My last day.
Today was the day that at one point a while back, I had hoped would come very soon. But once it came, I dreaded it.
We said our good-byes not only to each other, but to some of our favorite patients, Haitian doctors/nurses, and our beloved translators. The translators were a phenomenal group or smart, helpful young men who made our jobs possible and who were with us for every patient encounter. Many of them go home to a tent at the end of a long, tiring day of work...a day that earns them a mere $12. IMC gave us $300 for being here - which is both generous and embarrassing. I gave each of the 10 translators $20, as certainly they're more deserving of it that I. I go home to a job that I both complain about, and take for granted. Many do not have jobs anymore now that we are gone, and are fearful of their future that at just 20 years old, should be bright and full of opportunities and dreams.
Before I left Boston two weeks ago, everyone said to me that I would meet some incredible people on this trip. I was a bit skeptical, as I am convinced that I am friends with or in love with or am the daughter/sister of the most incredible people this world has even known. Which is still true...but – they were right. I have met some truly passionate, selfless people who truly embody the notion of "service before self".
I think I will leave this country with tears in my eyes and a heavy heart. I have been blown away by the sadness, destruction, and corruption. But I have also been equally impacted by the resilience of these people. For no matter how difficult their lives truly are, they have risen above. And whether we are here or not, they will persevere. I never once heard anyone complain about how difficult their lives are. Now I fully realize that we back home may have difficulties in our lives, but the people here undoubtedly have difficult lives. But there is a sense of pride the Haitian's have for their country - the very country that has robbed them of everything they have. I find that ironic, and beautiful.
Thank you to all of you who have taken interest in reading my stories from Haiti – I feel that conveying to you these very vivid and real events and emotions every night makes this even more of an enriching experience for me. Even if I feel that my effort here was futile at times, I will, at the very least, leave knowing that I have given an unbiased, raw, and real account about life here. It isn’t pretty. It isn’t polished, and it isn’t edited. But I think we would all agree that being informed and opening our eyes to the world around us, whether it is pleasant or not, gives us a chance to change ourselves or change the world in which we live.
Au Revoir, Haiti. And thank YOU for what you have given me.
PS - thank you to those who have been moved to ask "How can I help?" - please email me at gsbeverstein@hotmail.com and I will give you information about other great organization here that are doing really good things for this country, and will guarantee that your donation will be well spent.
Haiti
Wall graffiti we drove past every day: The image is of the country of Haiti crying
Tuesday, June 29, 2010
Sunday, June 27, 2010
Haiti - Day 13
Final thoughts from Haiti...
Tomorrow is not only my last day at Hospital Universite Etas D’Haiti, but it is International Medical Corps last day as well. The emotions are so unbelievably mixed, as we look back at all that we have seen and done here and realize that although we have done so much, there is so much more that we wish we could continue to do. But, our work is finished – now, we leave behind a Hospital that is exactly the same as we found it, and take what experiences we have had here and live our lives just a little bit differently.
We have just two patients left in the ICU. The only ICU in Haiti will officially close tomorrow. All of the other 16 patients either died, or went home to die with their family so they don't have to pay the morgue. One patient is a 20 year old kid with a neck mass so large that it is protruding through his skin, and has compressed his airway down to the size of a straw. Each day it gets bigger, and each day we try to provide the family with some hope that a throat surgeon will fix him. But we know that the likelihood of that happening is next to nothing. TOmorrow he will go with his family and try to somehow get to the Dominican Republic to find a surgeon there. Meanwhile, all the way across the room you can hear him gasping for air with every breath.
Our other patient is a young man with a brain mass. Well, we think he has a mass based upon his symptoms, but we don't actually know with 100% certainty because we haven't see a CT Scan yet. His parents, who are there with him 24 hours a day, sold some of their personal belongings and spent their life savings to be able to afford the $250 to get a CT Scan for their son. We strongly urged them to not do this, as it will not, unfortunately, change any outcome, as there are no neurosurgeons in the entire country. So even if he does have a brain mass, he will still just go home with his family to die.
This is the kind of stuff we have seen on a daily basis. How can any of this be acceptable? But we didn't come here thinking that we could change these problems. These problems existed long before the earthquake, and will keep right on happening.
90,000. That is the number of patients we saw and treated since January. That's more than a busy trauma ER sees in one year. Many we saved. Many we didn't.
But - in all honesty, despite all of the good we have done and the hope we have given and the lives we have touched, we are leaving this place exactly how we found it. Nothing has changed. Nothing we contributed has been sustainable. But you can't have sustainable change without societal change...and the societal problems in this country are hundreds of years in the making, and will take another hundred to fix.
And as i'm typing this, it's pouring rain outside. Right now, millions are hovered in shoddy tents with dirt floors and blankets for beds. And I'm in my air conditioned hotel room on a kind sized bed listening to my IPod. Life just isn't fair.
