"What About ME?"

Last week during the malnutrition clinic we again confronted a mom about the fact that her child was not gaining weight. 

She was a very small 6-month-old, holding around 11 pounds for the 6 weeks she has been in the program. This was week number 4 with no weight gain and last week she lost some. This is statistically impossible if they are eating the prescribed amount of Medika Mamba (Medical Peanut butter). 

The previous week we told her that she was not allowed to eat it, as the contract that she signed states. After getting after her she explained her philosophy of how if she eats the Medika Mamba she will be health and make good breast milk and her baby will also be health. It was a win-win for everyone. 

We explained to her that she had willingly broke the rules which she was aware of. That her baby is sick and it’s sad she has chosen not to take advantage of our program to help care for her baby. We advised her that she was being kicked out of the program and we hoped that she would somehow be able to keep her baby alive. But, we could not continue to allow her to break the rules when there were a lot of other mothers who would do what they were supposed to do for their child. 

Her reply was “what about me?” 

It’s sad to see the selfishness and the lack of value put on children here. We did tell her to tell her friends and she spent some time talking with the other ladies before she left so hopefully it will be a valuable lesson to all of them.

This little guy wanted to share his Medika Mamba with me. Hoping his giving and caring spirit doesn't change as he gets older!

I told you in my last post I would try to give you a better look at the normal day to day activity in Haiti. 

It was a busy time trying to get ready to come home for a little while to do taxes and get a little break. But I really decided that after a total of about 20 weeks in Haiti there is really no such thing as “normal” when it comes to medical work here.

My normal weekly schedule looks like this: 

Monday is medical clinic up the road at Coram Deo Mission (Latin for presents of God) run by Karen from Canada. We start at 9 am and can see up to 70+ patients. 

We only hand out 45 cards at the gate for patients but often a mother will get a card and then all 3 kids need to be seen as well. So, we usually finish anywhere from 1:00 to 2:30 but usually the later. Before and after clinic I try to see school kids in my school clinic.

Tuesday is malnutrition clinic at the same facility. I do the medical part of the malnutrition treatment. There is a medical component to being sure they are healthy enough to gain weight from the Medika Mamba. 

We currently have 11 kids in the program that we see each week. Last week we graduated 2 kids from the program that made their target weight! It doesn’t sound like a lot when a child gains 3 pounds but when your little that make a 37% increase in their weight!! 

We see up to 20 new patients each week as well. Most of them don’t meet the requirements to be admitted. I think they believe it’s a food distribution and don’t understand the concept of malnutrition treatment. They are evaluated medically and treated if any issues are found. Again, I see kids in the school clinic before and after if possible.

The Children lining up for school. I always try to be visible in the morning if someone needs anything when they arrive. They always sing, pray, and sing the national Anthem each day.

Wednesday through Friday I am available most of the day for the school clinic. I also try to go down to the Ravine with the baby feeders occasionally to check on things as well as going to weigh the kids twice a month. I never know what I will get into in the Ravine. 

On top of that our Monday clinic has produced several wound care patients. Last week we were up to 5 patients who needed dressing changes. So, every other day we go up to Coram Deo to do wound care. I am also available for calls with HERO Ambulance at any time as well.

The school clinic can produce any number of complaints. In the last 2 weeks, I have seen many patients for ear infections, sore throats, pink eye, allergies, urinary tract infections, scabies, headaches, dehydration, and abdominal pain. I also had a student that stepped on a burning piece of charcoal. 

After a week, he finally came to see me with an infected hole in the bottom of his foot. I also had a girl with a knee injury after being involved in a Moto accident on the way home from school. It’s not uncommon to have students who are involved in Moto accidents or have burns from the exhaust.

Saturday and Sunday I try to take a little time for myself, which doesn’t occur often enough. Saturday is laundry day. You always have to start early to get the washing done before the power goes out. Then its line drying after that. 

With the wound care schedule, we have to do wounds every other Saturday and Sunday. People from the community will also show up at the gate if they are in need at any time so there is never truly time off.

On Monday evening before I left one of the guys that lives at the school came to get me and said there was someone at the gate bleeding. 

I found a young lady bleeding from her hand. I took her to the clinic and found a deep wound to her left hand. She stated that she tripped and fell into a large pot that had a knife in it. It didn’t seem very likely. I would guess she was attacked and she grabbed the knife cutting her hand. She didn’t appear to have any tendon or nerve damage so 9 stitches later her hand was sewn up. It is very difficult to stitch between someone fingers. I hope her hand does well and she has no complications. 

She will be going to clinic to have the stitches removed while I am gone.

My Little girl whose mother started feeding her cookies and dirty water at 2 months is gaining weight and looking much better. Hoping she does well as she grows up. She was rather sick for a while and probably would have died if we had not intervened.

She is doing well!! I just wish mom would spend less on clothes and more on her food!

The other day one of the pregnant ladies I have been working with down in the Ravine asked if I would bring her some more prenatal vitamins as well as some for her friend. She also stated that she didn’t feel well and was having abdominal pain. 

