7/29 and 7/30
Worked in the TB tents all day until about 7:30pm. Pierre was with us and we did our usual dressing changes, labs, and IV checks. Megan also wanted us to talk to the HIV positive patients about their meds and make sure they understand they will take medicine for life. The main thing was to tell them that when they leave the hospital they still need to get meds and continue taking them every day. One patient was pretty defensive about how he got HIV-he wanted us to know that he is a good guy and that he has never had sex with anyone other than his wife. He wanted us to know that he has children and that he works very hard. As I was hearing this I was looking at a man who can’t walk and is extremely thin…I am picturing his children hugging him and sitting on his lap. His wife comes to the tent often to help take care of him. It was hard for him to accept his diagnosis…in Haiti HIV/AIDS has a really bad reputation for its association with promiscuity. We told him that we believe he is a good man and that since the test was positive we have to focus on the future and how he can be healthy and take care of his children. Another man we spoke to had a more positive outlook. He knew it was important to be a good example for other people with HIV. He also proceeded to ask us for some support, a new mattress, food, or anything we could give him. (Mary as I was writing this I thought of the song “Black and Gold” when I was singing it in your car at the beach-I love you). Another woman we talked to was extremely upset…Megan talked to her and Pierre was amazing. They both helped explain to her that with medication and following treatment she can live a good life. We moved on to some heparin flushes (drug to put through IVs so the blood doesn’t clot up the line). Cassidy came to the hospital to pick us up. In the meantime a patient came into the ER with TB and so Megan was called because no one else at the hospital really treats the TB patients. He had an oxygen saturation level in the 70s and it moved up to 85 or so with 5 liters of oxygen. He refused to keep the oxygen on his mouth. Megan was a little distraught and kind of had her hands full with this patient because she knew if he didn’t keep the oxygen on he was not going to make it through the night. The assumption was that he had a very low saturation level for an extended period of time and so his mind was not functioning properly-he was being aggressive as I tried to get some saline out of his IV…a needle was stuck in the bag and he yanked it away from me as I was sticking it. He then proceeded to pull out the needle and hold it like a weapon towards anyone that stepped near him (I am not exaggerating). The patient was 24 years old and probably had multiple drug resistant TB. His mom eventually came to the ER...Megan explained to her that if he didn’t keep the oxygen on he was going to die that night. Even after she told the patient and his mom repeatedly; he continued to refuse oxygen. The patient continued to refuse the oxygen for about 2-3 hours. His mom acknowledged that he made the decision to not use the oxygen and she respected it and let him make the decision. We thought of administering Haldol at one point but Megan decided against it because she knew it might decrease his respiratory effort. We couldn’t transfer him to another hospital because he probably had MDR-TB. Eventually Megan wrote a note saying that she did all she could and the patient refused treatment. One of her favorite TB nurses was working that night and so she felt better leaving.
Megan is an incredible doctor and getting to know her has been a blessing. I am learning an incredible amount from her throughout the days at the TB tents. Most times I don’t even have to ask questions…she explains things as she goes. We eventually got a ride from her driver and headed home. Once home I jumped in the shower and ate quick because I knew we were going to listen to Cuban music and then head to the Oloffson to listen to the owner’s band. We ate spaghetti and I noticed that the ghetto sled was gone officially. We were off…Alex drove and we got down the hill from the house when we noticed a flat tire on the truck. We stopped at a gas station and got the tire fixed-we rigged the flat tire to Cassidy’s bike and him and Chicago went to get it fixed. Willie a friend of Mike’s from IMC came to hang out for the night. Once the tire was partially fixed we made it up to Petion-Ville to go to another tire repair place on the side of the road. The place with the Cuban music was fancy and a lot of fun…it was packed, and the band played some Buena Vista Social Club which made me really happy! Off to the Oloffson around 11-we rode with Willie this time and Alex packed his car with some friends. The guys at the front door said it was $10 US dollars per person and eventually everyone got in except for Nick, Tuwanda and I so we just paid the money. The place was packed and a lot of fun.
In general when people tell stories about other volunteers or workers they meet in Haiti it begins with “so and so is crazy..” and I noticed that almost everyone says that about everyone they meet. My thought is we all are crazy for being here in the first place-not in a bad way, just in the sense that we all are doing something that others would call crazy while we are completely content with the decision to be here. I keep thinking about how/why God puts these people in my life…I know He has a plan and I realize that one day I will be able to figure it out (well…maybe).
8/2
Friday-worked at the TB tents until about 3 and then relaxed the rest of the night at home
Saturday-Went on a walk with Ellen, Tuwanda, and Ely. We originally wanted to just take a walk and get out of the house for a little bit, stretch out legs…but it ended up taking us to the plaza. We went and hung out on the roof for a bit. Tuwanda was making a beat for Ely and he was dancing away as usual. He loves Michael Jackson and can dance just like him…seriously the kid is a good dancer. Saturday was pretty laid back…we ended up going to Grass Roots United for the night. We had a good time there listening to music, socializing, etc. Just figured I would let you all know that we do get to hang out and decompress from time to time.
Sunday- we relaxed some more and did some organizing and planning of the next week.
Monday-Not sure what day this happened but two US marines joined us for a little while: Sully and Riaan. One stayed only a couple days but the other one stays until the 17th. They are both great guys and all I could think about was growing up hearing the rumors about how the marines go through some of the toughest training. They had a decent amount of gear on them and we had fun learning about the purposes of all their bags and things (not the best description, sorry).
