Dr. G. Day 6 2013

Haiti Day 6

I am now sitting on the back balcony overlooking the mountains full of farm lands, stopped by a short valley then the Caribbean sea. They tell me there is a island directly in front of us which I can faintly see the island and a long mountain on top of that area.

What a day! We went out early in the morning to the church which is a 10 minute walk from Gladys's amazing house. The earth is bright red, the path we took was covered in short grass, the surrounding land was all farm with a single cow, then a goat, then a horse from farm to farm, tied down by a stake and a thick rope. The bright red dirt made the green everywhere else this bright primary color green, its was like out of a movie on that you think”they must have really enhanced this” We passed some family tombs, some sheds, some farmers plowing. The church was already full in every pew of people who wanted to be seen and more were lining up outside. By the time we were set up , which was only about 10-15 minutes, the yard full of all ages from infants to elderly. With Gladys's help we got everyone out of the church and set up our stations with medications appropriate for each station. Hypertension, belly pain, gynecological issues or pregnant, anemia and the sick shack. For the sick frail elderly people we let them sit in the church. The rest were triaged outside. I started taking the elders blood pressure who were sitting patiently on the church pew to get their triage going. First blood pressure 210/120, next 180/100, next 230/104, “do you know that you have high blood pressure?...Oui...are you currently taking medications?...non”...they ran out a long time ago.

I then was assigned to the sick shack which was everyone else who was not clearly belonging to the other shacks and or may be truly sick. All day we treated hypertension, worms, malaria, chest pain, GERD, about 5 kids were treated for malaria, lots of cute kids, more tinea, two children had very loud murmurs and we looked into referrals for echos, but if the next step was surgical I doubted the country has a pediatric cardiologist or cardiovascular surgeon for that matter, they don't even have real adult ICUs for gods sake. Every patient with anemia got iron, each with suspected worms got a onetime oral treatment, every hypertensive patient got a handy pack of Amlodipine, HCTZ, simvistatin, and ASA 81mg, just in varying doses depending on how completely scary their BP was. There was some satisfaction in watching the patients take some of these meds on spot, which I did for the kids with worms and for the angina chest pain patients. We joked at the de-worming communion.

In all we saw over 200 patients. It was an organizational feat beyond belief. Out of a church with little grounds, no running water, no obvious electricity we set up a clinic extraordinaire. People did have some wait but we went through 200 citizens of Mussotte from 830 til 3pm. We ran out of goody bags, a prize for everyone who made it through. The kids got pediatric multivitamins, band-aides and anti-fungal cream, adults got condoms, “kotex” (when appropriate) and some routine stuff that we keep in our own medicine cabinets, such as tylenol, ibuprofen, antacids. We will make up more goody bags tonight, but supplies are already running low and we will likely move to second choice therapies in many cases. I asked if there will be fewer patients tomorrow but the answer is no, probably more. Its hard to imagine that more people live in Mussotte. The town does not exist on google maps, but we are located on the Southern part of the island, in the curve of the bay, facing West. I doubt there is an official count of how many people live here. Many of the kids were waring these bright yellow and navy uniforms for school. I suspect it is for the school that Gladys started, and I doubt there was a school here until she built it.

We marched back to the house on the “back roads” which was actually a hike on a trail. This route overlooked the ocean. It all is so untouched. It looks like what Portaviallta without all the towering hotels. If Haiti ever gets infrastructure and gives way to tourism I will be especially glad I saw it this way now.

We found out the history of the house. Gladys lives most of the time in a Port au Prince house which she states has the same view as this house, but much lower elevation. 30 years ago a friend took her to Mussot and she could not believe that this is still Haiti. She soon bought a house for $700, the asking price was $1000 but her husband talked the seller down. Years later the preacher at the church sold her the land we are resting on now for $7000 and she build this lovely home on top of the mountain. She converted the original home into the local school. The house we are in is not fancy by western standards. No electricity until after dark and they turn on the generator, no need for air conditioning or heat, just open and close the windows.. the front of the house has a large tall fence topped with broken glass for security, then an alcove, then a very functional kitchen with gas stove from magically they are able to feed us really delicious dinners, a dining area, a living room area, a back porch with the view, 2 bedrooms on upper floor, 2 in the lower level and a den, 2 bathrooms. Every room is being used by us for sleeping. Thank god Gladys is flexible and made this situation work. There are 19 of us now staying in this house.

The students went for a hike after dinner and now on the roof, having a 'party” with Colt 45 bought at the supermarket, the “adults” (the attendings and Brian) are hanging out listening to music, drinking more haitian rum and writing, reading chatting. Life is precious. We did good today. We are tired, relaxed and in heaven.   

Dr. G. Day 8 2013

Haiti Day 8 4/7/13

We left Mussotte this morning on the same bus that took us there. I got a better view of the mountain towns this time. So lush, Carla, one of the other attendings, wondered if those who lived there knew how incredibly beautiful it all was where they lived. Before we left Emanuel (our cook) and some other locals were picking carrots right next to the house. Cabbage was one of the more identifiable crops.

Emanuel took me, Sangiita, and TJ (third year students) for a walk and little tour last night. He pointed out a limestone quarry that is dug up for making cement (for cinderblocks?) , he pointed out various crops, horses stood in the sunset, goats with their baby goats close by, we took a picture of one man walking his goats back home. He was pretty pissed and made us delete the pictures. Emanuel explained that the people here are pretty proud and do not want to end up on an American magazine cover as the picture of poverty. Of course that was not our intention, although I must admit the purpose of some of the photos are to express what we are seeing in one of the most impoverished countries in the world.

This morning after we got to the bottom of the mountain, we drove through the slums of Port of Prince again. As I suspected,Susan confirmed, the slums appeared the same before the earth quake as after. An endless road of trash, cinderblock homes, people wandering around aimlessly. Today is sunday so lots of dressed people going or coming from church. More and more trash on the streets and in the canals, water occasionally running through the canals, people washing themselves in this same water, only slightly higher ground were the water is slightly cleaner (I guess). Everywhere you look there is a half constructed cinderblock building with no evidence that there is equipment nearby to or workers to complete if.

We picked up David, Joel's brother and dropped off three of our translators. They were so great. They really worked hard along side us. Really funny too, their constant chatter and giggling in Kreol is now feeling missed from our group. From the bus we bought banana chips from the street vender, still hot and salty, delicious. Joel yelled out to this guy who had a basket of them on his head. The vendor was laughing with joy when we bought 25 bags of the treats. Now at the resort walking into an air conditioned room is very very luxurious, but jumping in the Caribbean ocean is outrageous. Lynda was worried she would feel weird going to a resort after all of our time working as we did, but now it seems the right thing to do. Everyone is exhausted. A shower with water pressure was needed. The red dirt and dust that accumulated in every crease of our clothing and skin feels good running off. Its OK, no one ever expected us to stay in Mussotte forever. The pasture sons are both doctors and will continue to see those patients, as a haitian , not us “blan” should. We left them with any left over medications and some supplies. The goal was to give the students an experience of caring for the underserved, encourage them going into primary care. They got more hands on experience here in a few days than they did their entire third year. I think we made some brief difference in those we served. Maybe prevented a few strokes, prevented heart failure, alleviated pain, treated infections, prevented malnutrition through worm therapy. Anyway, I am justifying my pina colada, and day at the beach.


(Blan is the Kreol word for foreigners, from the french word for white blanc)