For those of you who are counting today is only our fourth day in Haiti and I have already lost THE game. Before we left Turks and Caicos we talked about how we were going to be together in close quarters for an extended period of time and inevitably we were going to get sick. We decided that under such conditions we were going to have to get comfortable talking about our “bathroom problems”. We also decided to make a game; the first person to fall victim to Haitian food would have to post their predicament on the blog. Thus, I have the pleasure of informing you of the (dys)functioning of my lower gastrointestinal tract. You’re welcome for the intimate details.
Despite my backfiring bowels, we have begun to settle into life in Milot. We were very fortunate to recover our bags after a days delay; it is a relief to not have to wear the same pair of underwear for the next 7 weeks. We have begun a daily routine; we usually wake up around 6 or 6:30 to get in some sort of exercise (plyometrics, yoga, or a jog) and then head to breakfast. We usually get to the hospital around 9 where we split up to shadow different doctors. My first day I followed Dr. Anna Michelle, a Haitian doctor, to the pediatric clinic where we saw lots of vomiting and diarrhea (surprise, surprise). It’s also not uncommon to see kids with parasitic infections, H. pylori, or giardia. Surprisingly, asthma and allergies are common problems.
My second day was spent with Dr. Pearlmutter (our project mentor) who was with us in Milot until this morning. In one morning Spencer and I saw a number of things that we would rarely (if ever) see in a US hospital. One patient, an older gentlemen who had suffered a fractured femur and received surgery some years ago, came in with a chronic infection of the surgical site that had formed a fistula. When he unwrapped his bandage we were overwhelmed with a rancid, sour stench. His uncovered wound then began to pour out a fountain of yellow-green puss. An X-Ray was performed to determine the extent of the infection and our surgical consult indicated the presence of an osteomyelitis requiring the attention of the next orthopedic team (which may not come for a while).
Other patients included an 88 year old woman with a large fibroid that could be palpated in the belly. She had come to the hospital hoping for a medical cure for her fibroid and was disappointed to hear that her only option was surgery (at her age she had to balance her discomfort with the risks of surgery). Another older gentleman presenting with problems urinating turned out to have either a hydrocele or an indirect inguinal hernia that had made its way into his scrotum. One man came in with problems swallowing and upon inspection he had esophageal candida (little white spots that scraped off with tongue depressors). I even got to anesthetize a woman’s wart and scrape it off with a scalpel (I should have brought my CAP cards).
Today was short for me. I got to follow Dr. CC (a Guinean doctor who trained in Cuba), the hospitals general surgeon. Unfortunately, he didn’t have any operations so we rounded on patients. One patient had had an amputation after a motorcycle accident and was being discharged. Our other patient however was a type II diabetic who had huge ulcers in his gluteal region. We had to pack the lesions in his gluteus maximus full with beta-dine soaked gauze and hydrogen peroxide and then place a bandage to hold them in place. Apparently there are lots of patients that come into L’Hopital Sacre-Coeur with uncontrolled type II diabetes, which took me by surprise.
Interestingly, when Maggie and Sophia were shadowing Dr. Sanville, an OB-Gyn resident, they saw a couple that came in together who lived in Florida. The wife needed a fibroid surgery but didn’t have insurance and couldn’t afford it in the US so she and her husband flew to Cap Haitian to get the surgery done here. Apparently this is not uncommon. I think the fact that someone who lives in the US is flying to the POOREST COUNTRY IN THE WESTERN HEMISPHERE to get a surgery is a pretty damning indictment of our current health care system.
We spent a good part of today trying to plan out our project over the next couple of weeks. One gets used to things moving at a slower pace here and requiring a lot of poking and prodding. We hope to be able to go out to a couple of towns nearby (Thibeau and Carrefour a Pere) to observe the community health workers in their villages to see the types of interventions they perform. Dr. Hyde and Dr. Pearlmutter have been phenomenal resources in getting things up and running. We also had our first creole lesson: mwen rele Alex (my name is Alex!)
In any event I’m going to pop some loperamide and hope for the best. It’s late now so I might wait until tomorrow to walk over to the hospital to post this in the AM.
Bon soi!
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