Léogâne - The Epicenter

On Wed I had another gratifying day of clinic in our clinic in PAP, which we revamped that morning with exam tables, dividers, a large wooden medicine cabinet, and new instruments/supplies. See the blog of my friends Aaron and Maryclaire for more details of the work going on in PAP now. Haitians continue their fight for survival on the crowded city streets, improvising with the few supplies and little space available - one long skinny median on the outskirts of PAP is covered completely with makeshift tents people are living in right in the thick diesel fumes.

Yesterday two nurses and I came to Léogâne (right by the epicenter, so the destruction here is profound, rated at 90% by the UN) with two nurses to replace a team that left that day (a PA, an FP, and two nurses), and now I'm the Heart To Heart provider coordinating the urgent care clinic at the Nazarene Church here. We'll get another doctor or two and another nurse or two as reinforcements in the next couple days.

The ICU nurse and I were the main providers in clinic today, and between the two of us we saw 62 patients. She consulted me alot, but actually she's been a provider like this on mission trips before, which experience is very helpful. The pastor's wife (Haitian) helped with wound care and the other nurse ran our pharmacy, which turns out to be a bit better supplied than the PAP clinic. The church we worked in has a tin roof on steel supports, so it feels a bit like an oven inside. Again we saw numerous patients complaining of gastritis, respiratory irritation, back aches, diarrhea, UTIs, wound infections, scratchy eyes, and most frustrating, lack of food and water. We are giving every patient a single dose of anti-parasitic medicine to free them of the worms that inevitably suck away over 30% of their already pitiful nutrition. Most people here suffer from physical manifestations of the intense psychological trauma they have gone through, including anxiety, despair, sleeping disruption, and even anger. The Doctors Without Borders website has an excellent article explaining the current state of international medical care here in Haiti.

One of my afternoon patients was a 50-year-old 9-mo-pregnant woman with headache and visual problems who turned out to have a BP of 220/120 (glad I checked!) so I diagnosed her with preeclampsia. Her first baby died at 1.5yrs, her second pregnancy ended in miscarriage at 6mo, so I hope for her that this child (probably her last) will be the one she'll raise to maturity, despite the odds being stacked against them both. Her cervix was not open yet, but for her safety she needed to deliver the baby, so I saw the last few patients then together with our driver brought her to the local Doctors Without Borders (MSF) hospital for induction or C-section. The American Seattle-trained FP doc in admitting there graciously accepted her promptly into the maternity ward and gave me a quick tour of the 100-bed full tent hospital on the way. Pretty busy and quite amazing. They have 10 deliveries a day there, including a couple C-sections, and the ortho doc there is apparently tiring of assisting the general surgeon on C-sections there, so now they may call me if they need a C-section assist this week that I'm in town, which would be pretty exciting.

We are staying in tents at a safe Mennonite compound nearby the clinic where for 25 years this group of Mennonites has been educating and sheltering 30 or so Haitian girls here from impoverished or abusive backgrounds. With various volunteers they make doilies, baskets and other crafts for sale, which proceeds help fund their school. The Mennonites here are all wonderful, kind-hearted people, and we are provided with three superb hot meals a day. The stars here are beautiful. The wash water is not that reliable, but now that we have tents to stay in the conditions are much better than the last "extreme team" endured. I've seen a gecko and plenty of mosquitos, probably malaria-ridden, but I haven't seen any of the infamous tarantulas or bats here yet. Wireless finally started working today since one of the Mennonite men spent hours fixing the satellite transmitter.

I just felt my first aftershock (a brief mild rumble), so I think I'll head to bed now. :) Many thanks to all of you who are listening in on my story here and showing me your support during this rough but amazing experience. God bless!