Tomorrow is not only my last day at Hospital Universite Etas D’Haiti, but it is International Medical Corps last day as well. The emotions are so unbelievably mixed, as we look back at all that we have seen and done here and realize that although we have done so much, there is so much more that we wish we could continue to do. But, our work is finished – now, we leave behind a Hospital that is exactly the same as we found it, and take what experiences we have had here and live our lives just a little bit differently.
We have just two patients left in the ICU. The only ICU in Haiti will officially close tomorrow. All of the other 16 patients either died, or went home to die with their family so they don't have to pay the morgue. One patient is a 20 year old kid with a neck mass so large that it is protruding through his skin, and has compressed his airway down to the size of a straw. Each day it gets bigger, and each day we try to provide the family with some hope that a throat surgeon will fix him. But we know that the likelihood of that happening is next to nothing. TOmorrow he will go with his family and try to somehow get to the Dominican Republic to find a surgeon there. Meanwhile, all the way across the room you can hear him gasping for air with every breath.
Our other patient is a young man with a brain mass. Well, we think he has a mass based upon his symptoms, but we don't actually know with 100% certainty because we haven't see a CT Scan yet. His parents, who are there with him 24 hours a day, sold some of their personal belongings and spent their life savings to be able to afford the $250 to get a CT Scan for their son. We strongly urged them to not do this, as it will not, unfortunately, change any outcome, as there are no neurosurgeons in the entire country. So even if he does have a brain mass, he will still just go home with his family to die.
This is the kind of stuff we have seen on a daily basis. How can any of this be acceptable? But we didn't come here thinking that we could change these problems. These problems existed long before the earthquake, and will keep right on happening.
90,000. That is the number of patients we saw and treated since January. That's more than a busy trauma ER sees in one year. Many we saved. Many we didn't.
But - in all honesty, despite all of the good we have done and the hope we have given and the lives we have touched, we are leaving this place exactly how we found it. Nothing has changed. Nothing we contributed has been sustainable. But you can't have sustainable change without societal change...and the societal problems in this country are hundreds of years in the making, and will take another hundred to fix.
And as i'm typing this, it's pouring rain outside. Right now, millions are hovered in shoddy tents with dirt floors and blankets for beds. And I'm in my air conditioned hotel room on a kind sized bed listening to my IPod. Life just isn't fair.
Saturday, June 26, 2010
Haiti - Day 12
We are officially done with our work in the Emergency Department, and are in the ICU only. It seems as though our lives have come to a screeching halt.
For the past 12 days for me, and 5 months for IMC, we have been tirelessly seeing anyone and everyone who has come to the HUEH Hospital. In fact, we have seen and treated 90,000 patients since January 13th. We have been in over our heads and besieged by the breadth and depth of illness here. And yesterday, we stopped this tireless effort in the ER, and passed the torch to the Haitians.
It is completely depressing to look over at the overwhelmed ER. They have only one physician and one RN, which is nowhere near enough. Patients are laying on the ground, as all of the beds have been filled. IV lines hang dry. People are moaning in pain. Foley bags are filled to the brim with urine. Full bedpans with flies lie everywhere. It looks as though the patients are receiving little to no care, and many of them will ultimately die there.
This is all happening while we are sitting around in the adjacent ICU. There are 5 of us for 6 patients. But our hands are tied. We have been told to not reach over to help them, as they need to start to take on what we have started. But to compare what we can provide, with our educational backgrounds, resources, and sheer manpower, isn't a fair comparison. However, we realize that we can not stay here forever, and at some point, we must leave.
That time is now. And it's harder than ever.
Being that we have only 6 patients, and plenty of hands, I walked over to the nearby re-feeding tent, where approximately 10 cribs line the perimeter of a hot, fan less tent. In each crib you'll see a cherubic Hatian baby in one various stage of the refeeding process. For a myriad of reasons, these children have been identified as malnourished, and are bought here to go through an intense feeding and weight gaining process. Many, towards the end of the cycle, look plump, happy, and healthy with a full head of hair and a robust smile. Others are frail and skeletal, barely able to hold their heads up. Most of the babies are orphans, as their parents either just left them at the doorstep and abandoned them, or couldn't care for them, or died in the quake, and a few are there with their mothers.
At first glance, my eyes welled with tears at the image of emaciated children with big heads bloated bellies. But after seeing the beautiful, plump outcome, and to see all of the good that they are doing to target these beautiful kids, I became happy. It was an hour of bliss, and exactly what I needed. It was a reminder that although there is a lot of misery here, there is a lot of good happening as well.
PS - Not sure what happened to my little girl from yesterday, as she went to the Pediatric Ward. We can only hope from here...
For the past 12 days for me, and 5 months for IMC, we have been tirelessly seeing anyone and everyone who has come to the HUEH Hospital. In fact, we have seen and treated 90,000 patients since January 13th. We have been in over our heads and besieged by the breadth and depth of illness here. And yesterday, we stopped this tireless effort in the ER, and passed the torch to the Haitians.
