Week 1 Musings

Hey everybody! I made it to Jeremie!

I'm staying in an insanely beautiful house with an ocean view and a balcony I can't get enough of. Dr. Katie, Nurse Cherlie, Cherlie's mother and Cherlie's nephew Clifton are all in the house and yet the place is so large there are still so many empty rooms. We all eat breakfast around 7: white bread, PB and coffee. Shortly thereafter we leave for our hour drive up into the hills. The road is brutal. It takes 6 gallons of diesel to get up it in the 4WD Toyota Land Cruiser. I can see why this type of vehicle is so popular here. On Wednesdays we have the day to work on house repairs, pack medicines and prepare for whatever's next. That said, this Wednesday I went into town with Dr. Katie and Clifton to buy internet access and then spent the afternoon floating in the Caribbean blue on a nearly deserted white sand cove. Tough luck!

But we're working too: we saw 17, 38, and 51 patients on Monday, Tuesday, and Thursday, respectively. We saw everything from a little girl with a likely left humerus fracture secondary to a fall, to an older man who was last seen 2 years prior. At that time, Dr. Wolf had suspected tuberculosis. He went to the hospital for a TB test. It was positive and he followed the 6 months of treatment as prescribed. He stood before us fully recovered and even 11 lbs heavier! A true success story.

The most frequent complaint is hypertension in the form of headaches and “tet ki vire” or dizziness. The problem stems from a salty, low fluid intake lifestyle and medical noncompliance. Dr. Katie explained that when people receive bad news the often stop taking their meds because they’ve heard of people dying after bad news secondary to taking their meds. Unfortunately, it can be a self-fulfilling prophecy. People arrive in hypertensive emergency and the causes are plenty: pa gen kob (no money), they feel well, can’t make it to clinic to refill their meds, they sell their meds, they don’t want to take them, or worst, they believe a rumor that convinces them to stop taking them.  For each, the treatment is the same: refill of their meds, an explanation/reprimand and encouragement to go to the hospital in Jeremie if their symptoms worsen or persist.

I’ve really enjoyed my time here thus far. We work long, hard hours, but my responsibilities are minimal. I’m the first moun ki kap pale Kreyol asse byen  (person who can speak Creole well enough) and take vitals. This is a great relief for Cherlie (the nurse) whose current responsibilities include intake and med consultations/outtake. I do intake now and she has the freedom to speak at greater length with people, as Haitians are wont to do. She also can give more young women advice, as older women are wont to do! I love being able to do this as the backlog in the wait time is due to the MD consultation and thus I have no reason to hurry. Instead, I can ask patients about their symptoms and past medical history and try to understand their responses without the pressure of having to do anything with the information except say “ok, tell the doctor what you told me, because I’m not the doctor, no?” This always gets a smile for some reason. I don’t mind one bit. 

Hope you're all well. I'll try to add pictures soon.