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Monday, March 22, 2010

Clinic in Cabaret

Thursday, Diana, Ritha, and I went to the Cabaret clinic to assist two American doctors, Forrest and Kensia.  
Ritha helped the doctors with translations & Diana helped take blood pressure.
This clinic usually has only one doctor but there were two additional doctors from Voices for Haiti volunteering for the week.
There is no anaesthesia so there was lots of loud wailing & crying children.
Many of the patients come with infections that were not taken care of from the beginning so they become much larger problems later. For example, the photo above is of a lady who got a piece of wood stuck in her foot.
She never got it treated so the infection ate into her whole food The nurse had to pour hydrogen peroxide over her open foot. 
I had to leave the room after a couple minutes.

A mother who looked eight-months pregnant, and her baby girl kept me company in the waiting room for most of the day.  The mother took turns with her two older daughters holding the baby.  At first glance I thought the baby was about a year old, she was actually two.  The doctors had trouble diagnosing her for certain, but in the end they thought she likely had a genetic condition.

A boy, age 11 or 12, came into the clinic in the middle of the day with his mother.  The day before he was running a 104 fever, and the day we saw him he received the news that his blood test showed he was in the advanced stages of malaria.  Kensia saw the boy and afterward his mother came back and told her she was sent from God because if the extra doctor hadn't been there then her son wouldn't have been been seen at the clinic.

Richard, our Voices for Haiti medical liaison, coordinated the doctors' trip to Haiti and the running of the clinic.  He also provided us with valuable insight on the functioning of the country's healthcare system.  

A young man came in after he was hit by a car while riding his motorbike.  The doctors feared he had internal bleeding, but there was no X-ray in Cabaret.  The doctors made the staff go on a search to find IV fluid and then ordered an ambulance to take the man to Port-au-Prince for further treatment.  To support him the doctors collected $30 to assist the patient in buying medications and treatment.  

Women my age (25) made up a large portion of those in the clinic.  They came to collect boxes of Monistat that DRN brought, carried tiny babies for vaccines, looked after each other's children, and nagged the harried nurses until older relatives were attended to.

I spent most of the day watching in the waiting room where I helped one of the clinic's two regular nurses and Forrest.  With Saskia on my lap, I managed a blood pressure monitor, which gave me the chance to the interact with all the visitors for the day.  Vendors came through the doors selling baked goods in plastic wrap, bags of water, and sodas.  A morning rush gave way to spurts of activity as emergencies were shuttled into consultation rooms..

After Saskia was seen and diagnosed with an upper respirator infection, she and I waited in line at the pharmacy window for an hour or so.  A hunt began for children's cold medicine, but none was found.  I asked but there was no other place to get children's cold medicine in town.  We wet home with a tired little girl whose cough will just have to work itself out over time

On a table in front of me babies were weighed on a scale that reminded me of fruit vendors.  Young and old alike had their temperature taken with the same thermometer- wiped cleaned with an alcohol swab and placed in the underarm.  Each patient's information was handwritten by a nurse on a blank sheet of paper in lovely cursive script.  

That evening I spoke with Hatnim and Ritha, all three of us tired without having done anything physical all day. We wondered at the ability of the clinic’s one doctor to return everyday to handle the steady stream of patients. The clinic in Cabaret was clean, the facility well cared for, but there were no resources. Forest had to borrow a flashlight from Kristina to examine children’s ears. What is incredible about Cabaret’s clinic is the care that can be managed with the resources available. The nurses and the staff worked with what they had, but I just kept looking around thinking of what could be accomplished with even a little more.

Forest and Kensia were a welcome addition for the doctor, who commutes daily from Port-au-Prince.  Friday's rain prevented him from opening the clinic.  Because of this, our American doctors lost a day of treating patients, Cabaret's sick were put off until after the weekend, and I was left wondering what would happen during the upcoming rainy season.  

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