It is completely depressing to look over at the overwhelmed ER. They have only one physician and one RN, which is nowhere near enough. Patients are laying on the ground, as all of the beds have been filled. IV lines hang dry. People are moaning in pain. Foley bags are filled to the brim with urine. Full bedpans with flies lie everywhere. It looks as though the patients are receiving little to no care, and many of them will ultimately die there.
This is all happening while we are sitting around in the adjacent ICU. There are 5 of us for 6 patients. But our hands are tied. We have been told to not reach over to help them, as they need to start to take on what we have started. But to compare what we can provide, with our educational backgrounds, resources, and sheer manpower, isn't a fair comparison. However, we realize that we can not stay here forever, and at some point, we must leave.
That time is now. And it's harder than ever.
Being that we have only 6 patients, and plenty of hands, I walked over to the nearby re-feeding tent, where approximately 10 cribs line the perimeter of a hot, fan less tent. In each crib you'll see a cherubic Hatian baby in one various stage of the refeeding process. For a myriad of reasons, these children have been identified as malnourished, and are bought here to go through an intense feeding and weight gaining process. Many, towards the end of the cycle, look plump, happy, and healthy with a full head of hair and a robust smile. Others are frail and skeletal, barely able to hold their heads up. Most of the babies are orphans, as their parents either just left them at the doorstep and abandoned them, or couldn't care for them, or died in the quake, and a few are there with their mothers.
At first glance, my eyes welled with tears at the image of emaciated children with big heads bloated bellies. But after seeing the beautiful, plump outcome, and to see all of the good that they are doing to target these beautiful kids, I became happy. It was an hour of bliss, and exactly what I needed. It was a reminder that although there is a lot of misery here, there is a lot of good happening as well.
PS - Not sure what happened to my little girl from yesterday, as she went to the Pediatric Ward. We can only hope from here...
Friday, June 25, 2010
Haiti - Day 11
My medical ailments continue here in Haiti.
I have self diagnosed myself with having the Giardia Parasite that is most commonly contracted through drinking contaminated water. Among many of its hallmark features, (I'll spare some of the lovely details) are sulfer-tasting belches. Yep, I got ‘em. And as if this wasn’t enough, I accidentally fell asleep last night without remembering to douse myself in deet, as I usually do before I shimmy under the covers. After a long day of feeling lousy, I passed out in an Ambien induced coma, and had a nice long, 7 hour sleep…
…until I awoke at 6:00am, feeling rather itchy, and rather lumpy.
I looked in the mirror to discover that I was covered with mosquito bites (at least I hope that the bites came from a mosquito, versus some other less desirable insect). 121 times over (and probably more as I can’t count the ones on the back of my neck), covering my face (I look horrendous), neck, arms, and hands.
After I fashioned a fine bag with cut out eyes to throw over my head, I pulled myself together, yet again, and hopped on the bus. I should have used my better judgment as once again, I could hardly stand up straight without feeling dizzy. It was a unanimous decision that I should be sent home. It probably had more to do with the fact that once people took a look at my wretched, pale, mosquito infested face, no one wanted to come within 3 feet of me. But regardless, back on the bus I went. I lasted a total of about 2 hours – better than yesterday – but at least I got to have some patient contact this morning.
Unfortunately, the one patient contact I had was not a pleasant one.
Overnight, the ER admitted a very small 3 year old girl, who was laying on the gurney with her mother. She had not yet been seen my any medical staff, so I took her chart and began to investigate why she was there. Aside from a ratty diaper, the girl was completely naked. I could tell just by looking at her that she had an obvious cognitive and developmental delay, and markedly stunted growth.
She whimpered a bit and looked uncomfortable, but she was by no means cry or looking in obvious distress.
Through the help of my translator, the woman conveyed to me that her daughter was having vaginal bleeding. Immediately concerned and suspicious, I got my head lamp and proper supplies. I removed the diaper and was horrified to see that she was ripped from top to bottom…from her urethra to her rectum. It was a bloody, macerated mess. This, of course, elicited a horrific scream from the little girl, and I realized that if I was going to get a more thorough exam then we would have to make her more comfortable. We gave her some ketamine (like we did for the little boy who needed his forehead sutured) , and our stomachs churned when we discovered that she had been so brutally assaulted that her injuries involved her colon/large intestine as well. She would need immediate surgery to repair this hole in her bowel, before she became septic. The chances of her getting this surgery immediately is almost slim to none, as I have seen dozens of people over the past 10 days require emergency surgery that never receive it, and are left to die, right in front of us.
Makes a million mosquito bites and an intestinal parasite seem like nothing.
I await the return of my colleagues tonight to find out what happened to her after I left.
