Haiti - Day 5

I’m happy to report that it was a much better day today for many reasons. I slept well, paced myself and made an effort to drink more water, and I believe I have come to terms a bit more with what is the reality here, and what we are, and are not, capable of. This doesn’t necessarily make it any easier, but it makes it less traumatic for me.

It was another day of really sick patients. Some have traditional diseases like we have in the US, such as Congestive Heart Failure, Pneumonia, Kidney Infections, Acute Surgical issues (gallbladders, appendicitis, etc….), but when these patients finally come to the hospital, their diseases are ten times worse. Again – there is no concept of primary care here, and no diseases are prevented or treated. And, we see some pretty uncommon and rare diseases that we don’t often see in the US…such as Typhoid, Dengue Fever, Dysentery, Tb, and lots of HIV. Many traumatic injuries are the result of violence and assaults and traffic injuries, as there are no traffic lights or rules.

We didn’t get breakfast today – not sure of the logistics behind that - but I successfully managed to prevent myself from panicking. We headed to the hospital, and I came back to some patients that I had said good-bye to when we left just last night. There is one patient that I have really taken a liking to and whose story is tragic. Early yesterday morning, this young businessman was outside with his family, and he was hit in the back of the neck by a piece of heavy, falling debris. The force was so great that it not only fractured his cervical vertebrae, but severed his spinal cord. He was immediately paralyzed in all four of his extremities and laid motionless, but still with a pulse and the ability to breathe, and a perfectly functioning brain. He was carried in by family, and after an xray (thankfully it was working yesterday), we all viewed his horrific image. What this kid undoubtedly needs is surgery to fuse his spine to prevent further spinal cord damage. But that kind of surgeon and that kind of surgery and the rehabilitation to support it just doesn’t exist here. So – here he lies, flat on his back in the ER, with a tube in his bladder and a diaper on because he can not control his bowel or bladder, and is essentially waiting to die. If we sit him up, he will damage his unstable spinal cord and could die instantly. Maybe that would be better than the slow, painful death he will face, laying flat on his back in the corner of a dark, putrid ER with a fever of 105.0. And every time I check on him and ask him if he needs something, he says, “no, merci, ca va bien” (no thank you, I’m fine) and asks how I am. Sometimes I just have to walk away because I don’t want him to see my tears.

At some point in the early morning, a frightened young woman came up from behind me and tapped me on the shoulder, and handed to me a swaddled bundle of bloody blankets. I could sense that something was wrapped inside. As I peeled back the layers, I discovered a very tiny tiny baby inside. He wasn’t crying, but I could see his small lungs retracting, very rapidly. He was born this morning at 27 weeks – an age that is barely older than the age where babies are considered viable. Mom was fine, but she was confused and scared, so she came to the ER. We checked her out, and her baby, and miraculously they were doing just fine. Can you imagine a woman in the US walking for miles and miles, just a few hours post op and completely alone, to find help for her baby?

Around lunchtime I sutured the arm of a 10 year old kid whose mother slashed him with a knife as a form of punishment. I saw a man who’s right testicle was the size of a football, as he has not had anyone to look at his large inguinal hernia in over 3 years. We admitted dozens of other sick sick patients…most stayed, some died. I have never put anyone in a body bag before. Until this week...

How did Haiti become so neglected? It's a long, complicated history, with a long, complicated list of problems. When will Haiti ever rebuild?...

Time for bed.
Love,
Gretchen