Haiti - Day 7

It was yet another hot, frustrating, exhausting day in Haiti...

There were many many deaths today, including that of a young 7 year old boy (kids deaths are really awful). Many deaths more or less anticipated, and others were sudden and unexpected. This beautiful young boy with soft brown skin and long eyelashes was carried in by his mother, who said that he had been ill for about a week; sick with a fever, not playing much, kind of lethargic, etc. When he came to us, he was barely responsive and had very labored respirations. The boy had many abnormal clinical features; he was a very thin and underdeveloped 7 year old. He had a very large liver that we could palpate. He had enlarged lymph nodes in his neck and in his arm pits. He had sores on the roof of his mouth. Simply put - he looked toxic. We got an IV in him and gave him some fluids and antibiotics, because everyone here has something infectious that responds to an antibiotic. He did well for a while, but a few hours later he began to drop his oxygen saturation. He suddenly stopped breathing and went into cardiac arrest. We tried to resuscitate him for 30 minutes or so, but because of all of his swollen lymph nodes, we could not intubate him. He died right in front of us with his wailing mom and did right by our side.

He probably died of HIV. Undiagnosed and untreated HIV. He was only 7.

We see so many newly diagnosed HIV cases. It presents in such occult, insidious ways that it require us to put many pieces of the puzzle together. Many are adults, but some are kids too. Yesterday a young, 16 year old girl came in through triage complaining of an earache and throat pain. She looked awfully anorexic, pale, and toxic. I took one look in her mouth and saw a white furry coat of oral thrush. There is no reason why a 16 year old girl should have thrush in her mouth...only if she is immune suppressed. We took a blood sample, and she came back positive for HIV. Nearly half of our current patient load are HIV positive. When untreated, HIV is rampant, scary, and deadly. The way that people die here from HIV doesn't happen nearly as often in a developed society, as back home, we have the proper screening tools, medications, technology, and resources to fight it. But not in Haiti.

On the ride home, while staring out the window at the hundreds and hundreds of tents homes fashioned atop garbage, rubble, and human excrement, I reflected on the day and thought to myself how people here lead such difficult, difficult lives. Their lives are a constant struggle for a myriad of reasons. And even in death, they struggle. Their death, from what I have seen in the past 6 days, is a slow, painful battle. They can't even die in peace. For the one moment in their life when they leave this earth to enter a new place, can't they just go in peace?