I end with an article sent to me by my Uncle Ralph yesterday, posted in the New York Times. It discusses Haitian women who are brutally assaulted and raped, and subsequently left to die. Many do, but this one woman didn’t. She tells her story; a story that is frighteningly similar to thousands of violated young girls and women, not only in Haiti, but throughout the world.
http://www.nytimes.com/2010/06/24/world/americas/24haiti.html?sq=haiti&st=cse&adxnnl=1&scp=2&adxnnlx=1277402434-+6wVGrwcN+WbEixM+2o3KA
I have self diagnosed myself with having the Giardia Parasite that is most commonly contracted through drinking contaminated water. Among many of its hallmark features, (I'll spare some of the lovely details) are sulfer-tasting belches. Yep, I got ‘em. And as if this wasn’t enough, I accidentally fell asleep last night without remembering to douse myself in deet, as I usually do before I shimmy under the covers. After a long day of feeling lousy, I passed out in an Ambien induced coma, and had a nice long, 7 hour sleep…
…until I awoke at 6:00am, feeling rather itchy, and rather lumpy.
I looked in the mirror to discover that I was covered with mosquito bites (at least I hope that the bites came from a mosquito, versus some other less desirable insect). 121 times over (and probably more as I can’t count the ones on the back of my neck), covering my face (I look horrendous), neck, arms, and hands.
After I fashioned a fine bag with cut out eyes to throw over my head, I pulled myself together, yet again, and hopped on the bus. I should have used my better judgment as once again, I could hardly stand up straight without feeling dizzy. It was a unanimous decision that I should be sent home. It probably had more to do with the fact that once people took a look at my wretched, pale, mosquito infested face, no one wanted to come within 3 feet of me. But regardless, back on the bus I went. I lasted a total of about 2 hours – better than yesterday – but at least I got to have some patient contact this morning.
Unfortunately, the one patient contact I had was not a pleasant one.
Overnight, the ER admitted a very small 3 year old girl, who was laying on the gurney with her mother. She had not yet been seen my any medical staff, so I took her chart and began to investigate why she was there. Aside from a ratty diaper, the girl was completely naked. I could tell just by looking at her that she had an obvious cognitive and developmental delay, and markedly stunted growth.
She whimpered a bit and looked uncomfortable, but she was by no means cry or looking in obvious distress.
Through the help of my translator, the woman conveyed to me that her daughter was having vaginal bleeding. Immediately concerned and suspicious, I got my head lamp and proper supplies. I removed the diaper and was horrified to see that she was ripped from top to bottom…from her urethra to her rectum. It was a bloody, macerated mess. This, of course, elicited a horrific scream from the little girl, and I realized that if I was going to get a more thorough exam then we would have to make her more comfortable. We gave her some ketamine (like we did for the little boy who needed his forehead sutured) , and our stomachs churned when we discovered that she had been so brutally assaulted that her injuries involved her colon/large intestine as well. She would need immediate surgery to repair this hole in her bowel, before she became septic. The chances of her getting this surgery immediately is almost slim to none, as I have seen dozens of people over the past 10 days require emergency surgery that never receive it, and are left to die, right in front of us.
Makes a million mosquito bites and an intestinal parasite seem like nothing.
I await the return of my colleagues tonight to find out what happened to her after I left.
I end with an article sent to me by my Uncle Ralph yesterday, posted in the New York Times. It discusses Haitian women who are brutally assaulted and raped, and subsequently left to die. Many do, but this one woman didn’t. She tells her story; a story that is frighteningly similar to thousands of violated young girls and women, not only in Haiti, but throughout the world.
http://www.nytimes.com/2010/06/24/world/americas/24haiti.html?sq=haiti&st=cse&adxnnl=1&scp=2&adxnnlx=1277402434-+6wVGrwcN+WbEixM+2o3KA
Thursday, June 24, 2010
Haiti - Day 10
Well, it's been a bit of a rough 24 hours...
Last evening, while completely immersed in a great book, I began to feel some rumblings in my stomach. You may, in fact, have felt or heard these noises all the way back in the States. It was just the sinister precursor to what was an abysmal night either on or in front of the toilet. I slept very little, and when it came time for the alarm at 6am, I washed my face, donned the scrubs, and desperately tried to pull my aching, pale body together. I still really wanted to go to work. Today was our last day staffing the ER, as we pull out tomorrow to allow for the Haitian staff to take over. Going forward, we're just in the ICU, with the intention of making a gradual departure out of the Hospital by the end of next week.
I hopped on the bus, and lasted only about an hour at the hospital. I was just too nauseated and light headed to be of any help. Everyone insisted that I leave once I was caught slumped over in the chair with my head between my legs. I came back to the room, and 10mg of Ambien later, I awoke feeling somewhat better. I still haven't eaten all day, as I'm still tasting last night's dinner, but I may attempt to mosey down later for a little rice. I'll be fine. I hope this was the worst of it...
The unpleasantness of this was slightly compounded by the fact that right before I began to feel ill, Collette and I realized that some things from our room had been stolen. Chris's international phone that he had let me borrow, and a total of about $50 cash, were gone. It's not that big of a deal - at least we still have our passports and stash of chocolate (: Seriously - we really aren't that upset about it. $30 goes a long way here. Heck - someone maybe needed it to get his loved one out of the morgue.
