It’s been a tough week already, and it’s only Wednesday.

On Monday morning, my first patient at the clinic was a little girl.

Auze, a 9 year old, had some strange complaints. She was feeling light-headed and dizzy and was having chest pain and shortness of breath. Not to out-of-the-ordinary if you're 90 years old. But it is NOT normal for a nine-year-old. But sometimes these symptoms can happen with severe anemia, which is common here.

As I started to assess her, I put my stethoscope on her chest and immediately my heart broke for her. My first thought was "this girl is going to die if she stays in Haiti."

It’s interesting how much medicine has changed for me already during my short time here in Haiti. If I was back in Michigan, this little girl would have been in the back of my ambulance and we would be running lights and sirens and headed for the children’s hospital.

Auze's heart rate was fairly normal at 86. But her blood pressure was 88/82. Her oxygen saturation was only 78% but did come up to 82% for a minute when I had her take deep breaths to listen to her lungs.

This little girl is sick!

So, what was our course of treatment? We told her to go home and we would contact her if we could find treatment options for her.

It was obvious that she has a significant heart defect. As she continues to grow her heart will no longer be able to keep up with her body's demands.

We made arrangements to get her an Echo Cardiogram and to be evaluated by a cardiologist. This would begin the process of trying to get her accepted into a program which would take her to another country for open heart surgery to repair the defect. I told her to show-up at the clinic at 7:00am on Monday morning and we'd take care of things from there.

She never showed up.

Yesterday, at the malnutrition clinic, we had two very sick kids show up. The first one was 18-months-old and weighed in at just under nine pounds. He was tiny and frail and you could tell the malnourishment had taken a disastrous toll on his body. He has also been having seizures since he was a week old, and had never been treated for them.

The second child was six years old. He weighed 18 pounds.

He had some obvious medical issues with Cerebral Palsy being one of them. We made arrangements to try to get both of them into inpatient clinics. It’s very difficult to find inpatient malnutrition clinics that will take special needs kids because what often happens is this: the parent takes the child into the clinic for care, but the parent doesn't return to get their child. The malnutrition center becomes an orphanage. But, none-the-less, we had a plan.

I told them to show-up at the clinic at 7:00am on Wednesday morning and we'd take care of things from there. They never showed up…

That's three patients in two days who did not return for life-saving follow-up care. In frustration I say to myself, "Don’t You Understand?! Your children are going to die without some significant intervention. And very soon!"

Please remember to pray for these children. Pray that their parents will do the right thing for them before it's too late. And that their lives can be saved.

Until No Child Dies,

Kelby