Well I finally decided to come out of my little rabbit hole I was hiding in. It took me a little longer than normal to get back into the swing of things. I’ve stopped having panic attacks when the cat knocks things over, and my heart no longer races when I read the news. All in all that’s a vast improvement from last week.
We had 5.5 days of clinic. In those 5.5 days we treated over 1,600 patients.
We started out in Port-au-Prince. Our first clinic was about an hour from the city limits in an area called Leogane, which is about 7 miles from the epicenter of the first earthquake. Over 90% of the homes in the area were destroyed. Any remaining building were not safe to live in, or people feared being indoors too much to stay in them.
We arrived at one of the tent cities which had previously been a soccer or futbol field to a school. There were so many tents. Most were smaller than a small bedroom, housing 4 or 5 people. We drove our bus into a clearing, attached a tarp to the top of the bus and secured it to a wall of the school. Instant clinic. We brought fold up tables and chairs that have been around the world a few times.
We had about 10 people seeing patients at any given time. There were 6 physicians, 2 medical students and 4 nurses. The nurses traded off seeing patients, doing wound care and being the runner for supplies and injectable medications.
Each patient had a triage form that had their name and age on it, if female if they were pregnant or not, and the list of common complaints – cough, fever, diarrhea, pain, tooth pain, etc. The triage people would try to circle what the main problems were so we could be more focused with the exam and thus see more people.
In Leogane they live too far outside the city limits to receive care from Port-au-Prince. Some doctors had been out that way already, but living in tents causes infectious diseases to rapidly spread. Anyone needing long term treatment would receive things in spurts if someone came to them.
One lady was brought to us in a wheelbarrow. A wall had collapsed on her foot during the earthquake. It was black and necrotic. Dr. Ashby (an ER doc from Charlottesville , VA) spent about 2 hours removing the dead tissue from her foot and cleaning it. He did all of this with local anesthetic and a few shorts of versed. So while she didn’t feel pain, she was definitely awake during all of it.
I saw two children – while not related to the earthquake – who definitely had things wrong them. One little girl was badly burned as an infant and had a scar tissue contraction from the middle of her shin attaching to the top of her foot, deforming it so she could only walk on the heel of her foot.
It’s sad in the fact that her foot could be corrected in a really short and simple surgery. Just cut the contraction and her foot would go almost flat immediately. She walked relatively well for the deformity that she had. I wish we had better shoes to give her.
The other baby I saw – I’m about 99% sure it had some genetic/trisomy/Down Syndrome thing going on. The baby did not cry correctly – more of an eh sound, had a cleft lip, low set ears and close set eyes. In pediatrics terms – a funny looking kid. Not sure exactly what the issue is, but we treated the general illnesses and I asked a bunch of questions to make sure the baby was eating well without coughing. I saw no cleft palate – but a baby like that can die from aspiration or malnutrition easily.
After seeing the doctors the patients headed to our high tech pharmacy. A numbered roll out bag with little baggies of medications in it. Portable and able to be used by non-medical people. In fact everyone who worked in the pharmacy had no medical training. They got a crash course in what BID/TID/PO/IM/PRN meant. They did an awesome job, not knowing what we were writing and not knowing what the drugs were for. Way to go Pharmacy team!!!
After the pharmacy was a trip to the out reach group… who distributed clothes/diapers/bottles/baby formula.
At the very end of the day we gave out water. We couldn’t do it earlier in the day because things like water and food tend to cause mobs. It’s harder to control the masses after that. So we gave out water and headed back to Port-au-Prince.
Even while living in tents… the Haitian people still fly the flag and have pride in their country.