Here's to good sleep tonight and better health tomorrow!
Last evening, while completely immersed in a great book, I began to feel some rumblings in my stomach. You may, in fact, have felt or heard these noises all the way back in the States. It was just the sinister precursor to what was an abysmal night either on or in front of the toilet. I slept very little, and when it came time for the alarm at 6am, I washed my face, donned the scrubs, and desperately tried to pull my aching, pale body together. I still really wanted to go to work. Today was our last day staffing the ER, as we pull out tomorrow to allow for the Haitian staff to take over. Going forward, we're just in the ICU, with the intention of making a gradual departure out of the Hospital by the end of next week.
I hopped on the bus, and lasted only about an hour at the hospital. I was just too nauseated and light headed to be of any help. Everyone insisted that I leave once I was caught slumped over in the chair with my head between my legs. I came back to the room, and 10mg of Ambien later, I awoke feeling somewhat better. I still haven't eaten all day, as I'm still tasting last night's dinner, but I may attempt to mosey down later for a little rice. I'll be fine. I hope this was the worst of it...
The unpleasantness of this was slightly compounded by the fact that right before I began to feel ill, Collette and I realized that some things from our room had been stolen. Chris's international phone that he had let me borrow, and a total of about $50 cash, were gone. It's not that big of a deal - at least we still have our passports and stash of chocolate (: Seriously - we really aren't that upset about it. $30 goes a long way here. Heck - someone maybe needed it to get his loved one out of the morgue.
Here's to good sleep tonight and better health tomorrow!
Wednesday, June 23, 2010
Haiti - Day 9
I'm coming down the home stretch!
It was another busy day (this is a reoccurring theme). It was actually one of my busiest days yet, as I had 7 little nursing students following me around until noon. I tried to keep them busy, stimulated and interested, and I think they had a good time. I used as much French as I could (most educated Haitians can speak French in addition to their native language of Creole) but had to resort many times to my excellent hand gestures. They actually taught me a thing or two - yikes! it has been a long time since I have done bread and butter nursing, which is what we were doing today. it was mostly a morning of teaching, and then when the students left at noon, I switched back to the ER.
It was a very sad afternoon in the ICU yesterday, while I was having my afternoon off. We have had this young kid, just 15 years old, who developed a severe, acute renal disease (Acute tubular necrosis) several weeks ago. He was already in the ICU when we arrived last week. This serious disease requires patients to have dialysis, as their kidneys have failed. Dialysis is vital to their survival. If patient's miss a day of dialysis, then they can develop horrible systemic problems that involve every vital organ. He got dialized a few times last week, and was doing relatively well...
In fact, Dr. Ansell, an MD from Rush Medical Center in Chicago who is on our team now, had arranged through his clout and heart and passion for this kid to fly to Chicago and receive a kidney transplant from his brother. His family just had to get to Miami, and they would take care of the rest. All he needed was a few more dialysis treatments, and he was all set for his life saving surgery.
And then last weekend came.
He was to have his dialysis on Saturday afternoon. We waiting all morning for someone from the dialysis "clinic" to come get him. No one came. We waited all afternoon. No one came. We made calls. We had our director work on it. We had family check into it. Night time came, but no one from dialysis did. Sunday morning rolled around, and he began to have some mental status changes. The lack of any organ or machine filtering his blood of waste and toxins was building up to lethal levels, and was now affecting his brain. He became encephalopathic, and the need for dialysis was now greater than ever. All day Sunday came and past, and the kid never got dialized. Monday he was critically ill and had at this point suffered brain damage.
Finally, the dialysis folks came to get him on Monday afternoon, but it was too late. He had suffered a severe stroke, and by Monday evening, he was nearly dead. He required intubation, and remained on a ventilator overnight.
Yesterday afternoon, while I was floating in the pool, the decision was made to unplug the ventilator and to let the family take their son home to die, instead of passing in this catacomb of a hospital. You see, if someone dies at the actual hospital, they are taken directly to the morgue where the family has to come by the next day and pay $25 to take the body home. ($25 is a ton of money here). Instead, we let the family take him home to die in peace.
We discovered today that the dialysis team just decided to not work this weekend. Just didn't show up. Maybe they weren't getting paid...who knows. The point is - how can one ignore the complete irony of the family having to pay the ones responsible for killing their son?
This story makes me sad, and angry. This is just one example of many that reflects how messed up the system is here. We wait and wait and just watch people die. It is a horrible thing to know that at some times, our hands are tied, despite our passion and best efforts. This was a life that we were going to save, and for many reasons that are hard to explain or accept, we didn't.