I went back to the school and got some equipment and some vitamins and went back to the ravine. I gave her the vitamins and checked on her and the baby. She’s been pregnant five other times. 

We’re really trying hard to help her birth her first child. Everything looked good. 

I don’t think they understand that process of pregnancy and what happens to your body as the baby grows as all of the pregnant woman I have seen complain about abdominal pain. So now we went to find her friend… 

She reported that her friend had no complaints but she wanted me to check on her as well. 

As I went into her hot little tent shack and I met Rachel who was obviously pregnant. Her boyfriend (not reported to be the babies father) was irritated by me being there as he was taking a nap. As I was evaluating her she told me, through the translator, that at 29 years old, with 2 children, this was the first time in her life that she has ever had her blood pressure taken. 

As it turns out, it was one of the most important blood pressure checks I have done in Haiti thus far. Her blood pressure was 222/130. 

This screamed Preeclampsia to me. But, this is Haiti. I explained to her what was going on and how much of a problem this was. She became very upset when I explained what would probably happen today. 

But, she also was very dehydrated and possibly had hypertension before the pregnancy. She said that she didn’t want to go to the hospital and that whatever I could do was enough. I told her that I would give her some fluid and see what that did for her and we would re-evaluate from there. SO, I went back to the school again and got some IV fluids and more equipment. 

When I returned to start an IV, her boyfriend finally decided he could get up and let her lay down. 

As I started her IV in this tiny little dirt floor tarp shack it was so hot that I had to lean to the side so I didn’t drip sweat on my IV site. The smoke from the neighbors cooking fire was flowing into her house and as it past in front of the light from my headlamp that I had to use to see, it looked like something from a concert. 

It still amazes me how the people live and survive in these conditions. 

Over time I gave her 2 liters of IV fluid. I was able to get her blood pressure down to 160/96, which still isn’t good, but is a 62-point drop from where we started. I lectured her about drinking fluids. 

It was noon when I started the IV and at that point she hadn’t urinated yet since she woke up. I explained that she had 16 hours and if she didn’t drink enough and if she didn’t keep her blood pressure down I was taking her to the hospital in the morning and she would have her baby. I told her that she needed to drink a lot and be on bed rest until I come back in the morning. 

She tried to tell me that she felt better than she has felt in a while, that she couldn’t be sick. I assured her that this was a very dangerous situation and it went against my better judgment to not take her to the hospital right then. 

I got back to the school just as school was ending. When the school secretary seen me she asked me if I had taken a bath with my clothes on. I told her no, I was just down hanging out in the Ravine trying to keep warm. The real feel temp was 103 degrees which felt cool after coming out of her house.

The next morning, I returned worried about what I would find. I found her sweating like crazy and cooking over a charcoal fire inside her house. I asked her what happened to bed rest and taking care of her and her baby? She didn’t really have an answer for me. 

Her blood pressure was 200/120. 

I told her “congratulations.” Because she was going to have her baby that day. 

She had reported to be about 8 months but they also think that its possible be pregnant for a year or more. She said that she didn’t feel like it was necessary to go. I explained to her the she was in preeclampsia and that eclampsia was when she has a seizure. I told her that the only way to fix this was for her to have the baby. I also told her that if she had a seizure here that it was almost certain that her and her baby would die. With some encouragement from some of the neighbors ladies that had gathered around her door she agreed to go to the hospital.

After she left for the hospital I was taken to the home of another pregnant lady. 

Before I finished checking on her 2 more pregnant ladies came to be checked. Word had quickly spread and everyone who was pregnant wanted to be sure they didn’t have the same problem. As it turns out they all had low blood pressure so we educated then about drinking lots of water and less coffee.

Everything gone...

Had a house fire a couple blocks from the school the other day. People were running around but there was nothing that could be done. It’s sad how often this probably happens. They just have to walk away and start all over. So many people cook inside their homes. Children often get burned from accidents in the home with cooking fires.

So just before I left I went to check on the mother I sent to the hospital. Her boyfriend stated that she was still in the hospital after a week. We decided to go and check on her. After a much longer walk than I anticipated we arrived at the Doctors Without Borders Hospital she was at. 

After a while looking around we finally found Rachel. The look on her face when she seen that we came to check on her was priceless. She was so excited! She stated that her little girl was doing pretty good but was on oxygen for some breathing issues. She was in the ICU so we were not allowed to go and see her. She was unsure how much she weighed but said she was little. 

She was very thankful that I had found her and made her go to the hospital. She said the doctor told her that she would have probably been dead in the next day or so. Two lives saved because of a simple blood pressure check.

I will try to have a picture of Rachel and her baby for the next post!

I told my co-worker, Meredith, that we have a medical clinic, a malnutrition clinic, and a wound clinic. Maybe it’s time to start a Maternity clinic too!

Thank-You doesn’t seem like enough for your continued prayers, financial support, and encouragement! Together we are making a difference in lives here in Haiti.

Until No Child Dies,

Kelby