This was our last day in Haiti and some of us were feeling the drain both emotionally and physically. In the last five days we had seen over 1,000 patients and today we were back in the countryside. Just like yesterday, we were at a location that International Medical Relief had never been to before.
What is interesting about Haiti is in every location, the patients we met were distinctively unique. Some locations earlier in the week were severely malnourished, some had more STDs and infections, and some were healthier, but had run out of the medications and needed our help to keep them healthy.
Today’s clinic was no exception. We saw many cases today that we hadn’t come across before in our clinic such as an infant that had been born with its fingers fused together, a child with Down’s syndrome and a 5-year-old with severe scoliosis.
One of our first patients was a 33-year-old woman with a strange 4-inch indentation on her upper thigh. It looked like a large abscess that was healing. She told us 8 months ago, the area had become swollen but she didn’t know why. Puss started to ooze out of it so she went to the hospital to have it drained. When we saw her today, it was obvious it was still there, and she said it hurt. The good news is that it was no longer swollen and looked like it was on its was to healing. There was nothing more we could do for her except confirm that it was no longer infected.
In Haiti, giving birth is still dangerous for the mother and the baby. Mothers don’t always have access to a hospital and sometimes give birth at home. And others die in the hospital or if there are complications, both the baby and the mother may not make it. We came across a couple of these situations today. One was a little 6-month-old baby, whose mother had died during childbirth so the baby’s aunt was taking care of it. The baby was underweight for its age and hadn’t been eating.
“The baby didn’t have any strength in its legs which is not normal for a 6-month-old,” our doctor said, when checking out the infant. "We fed it using a syringe, and because the aunt didn’t have a bottle, we showed her how to make the formula using boiled water and how to feed it with a syringe to help it thrive."
Another baby that stole our hearts was a 7 month old who was so malnourished that it looked like it was only a month old. It weighed 3 kgs (just over 6.5 pounds).
“Mom died when the baby was born and they had been feeding it cow’s milk once a day,” said nurse Jodie.
When the mother died, Grandma – who was only 29 years old and had a 3-year-old of her own at home – tried to breastfeed the baby until her milk dried up. We syringe fed the infant until it was full, and then gave the family formula for the baby with feeding instructions. “I was not going to let him leave here without eating,” the nurse said.
Dr. Erica also had a unique case. A 56-year-old man came in with a swollen nipple. He said it started 7 months ago, and he didn’t know what had caused the large abscess.
“Normally, I would have used scissors to open up the area and drain it all at once, but we don’t have a strong enough pain medicine here. I tried, but he couldn’t tolerate the pain. So I had to try to drain it the best I could with what we had,” Erica said.
After draining the area as best she could to alleviate the pressure around the nipple, she prescribed something for the man’s pain and to help stop infection from occurring.
Another case that came in was a man with a swollen knee. He was 60 and said he fell two years ago and it’s been swollen ever since. In fact, his whole lower leg from the knee to the foot appeared swollen and he had no feeling in the bottom of his foot.
“At first I wanted to drain the knee, but even if we had the tools, it would just become swollen again without proper follow up care,” said Dr. Erica.
It’s frustrating at times like this, but it’s one of the things the doctors and nurses on the IMR team have to think about. Many of the patients won’t have access to follow up care so the treatments they do and medications they prescribe need to take that into consideration.
Another thing that adds an extra challenge to our providers is many of the women aren’t sure if they are pregnant or not. We ran out of pregnancy tests the day before, so we needed to rely on the patient’s knowledge of their own body before prescribing things. In Haiti, many women don’t know they are pregnant until they start showing, which is usually around the second or third month.
“One of the translators told me it’s common for Haitian babies to be born at 7 months. In reality, it has been the full 9 months. They just didn’t realized they were pregnant until they were two months along,” said Nurse Natalie.
But amongst the sad moments, there were times of joy. “For the first time today, I got hear a fetal heartbeat. It was so sweet, I cried,” said one of the nursing students.
