I had the unique pleasure of working with a group of medical
students and doctors from the University of Mississippi this week as they went
out into rural areas in the Leogane area to provide care. I could talk about it
for hours, but I will leave it to a few points.
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Confession: This is actually a picture from a different trip, but just to give you a sense of what "rural" looks like |
I have learned a lot
in a year here, though it is not necessarily the kinds of things you want to learn.
I spent time sitting alongside of doctors as they assessed and treated
patients. Sometimes, I was clueless. Sometimes, I was really thankful for my
Physiology and Virology that made me sound like I sort of knew what I was
talking about. And sometimes, well, I
was a rock star. But not in the way that you want to be a rock star. Turns out,
after seeing enough cases of lymphatic filarisis walking around, you can
diagnose elephantiasis on the spot and know right away that there is nothing you
could do for them. I can diagnose severe malnutrition in an infant with a fever
faster than a 4th year med student (orange hair means that a black
baby is so deprived of amino acids that their body has stopped making melanin).
And mosquito-borne illnesses? Let me tell you about them. These are illnesses I will see rarely, if ever, in the USA but are incredibly common here.
Malnutrition is
heartbreaking. Let’s go back to this orange-haired infant. She comes in and
she is one sick little baby. So we give her medicines and some vitamins but… it
isn't going to be enough. You know this baby is going to just get sicker and
sicker and there is nothing you can do. Mom doesn’t have money for food, there
are 2 other kids at home, and we are highly suspicious that the mother is
infected with HIV. So I do what any other else would do: I search around to see
what leftovers from lunch we can offer them. Someone finds a container of baby
food to give to the mother. But really, what does that PB&J sandwich mean a
week from now? How about in a month when the children’s vitamins run out? I did
what I could do in the day we saw them, sending them off with toothbrushes and
soap and sandwiches and medicines, but I just can’t get this family out of my
head. Lottery of birth put us on opposite sides of the table and I would hope
that if roles were reversed, she would be having the same thoughts.
Chronic diseases are
still chronic, even if we can hand you a month of pills. “Ma’am, has anyone
ever told you you have dangerously high blood pressure?” “Yes, I had some pills
that the last group gave me but I ran out a couple of months ago.” Medical missions are desperately
needed in Haiti and fill a gap in rural and desperately poor areas that the
Haitian medical system cannot handle. Still, the gaps remain. Limited supplies
mean each person gets a 30 day supply and then these people are out of luck if
they cannot afford more medication to carry them between groups. There are some groups that work in conjunction with the nursing school to address this gap: they hire a nurse to go to where they held their clinics on a monthly basis to manage long term care, but this is not an option for all groups.
Haiti has hooked me.
As I walk through my final 5 weeks on this little island, I am immensely and
continually happy about its geographic location. I have a privilege that many
of my fellow YASCers do not have: the ability to have a long and intimate
relationship with this country. Throughout the week, I found myself making
notes for when I am back, leading
medical groups. Nursing student friends talk about the rural places they want
to go and work with me as a physician in the years to come. Someone said to me once that Haiti
gets under your skin and you can never truly let go of it once you get
infected. But I think it has also gotten into my heart. And I am so incredibly
happy that this relationship does not end in a little over a month, but can
continue on.