Friday, February 22, 2008

Clinic Day 4 - St. Elen

Tuesday, February 19, 2008 (St. Elen)

Today’s wake-up theme was “rivers” as Dr. Don played those hymns on his violin.

We began the day with a visit to the woman with gangrene. Marcia was along so she helped Mark. The woman’s leg continues to look more rotten, but perhaps the woman was not septic now. It’s imperative she get to a hospital very soon; we asked MSH to help that happen. If she doesn’t get an amputation she will surely die soon. Her husband, who is blind with cataracts, sat on the bed with her and just stroked her head. The room they’re living in is no bigger than 8’ x 8’. After changing the dressing, we waited for Rivenson to catch up in his vehicle. In the meantime, a dog came along the street and lifted its leg on Marcia’s skirt – out of the blue! That was a bit of a shocking surprise.

Amoce exchanged money for us at the drive-up teller in Okay (that’s really a street-side money-changer sitting in a chair with a wad of money in his hand.) Rivenson's truck drove up with another passenger inside - a local woman who had her x-rays with her and wanted the doctors to read her x-ray (shoulder). In Haiti, you get an x-ray taken and then it's up to you to find a doctor to read it. Mark and Don consulted in the middle of the street and eventually the woman received a cortisone shot in her shoulder once we arrived at St. Elen.

We had an easy drive out to St. Elen with Rivenson stopping along the way to pick up some people we didn’t know. They turned out to be Witchner’s family (sisters and aunts) and someone else’s cousin. Many people were angry along the way because Rivenson’s tap-tap would not stop to pick them up.

Once we got to St. Elen, we were told they didn’t want us to set up in the church, primarily the altar area. That’s unusual because we always do that in every church we go to; churches are our primary site. The altar is usually just a raised area in the concrete floor. However, we honored their wishes and moved to 2 empty classrooms. The classrooms had no windows and just one door with a tin roof less than 3’ above our heads. At 10 a.m. it was already beginning to be hot. By 10:30 Greyson and I decided that it was time for a womanly decision and we moved the clinic out under a mango tree where there was a lot of shade and a nice breeze (also lots of rocks under our feet). It was a much better site. It took us a while to get started because the regular set-up options were no longer part of the plan. Following that our first patients ended up being “the relatives”…this made the rest of the morning a little challenging since everyone else wanted all of the same meds that the relatives got.

The intake area was a little chaotic and challenging again. Marcia ends up having to do most of the history, temp and BP and gets backed up. We need to come up with a better plan. She really needs another nurse-type of person to work with her, but one who can speak kreyol in order to understand the names. We saw much more malaria here than in the other 4 places we’ve gone to. St. Elen sits among rice paddies, so it’s no surprise that it would be a perfect breeding ground for mosquitoes. We also saw sick children, including a little girl named Joanna who is still very touch and go. She had quite a serious respiratory infection and was very, very dehydrated. Mark took her into the church, laid her on the floor, and with Marcia and Greyson’s help tried four times to get an IV into her. It was a long day with Mark worrying quite a bit about whether she was improving. Marcia, Rivenson, Dr. Don and I prayed for her. Toward the end of the day she appeared to improve a little…she was a little more alert. Dr. Mark said he had never seen the medicine work that fast. Joanna’s family history is also sad with her grandfather having fathered a child and then taken it to an orphanage soon after it was born without ever recognizing it as his. The sociology of Haiti is very complicated.

We saw 165 people today; it was a long hard day, but it wasn't over yet.

We still needed to have a MSM/MSH meeting. We always meet together to get a financial report from MSH (the Fonkoze account) and to talk about our mutual plans. This evening's meeting primarily focussed on the positive and the negative aspects of each clinic day so that we can make them as good as possible. We didn't get through our entire agenda; we'll have to reconvene later in the week. Most of the team heads home in 2 days, but Paul and Jan will be able to meet with MSH.

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