It was another busy day (this is a reoccurring theme). It was actually one of my busiest days yet, as I had 7 little nursing students following me around until noon. I tried to keep them busy, stimulated and interested, and I think they had a good time. I used as much French as I could (most educated Haitians can speak French in addition to their native language of Creole) but had to resort many times to my excellent hand gestures. They actually taught me a thing or two - yikes! it has been a long time since I have done bread and butter nursing, which is what we were doing today. it was mostly a morning of teaching, and then when the students left at noon, I switched back to the ER.
It was a very sad afternoon in the ICU yesterday, while I was having my afternoon off. We have had this young kid, just 15 years old, who developed a severe, acute renal disease (Acute tubular necrosis) several weeks ago. He was already in the ICU when we arrived last week. This serious disease requires patients to have dialysis, as their kidneys have failed. Dialysis is vital to their survival. If patient's miss a day of dialysis, then they can develop horrible systemic problems that involve every vital organ. He got dialized a few times last week, and was doing relatively well...
In fact, Dr. Ansell, an MD from Rush Medical Center in Chicago who is on our team now, had arranged through his clout and heart and passion for this kid to fly to Chicago and receive a kidney transplant from his brother. His family just had to get to Miami, and they would take care of the rest. All he needed was a few more dialysis treatments, and he was all set for his life saving surgery.
And then last weekend came.
He was to have his dialysis on Saturday afternoon. We waiting all morning for someone from the dialysis "clinic" to come get him. No one came. We waited all afternoon. No one came. We made calls. We had our director work on it. We had family check into it. Night time came, but no one from dialysis did. Sunday morning rolled around, and he began to have some mental status changes. The lack of any organ or machine filtering his blood of waste and toxins was building up to lethal levels, and was now affecting his brain. He became encephalopathic, and the need for dialysis was now greater than ever. All day Sunday came and past, and the kid never got dialized. Monday he was critically ill and had at this point suffered brain damage.
Finally, the dialysis folks came to get him on Monday afternoon, but it was too late. He had suffered a severe stroke, and by Monday evening, he was nearly dead. He required intubation, and remained on a ventilator overnight.
Yesterday afternoon, while I was floating in the pool, the decision was made to unplug the ventilator and to let the family take their son home to die, instead of passing in this catacomb of a hospital. You see, if someone dies at the actual hospital, they are taken directly to the morgue where the family has to come by the next day and pay $25 to take the body home. ($25 is a ton of money here). Instead, we let the family take him home to die in peace.
We discovered today that the dialysis team just decided to not work this weekend. Just didn't show up. Maybe they weren't getting paid...who knows. The point is - how can one ignore the complete irony of the family having to pay the ones responsible for killing their son?
This story makes me sad, and angry. This is just one example of many that reflects how messed up the system is here. We wait and wait and just watch people die. It is a horrible thing to know that at some times, our hands are tied, despite our passion and best efforts. This was a life that we were going to save, and for many reasons that are hard to explain or accept, we didn't.
Tuesday, June 22, 2010
Haiti – Day 8
The day that I never thought would come, came.
I got the afternoon off.
As soon as I had heard that I was the lucky nominee of this coveted honor, I gladly accepted. When I got back to the hotel, I nearly jumped right into the pool with my scrubs on. I nearly had one foot in the water when I noticed a large sign that explicitly said “no scrubs on in the pool”. Darnit. It's a good rule, actually. If all of us did that, there isn't enough bleach and chlorine that can kill what's on us at the end of the day. Instead, I peeled them off in my room, grabbed my towel and an icy cold Prestige, and dove in.
All afternoon I laid by the pool, took two naps, read my book, and wrote this blog. It was just perfect. I looked in the mirror and hardly recognized the rested, rejuvenated, sun kissed person who was staring back at me.
It’s a bit ironic that this time off came on a day like today, as today, more than any other day, I really looked forward to going to work. My mindset has shifted quite a bit from just 5 days ago. And even as wonderful as this time away is, I’m already feeling that I’m actually kind of missing it. This “thing” has totally grown on me, and I can at least begin to understand how some people have come here to volunteer for 2 weeks, and months later, haven’t left yet.
I feel a bit wimpy being completely wiped out after 6 and ½ straight days of work, but honest to God this is the hardest work I have done in my entire life; probably more mentally than physically. IMC actually requires that we take at least one day off, and it is hard for many to do because we get so immersed in what we are doing. It is a bit hard to leave, as you feel that you’re not only abandoning your critically ill patients but your cohesive group of coworkers. But alas, this is very necessary.
The driver took me home on a different route, as we drove past the Parliament building and Presidential Palace so I could see a bit more of the city. Many of us have seen this now infamous image of the crumbled domes and collapsed surroundings of the palace, where President Rene Preval once resided. I hear that he and his wife now live in an army barrack near the Airport.
This down time of the afternoon has allowed me to really reflect on the past 6 days; how I have felt, what I have smelled, the lessons I have learned, and the atrocities I have witnessed. It is difficult to put many of it into words, but I think anyone can read the stories and see the pictures and formulate their own feelings.
