Today is a full, hard and fulfilling day at the clinic. There are three of us in station one, a primary tent. It is a pop-up shelter, like the one you'd find at a wedding or catered outdoor event. There's canvas walls and roof, and it seems fairly well anchored. The floor is dirt, as we're in the courtyard of the police compound. There are old, rubber and steel patio lounges that serve as patient beds. We sit on old home depot buckets. At the rear of the tent is the "pharmacy": two folding tables covered in medications (majority labeled in Spanish) that we try futilely to organize each morning. There is a rapidly dwindling supply of oral-rehydration electrolytes, cough syrup, Ibuprofun, antibiotics, antifungal/antibacterial creams, and antihypertensives. It seems we are always out of what we need most.
Joining me in the tent is TJ, and our hero of the week, Dr. C. Dr. C is a primary doc....a really really smart doc. He leads station one, and is more than patient with TJ and I as we get his input on patients.
The patients...well, there's a seemingly endless stream. They line up outside the gates hours before the sun rises. There, Haitian volunteers "triage" the patients, but they really just provide them with slips of paper with their name on it that shows their place in line. Once outside our tent, there is a second line, with a few chairs to sit in. This is were TJ and I try to scan, and pick out the sick kids. I mean, the really sick, comatose in their mother's arms sick. There's usually 3-4 of those a day.
With the help of translators, we see patients as fast as we can. There is minimal paperwork, which is nice and means we can see more people quickly--around 500 a day.
There are a few complaints that seem to permeate the entire populace. Everyone has diarrhea. A headache. A stomachache. Worms. Scabies. Especially the kids. The adults are stoic, smiling a polite smile that doesn't crack the pain in their eyes. Kids are....kids. To a point. The young ones are wonderful. They laugh, smile, or are shy and hide away in their mother's breast. Some of the older children sense what is happened, and the shock reads more clearly on their faces. One girl of about 12 starts crying when I ask her how she is today. Everyone is grateful to be seen. No one complains about the wait in line.
I find that I can't get enough of these kids, which is good because our patient population is probably 75% pediatric. Even though most people live in tents or tarp shelters, every child somehow has clean clothes. The girls wear ribbons in their hair and fathers fret over sons who have dirty hands.
As we see more and more people, the complaints through the language barrier begin to make sense. A headache, a stomachache....it's stress. Lots of stress. I don't think mental health is something that is stressed in Haiti. So it presents as these complaints. Many adults state they can't sleep. Or have nightmares. All we can do is give Benadryl, and a reassuring smile.
The kids would all be healthier if we could just make their environment cleaner. Diarrhea runs rampant due to the food. Skin infections because of the sanitation issues. Open sores and crusted, itching blisters abound. Our creams disappear quickly. Others have upper respiratory infections, sinus infections, or ear infections. We are all on edge to catch fevers in our history--everyone is worried about malaria. Many single mothers come with three or four children, all sick. They leave with armfuls of medications, and my hope that they don't get mixed up.
I know I'm rambling. I'm trying to give a sense of the day. Of the kids. I'll talk about adults tomorrow. It became my goal to see who I could pull a smile out of. Kids became easy--parents were the challenge. Sometimes, I feel like it was the best thing we did. The toughest part was knowing this was all a temporary fix to a larger problem.
I'll leave with this picture. This adorable girl blew kisses throughout her interaction with TJ.
