Deep Thoughts at Club Med(ical)

Yesterday, Megan and I had another day running triage at Petionville club. The system there is, all patients stand in one line at a gate, then are let in about 50 at a time. Once into the medical area, they stand in another line to see the triage team. At triage, we found out their main problem (or several problems). If it was a problem we could deal with pretty easily, like a minor infection, we would take care of it at triage and sent the patient home. If it was more major, we sent the patient up to the hospital. During the day, Megan and I saw 80-100 people between us. Problems ranged from back pain to congenital tumors. Everyone had symptoms of stress - headache, difficulty sleeping, heartburn and poor appetite. All the kids needed vitamins. Half the women were pregnant or breastfeeding. It became standard to ask everyone about parasites, malaria or worms in their stool.

We had some heartbreak cases - a 4 month old baby, so skinny with legs like match sticks because her mother was feeding her only watered-down cows milk - a mother with her 5 malnourished kids who all had signs of vitamin deficiency, scabies, and worms. The oldest child in the family, a 14 year old boy named Sohel had broken his leg before the earthquake, and rebroke it while running away during the earthquake. His knee was terribly swollen and his lower leg was angled away from his body. He walked with a long stick and was obviously in a lot of pain. Strangely, he might end up saving the family with his injury. He will be transferred to the Children's Hospital for orthopedic surgery, and hopefully someone will notice the family there and get them hooked up with some care. When Megan and I were about to leave, a group of transporters ran up, carrying a teenage girl who appeared unconscious. She was covered in dust, her body was limp and her eyes kept fluttering. Her mother had beaten her up. We looked but could not find any blood or obvious injury, and her vitals were stable. We did the painful stimulus routine, but she didn't move or flinch at all. After a few minutes, her eyes popped open and she started keening and crying. We realized then that with the trauma she had gone catatonic. And she'll probably just have to go back to her mother's tent unless she somehow has friends who can take her in.

Megan and I got a lot of great feedback from the team at Petionville. They were grateful that we had been able to control the flow into the hospital so truly sick people did not need to wait. They were impressed at how independent we were, and how well the lines flowed. We're a little sorry not to go back, and I'm really going to miss my translator, Hubert. He was fantastic - he worked hard, refused to take breaks and had a wonderful calm voice when he spoke to people. He picked up my rhythm really quickly, and could explain treatment regimens and medications. He learned English from the internet and programs on his MP3 player. He said that he was thinking of going into medicine, so I gave him a stethescope when I left. We exchanged e-mails. I hope we keep in touch.Megan and I were a little sad to leave but are now excited about our upcoming adventure. We're going to Delmas 31 today, a different tent city with NO existing clinic. We're bringing everything on our backs - and finally the supplies we brought are going to come in useful. Last night, we had a packing party with our team - otoscopes, thermometers, wound care, OB supplies, lots and lots of medications and vitamins. We're going with 4 other women - an OB/GYN, a 4th year med student, an ICU nurse and a non-medical support person. We have no idea what to expect, will write again later.

Late last night, Megan, Danielle and I had a serious talk. Danielle was so saddened about the desperate needs of most Haitians. The patients she had seen had just had high-tech surgery, but then no one thought to provide food for them in the wards. Nursing care, sanitation and wound checks were inadequate. How can these people heal? Danielle wondered if we were really doing any good at all in the big picture. It definitely sticks with you - yes, we're doing something now, but what about tomorrow? How many infections will come right back? What happens after the vitamins run out again? Megan and I were more hopeful - at LEAST we're doing something now. At LEAST we're showing our patients that the world cares about them. At LEAST mothers and children are getting a little education in sanitation and nutrition. And maybe tomorrow something else positive will happen, and Haiti will slowly, SLOWLY start to build into a functional nation. It's going to take years of work - and that work will have to be so carefully planned to foster sustainability and independence instead of just giving handouts. I know that smart people are working on it - I just hope so desperately that they get a few things right.

I keep meaning to write about our living conditions at Quisqueya - it's a much lighter subject! I'll try to get to that tonight. Happy Tax Day! xxoo Rachel