enter the clinic, are handed a number and de-worming medication, then sit in order to be seen. Most of these people have never been evaluated before. When you ask them, “How can I help you today?” On more than one occasion they have responded, “I don’t know you are the doctor.” It cracks me up each time I hear it. I am forced to re-phrase. Is there something that hurts you? They also have no idea what to do when I take their blood pressure; they wiggle their arms all around, and need step-by-step instructions because they were not raised with medical care like we were. The average Haitian’s life expectancy is very short, approximately 46, so elderly Haitians have a large education and generation gap. Most of my elderly patients don’t know their birthday or their age. Not because of a dementia but because they were not educated, and were so poor that they did not see reason to celebrate. That record was simply not kept, so they usually make one up that is off by a estimated 15-20 years. But the one that really got me was they do not know how to provide a deep breath so that we can listen to their lungs. I act it out, the translators translate it and also act it out, and it has been something that they have struggled with repeatedly. So you can imagine how fun it is to teach them how to use an inhaler. Non-treated hypertension and diabetes have been a huge problem that I have noted so far. Today I had someone with a blood pressure of 248/146, for those of you in the medical field and probably anyone that is on a low salt diet knows that that is no bueno.
I have much more to write about the day but it is 11pm, and I am out of fuel… I will write tomorrow (I hope) about the palace visit, walking the town, awesome beer, and bonding with Marc my translator. J