Tuwanda, Ellen and I worked at a clinic set up in an old amusement park-the organization’s name is AMIR Haiti. There were only 2 doctors there: Tuwanda and a Haitian doctor. Usually there is a big group of people from the states and they see 300 patients per day. This Monday there were only two doctors and 4 nurses. Ellen and I can’t do much diagnosing so we helped obtain vital signs from everyone and aided in filling prescriptions. I did a couple IVs and ran around helping Tuwanda the best I could. Tuwanda ended up seeing 50 patients or more-which is amazing, she was exhausted. It was a long day and we made grilled ham and cheese sandwiches for dinner!
8/3
Breakfast was really good…we had bananas, peanut butter and granola. I think I am going to phase out eating MREs (Meals Ready to Eat). Working at the TB tents. Lina died last night, her body was still there when we arrived around 930. Ellen and I did some dressing changes, labs-11 labs and 1 IV. I brought Megan a cliff bar because I know she doesn’t get a quick break to eat too much. The Haitian nurses feed her in the afternoon usually but I thought a cliff bar couldn’t hurt. We had to draw a lab from a 15 year old patient today…she was crying, upset, and nervous. We have developed a really good relationship with her and so we tried our best to distract her and tell her it wouldn’t take a long time. The marines picked us up from the general hospital/HUEH (where the TB tents are located). Ellen was on this one and so we eventually got a smaller needle and when she stuck her the patient didn’t even flinch…I don’t think she even knew it happened. We told her she did great and was very brave. There is a patient we draw blood from a lot and the first couple times we drew blood she would jump pretty bad. When I say jump I mean move her arm as the needle is going in her vein. She was really sick, throwing up most days and she received normal saline (fluids) almost every day. She has improved dramatically and did not move when I drew the blood this time. I told her I was very proud of her and that she is looking a lot better. She walks around now and is doing great.
Another patient-an older man-lights up every time we bathe him. He likes to feel “fresh” he says. After lunch we asked a list of patients about the amount of sputum cups they were given. Megan was starting a new round and to have a good sample you need to do 3 sputum (spit) cups, one each morning, and cough into a cup before you eat, drink, or brush your teeth. This is one of the best ways to diagnose TB and to see if a patient is still infectious.
8/4
One of the marines left and Ellen, Tuwanda and I were off to Partners in Development for two days. Junior and Riaan drove us to Medishare where we met the PID people. The boys picked up a 16 year old boy with a mandible fracture (jaw). We got some egg sandwiches for everyone because Heather told us about an egg sandwich lady that works outside of Medishare. They were really good egg sandwiches. Once we got to PID they linked us up with some translators and we began seeing patients. Once again Ellen and I cannot diagnose so it was more or less triage work for us. Tuwanda and an experienced nurse at the clinic helped teach me how to do a vaginal exam. It was my first time and I am so glad they were there to teach me! PID does amazing stuff in Haiti and Guatemala. They are doing a major parasite study in Guatemala that has been successful in decreasing the amount of parasite infections in a couple towns. We ate really well at PID, they had some good authentic Haitian food as well as some good pasta with meat sauce. We talked a lot about parasites…which I learned is one of Tuwanda’s favorite topics. On a side note, Tuwanda is so much fun and I can’t wait to visit her in the states. She told us that she does the centipede in the office where she works…her patients have seen her do the worm on the floor before, man I wish she was my doctor growing up. She would fit in well with my family because that girl is crazy (remember what I said earlier about crazy people in Haiti).
I am truly grateful for everyone I am learning from down here…I am not sure they know it but at night I am in awe of how much they know. I realize I will hopefully be there one day, but for now I am blessed and thankful for everyone who is willing to teach and answer all of my questions.
8/5
Prenatal day at the PID clinic-Ellen and I are not great with prenatal stuff so we hung with Tuwanda all day and learned how to do a full prenatal assessment. The questions to ask, feeling the fundus (top of the uterus), feeling baby, using a Doppler to hear the baby’s heartbeat., etc. We got picked up around 7, 8 at Medishare.
Random culture thing I wanted to share-One day at the TB tents there was a woman in distress, her clothes were every which way and so I straightened her clothing up to cover her breasts. Megan told me later on that it isn’t necessary to cover anyone up here because in their culture being exposed is not a bad thing. I should have known this because all around the tents people take baths/showers out from under the tents and do not feel ashamed in any way.
We went to a tent camp to see a child with Cerebral Palsy. Tuwanda was supposed to take a look at his meds to make sure he had the right ones and was taking the right ones. While in the tent camp I had to hold it together…as in hold back tears. It is extremely hard sometimes to stand in the tent camps and see how these people live. Their energy is incredible despite their living situation. This particular camp shares grounds with a hog farm. Most children run around barefoot on the mud. Truly it is hard to describe…thinking of how unsanitary it is, how unhealthy it is, and how they struggle getting food day to day. I have a hard time describing the situation…it breaks my heart at times, but other times I realize that they do not know anything more than what they live with every day. The wealth and abundance of the American life might be unknown to them and so for them, family and some sort of roof over their head is enough. These are just my observations as a 22 year old American girl working in Haiti. The smiles and energy from the people help me get through the day.
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