Here are some staggering statistics about both pre and post quake Haiti, that I have learned over the past week. I think it helps to illustrate why this country has as many problems as it does and helps me understand what we’re up against:
* About 85% of all Haitians live in poverty.
* Most Haitians live on $2 or less per day.
* 50% of Haitians are illiterate. I learned this just yesterday, as I was explaining to a young man how to take his antibiotics. I handed him the bottle of pills, on which I had written “un grain, trios fois de jour” (one pill, three times per day). He stared back with obvious confusion and shame on his face. My translator explained to me that he could not read. I felt more ashamed than he did
* 80% of college graduates from Haiti have emigrated, mostly to the US
* Only 30% of Haitians have access to basic health care. Thirty percent? Wow...
* Poverty has forced at least 225,000 Haitian children to work as restavecs, which is essentially a form of slavery, as they perform free labor for their 'owners'. The children are sent away by their parents who are unable to care of them. Many of the restavec children are abused.
* Half of the Haitian children do not receive their childhood vaccinations. A child should never get the measles, or the mumps, or diphtheria. But I’ve seen it. There are reasons that there are vaccines for these diseases…they are horrible and deadly.
* Even before the January earthquake, nearly half the causes of deaths in Haiti have been attributed to HIV/AIDS, Tb, and diarrheal disease (typhoid and cholera)
* Ninety percent of Haiti’s children suffer parasites and waterbone diseases as a result of a lack of clean water
• The January earthquake immediately claimed the lives of 230,000 people, most of whom were ultimately buried in mass graves. 300,000 were injured, and they estimate that 30% of these later died from their injuries.
* One million people were made homeless.
* This one hits a bit closer to home; Haiti’s Nursing School (the one and only) completely collapsed during the earthquake. It was located right outside of our Hospital. I have attached a picture of what was once the building, but is now a pile of rubble and a new tent. The majority of the faculty was killed, along with more than half of the students, who were still in class that late afternoon on January 12th. The building was so horribly collapsed, and therefore, it was nearly impossible to reach any of the survivors or bodies. The stench grew to be so horrific that hey had to burn what was left.
This morning, we had the privilege of having 6 adorable, precocious nursing students join us in the hospital. They are among the remaining survivors from their class, so in essence, all 6 of them are the future of Haitian Nursing. They are shy, eager, sharp, and so darn cute in their white pinafore blouses and skirts. I want one to wear back home.
I’ll close with one final story from the day. You can see pictured to the right a beautiful little Haitian boy, who came in through the ER, with his mother (we think), and a laceration to his forehead. The boy was apparently misbehaving, and therefore his mother threw a bottle at his head as a form of punishment. The boy was completely petrified…not only of the surrounding ER atmosphere, but of my lidocaine-filled syringe. It took 4 of us to hold this little guy down. He, of course, like any normal child would, fought back with his life and thrashed around in hopes that he could win the war against the needle. During his fight, his mom beat him…right in front of us. She slapped him and hit him because he was scared. Heartbreaking doesn’t describe this.
We took a break from the action, and I played with him a bit and took his picture several times to show him the image on my digital camera. He loved it. I asked him if he was in school today, and he told me that he doesn’t go to school. He is probably a child restavec. Knowing that, and witnessing the public violence displayed by his mother, what kind of future does this child have?
Seeing that this wasn’t going to be easy, and not being able to stomach witnessing mom beating him more, we resorted to an intramuscular injection of Ketamine right in his thigh. This is a short acting sedative that is wonderful for doing minor procedures in kids. Within minutes, he was higher than a kite and fast asleep, and his forehead was beautifully and carefully sutured closed. He work up with a smile, holding a shiny new nascar toy that he “zoom zoom”-ed along the edge of the filthy, blood stained cot on which he laid.
Hear his story. Look at his picture. An image and tale that is tragically reflective of so many many children here. Don’t you want to take him home with you, too?
I got the afternoon off.
As soon as I had heard that I was the lucky nominee of this coveted honor, I gladly accepted. When I got back to the hotel, I nearly jumped right into the pool with my scrubs on. I nearly had one foot in the water when I noticed a large sign that explicitly said “no scrubs on in the pool”. Darnit. It's a good rule, actually. If all of us did that, there isn't enough bleach and chlorine that can kill what's on us at the end of the day. Instead, I peeled them off in my room, grabbed my towel and an icy cold Prestige, and dove in.
All afternoon I laid by the pool, took two naps, read my book, and wrote this blog. It was just perfect. I looked in the mirror and hardly recognized the rested, rejuvenated, sun kissed person who was staring back at me.
It’s a bit ironic that this time off came on a day like today, as today, more than any other day, I really looked forward to going to work. My mindset has shifted quite a bit from just 5 days ago. And even as wonderful as this time away is, I’m already feeling that I’m actually kind of missing it. This “thing” has totally grown on me, and I can at least begin to understand how some people have come here to volunteer for 2 weeks, and months later, haven’t left yet.
