Malnourished Baby, HIV Test, Wadner's House, and Vicki's Birthday

Thursday, July 3, 2008

Today was Well Baby Clinic, so Nadine and Vicki helped out by admiring the little babies taking weights and temperatures, giving vaccines, etc. Amy and Evan consulted patients (mostly babies today) together as they have been doing this week. I shadowed Dr. Rodney this morning, so I got to see sick patients including babies. We saw one 8-month old girl who weighed a mere 5kg, which is way below normal (lower limit is 6.5kg). She was so skinny and small, and it was heartbreaking to see her. Her mother brought her in because the baby was having fever and diarrhea. We gave her medicine for the symptoms, and put her on the nutrition program (part of the World Food Program) to help her gain the much needed weight. I'm so thankful that we have these programs to help little babies like her.

Another patient we saw was a young man who had headaches and some kind of rash on various parts of his skin. I can't remember exactly, but I think he also had a little abscess of some sort on his neck. He reminded me of a Haitian friend from last year who turned out to have syphilis. Just as I was thinking this patient might have some kind of sexually transmitted disease, Dr. Rodney asked the patient if he wanted to get tested for HIV. The patient seemed hesitant and concerned about the cost of the test, but I could tell that he was relieved when Dr. Rodney said the tests are free of charge. Dr. Rodney explained to the patient about the pre-test consultation where they educate patients about STDs and HIV as well as ask risk assessment questions. I didn't get to see the results (I was probably eating lunch when Dr. Rodney saw him again with the results), but it was good to see how cases like this was handled in consultations (and that my instincts weren't far from Dr. Rodney's line of thought).

In the afternoon, Amy, Nadine, Vicki (three Canadians), Laura, Evan (two N. Irish), and I reorganized the operation room into an emergency room. While we were going through stuff around the room, we found some circumcision kits, and had a little laugh while Amy explained how to use it. It's basically a metal clamp that cuts the circulation to the foreskin and act like a stencil to direct the incision. The others almost seemed appalled to see it, but I wasn't surprised at all because I had seen one similar to it at my pediatric preceptorship last quarter. Apparently they had never seem those in Canada or Northern Ireland... but I bet they use them, too.

Vicki and I reorganized the little storage room next door. I was impressed by the variety and quantity of stuff we had, but it was a bit difficult to figure out what should go where. Also the room wasn't well ventilated, so we were kind of sweaty. Overall, I think we got a lot of work done in both rooms.

Afterwards I had a Creole lesson with Wadner for an hour, then the six of us (three Canadians, two N. Irish, and me) took a walk outside the compound walls. We briefly visited Wadner's house. Wadner is 25, and since his father passed away, he's been looking after his mother, his three sisters, and his niece. He's building his own house on the land given to him by his grandfather. Wadner also built a pretty intricate workout machine in his uncle's house next door. I was thoroughly impressed by how he maximizes the little resources that he has.

Today is Vicki's birthday, and we had planned to give her a little gag gift. The plan was to steal some of her clothes, put them in a box, and give it to her as a present. I got this idea from my birthday two years ago in Kenya when some of the missionaries pulled it off on me. The entire time we were reorganizing the operation room (now emergency room), I was looking for a small cardboard box, which we eventually found. Luckily, just as we got back from the walk, a few of the local kids showed up wanting to play some football (soccer), so Vicki enthusiastically went out to play with them. Meanwhile, Nadine (Vicki's roommate) helped me steal some of Vicki's clothes. Actually Nadine ended up stuffing the box with most of Vicki's clothes. We taped it up and hid it up at the Holiday House (that's where we eat our meals). Soon after that, I realized that, since Vicki was playing football, she'll want to come back to her room to change before dinner. So I decided to join her to keep her playing until dinner time and convince her to go straight to dinner instead of changing. It worked out just as I had planned. Oh, the power of suggestion!

After lunch today I had asked the kitchen ladies to put some candles on the dessert tonight. They said that if I had asked them earlier, they would have made a cake, but instead they had already made some jello. So after dinner, we lit up a few candles on a bowl of jello and sang happy birthday for Vicki. Then I brought out the box and gave it to her. She looked excited and nervous because we were all giggling. She opened the box and the first thing she said was, "Oh, my skirt!" She dug further and said, "This is all my clothes!" We had a good laugh.

After dinner, we went over to Amy's house, and Vicki, Nadine, and Laura got a pedicure from one of Amy's Haitian friends while we watched August Rush. I really liked the soundtrack.