I feel a bit wimpy being completely wiped out after 6 and ½ straight days of work, but honest to God this is the hardest work I have done in my entire life; probably more mentally than physically. IMC actually requires that we take at least one day off, and it is hard for many to do because we get so immersed in what we are doing. It is a bit hard to leave, as you feel that you’re not only abandoning your critically ill patients but your cohesive group of coworkers. But alas, this is very necessary.
The driver took me home on a different route, as we drove past the Parliament building and Presidential Palace so I could see a bit more of the city. Many of us have seen this now infamous image of the crumbled domes and collapsed surroundings of the palace, where President Rene Preval once resided. I hear that he and his wife now live in an army barrack near the Airport.
This down time of the afternoon has allowed me to really reflect on the past 6 days; how I have felt, what I have smelled, the lessons I have learned, and the atrocities I have witnessed. It is difficult to put many of it into words, but I think anyone can read the stories and see the pictures and formulate their own feelings.
Here are some staggering statistics about both pre and post quake Haiti, that I have learned over the past week. I think it helps to illustrate why this country has as many problems as it does and helps me understand what we’re up against:
* About 85% of all Haitians live in poverty.
* Most Haitians live on $2 or less per day.
* 50% of Haitians are illiterate. I learned this just yesterday, as I was explaining to a young man how to take his antibiotics. I handed him the bottle of pills, on which I had written “un grain, trios fois de jour” (one pill, three times per day). He stared back with obvious confusion and shame on his face. My translator explained to me that he could not read. I felt more ashamed than he did
* 80% of college graduates from Haiti have emigrated, mostly to the US
* Only 30% of Haitians have access to basic health care. Thirty percent? Wow...
* Poverty has forced at least 225,000 Haitian children to work as restavecs, which is essentially a form of slavery, as they perform free labor for their 'owners'. The children are sent away by their parents who are unable to care of them. Many of the restavec children are abused.
* Half of the Haitian children do not receive their childhood vaccinations. A child should never get the measles, or the mumps, or diphtheria. But I’ve seen it. There are reasons that there are vaccines for these diseases…they are horrible and deadly.
* Even before the January earthquake, nearly half the causes of deaths in Haiti have been attributed to HIV/AIDS, Tb, and diarrheal disease (typhoid and cholera)
* Ninety percent of Haiti’s children suffer parasites and waterbone diseases as a result of a lack of clean water
• The January earthquake immediately claimed the lives of 230,000 people, most of whom were ultimately buried in mass graves. 300,000 were injured, and they estimate that 30% of these later died from their injuries.
* One million people were made homeless.
* This one hits a bit closer to home; Haiti’s Nursing School (the one and only) completely collapsed during the earthquake. It was located right outside of our Hospital. I have attached a picture of what was once the building, but is now a pile of rubble and a new tent. The majority of the faculty was killed, along with more than half of the students, who were still in class that late afternoon on January 12th. The building was so horribly collapsed, and therefore, it was nearly impossible to reach any of the survivors or bodies. The stench grew to be so horrific that hey had to burn what was left.
This morning, we had the privilege of having 6 adorable, precocious nursing students join us in the hospital. They are among the remaining survivors from their class, so in essence, all 6 of them are the future of Haitian Nursing. They are shy, eager, sharp, and so darn cute in their white pinafore blouses and skirts. I want one to wear back home.
I’ll close with one final story from the day. You can see pictured to the right a beautiful little Haitian boy, who came in through the ER, with his mother (we think), and a laceration to his forehead. The boy was apparently misbehaving, and therefore his mother threw a bottle at his head as a form of punishment. The boy was completely petrified…not only of the surrounding ER atmosphere, but of my lidocaine-filled syringe. It took 4 of us to hold this little guy down. He, of course, like any normal child would, fought back with his life and thrashed around in hopes that he could win the war against the needle. During his fight, his mom beat him…right in front of us. She slapped him and hit him because he was scared. Heartbreaking doesn’t describe this.
We took a break from the action, and I played with him a bit and took his picture several times to show him the image on my digital camera. He loved it. I asked him if he was in school today, and he told me that he doesn’t go to school. He is probably a child restavec. Knowing that, and witnessing the public violence displayed by his mother, what kind of future does this child have?
Seeing that this wasn’t going to be easy, and not being able to stomach witnessing mom beating him more, we resorted to an intramuscular injection of Ketamine right in his thigh. This is a short acting sedative that is wonderful for doing minor procedures in kids. Within minutes, he was higher than a kite and fast asleep, and his forehead was beautifully and carefully sutured closed. He work up with a smile, holding a shiny new nascar toy that he “zoom zoom”-ed along the edge of the filthy, blood stained cot on which he laid.
Hear his story. Look at his picture. An image and tale that is tragically reflective of so many many children here. Don’t you want to take him home with you, too?
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