Tears, Baby Fever, Ankle Sprain, and Canada Day

Tuesday, July 1, 2008

After devotions at clinic this morning, we had a farewell party for Julie (physio from N. Ireland) because she's leaving tomorrow. She has been here for 6 months, and had become an invaluable part of the clinic. Dr. Rodney, who is one of Julie's best friends, gave a little speech and presented a certificate of honor and merit to her. Julie also gave a speech in Creole, then per her request we sang "Ala m kontan wè Jezi renmen m" (How happy I am to see that Jesus loves me) in the upbeat style. Tears were exchanged among many.

The rest of Tim's team (Tim, Mary, Christina, Carly, Anna, Emily, Beth, and Jen) left after lunch. It was really sad to see them go. They had become like family to me. It won't be the same without them. Lots of tears were exchanged here as well.

I shadowed Ms. Ketlye at the clinic today. One of the patients we saw was a little baby boy with a fever. I don't know exactly what was going on, but I assisted Ms. Ketlye by fetching whatever she asked me to bring. We did what we could to reduce his fever and then referred him to a hospital. I was impressed by how well Ms. Ketlye handled the case even with the limited time and resources.

In the afternoon we (those of us still here are Laura, Evan, Nadine, and Vicki) played football (soccer) with some local kids. While playing Evan sprained his ankle, so we didn't play for long.

Soon after that a truck from the World Food Program arrived, so we went over to help unload. Today is Canada Day, and most if not all of the food (rice, beans, soy/corn meal) that we unloaded were from Canada, so we, especially Vicki and Nadine, felt patriotic for Canada. Later on after dinner, Vicki and Nadine sang the Canadian National Anthem. Then we went over to Laura's room and watched Hairspray together. There are only 5 of us left now, but we still manage to have fun.

TB Clinic, World Food Program, and Football

Friday, June 27, 2008

Once a month on Fridays we have tuberculosis clinic. We have all the TB patients come in with their empty plastic containers to make sure they've taken all the meds. After they've gone through 8 months of treatment, and if their sputum test comes out negative, we do a little graduation ceremony and give them a certificate. It seems like certificates mean a lot in Haiti. So the first thing we did was the graduation ceremony, and all the patients graduating from TB were given a chance to make a quick speech. I didn't catch what they said, but in the past, patients have said things like, they used to rely on witch doctors and never got better, but the medicine they got from the clinic really cured them. We hope that other patients will be inspired to comply with the treatment plan so that they can be cured, and so that they don't develop multiple drug resistant strains.

I got to work with Ms. Prudence for the TB clinic today. Ms. Prudence has been working at the clinic for over 20 years, and she is the head nurse. We'll be doing the mobile clinic at her husband's church this weekend. Since we had many patients as we usually do for TB clinics, we had to work fast. We asked each patients if they've been taking their medicine, check their lungs, and get their sputum sample. Ms. Prudence put me in charge of checking their lungs, and I got to hear wheezing, crackles, and rales, the lung sounds that I had learned about in class but had never actually heard before. They sounded just like I was told, but it's hard to imagine what it sounds like without actually hearing it. I could hear the abnormal sounds in patients who had just started treatment, but those who were well into to the program sounded much better.

To encourage the patients to come every month because it's very important that they come every month for 8 months, we give out some food through the World Food Program. So all the TB patients got some beans, oil, rice, and flour. I had always heard about WFP, so it was cool to see it in action.

While the food distribution was taking place, Vicki, Laura, Evan, and I sorted out some medical supplies in the depot. There were hundreds of birthing kits, which we packed tightly into boxes. Because of the power-line incident yesterday, the power had been going on and off today. Usually the depot is the coolest place at the clinic because of air-conditioning, but we were all quite sweaty at the depot because we didn't have power most of the time.

Afterwards we played football with some local kids. I hadn't played soccer in forever. I usually don't like sports much, but it was a lot of fun. Emily, Vicki, Wilfried, and I were a team, and we called ourselves Team Mango.

Amy and Julie got their power back, so we watched Enchanted at their house. The power went out (after 10pm), so we couldn't finish it.

We're going to mobile clinic at Souffrier tomorrow. I'm excited!

Haitian Breakdance

Here's a video clip that I recorded at a football match (read: soccer game) in Haiti. It's a guy doing a breakdance to kompa music during half-time. It was the best part of the match.