Day 3~First Day of clinical, teaching NRP and home visits
Alarm goes off and I wake up. I am eager and excited to start my day and help teach Neonatal Resuscitation Program. I get up and get ready for the day. I go get some coffee made by Cindy and make a piece of toast. I also eat a yummy banana. I’m ready for the day and soon the Skilled Birthing Attendant students are singing. I walk out and go to the front porch. There are 2 tables set up with baby mannequins and necessary equipment for resuscitation. I have a translator and we chat for a moment. Before long, I have my first of 4 groups of 4. I tell them to practice doing NRP on the babies and after some time we will sit down and talk about what NRP is and crucial steps in NRP. After that, I take one at a time and do a practice code. If they are really ready, I test them.
I find that most students have the basics down and I’m really impressed how ready these students are. Group after group has very strong students and one that needs some guidance. I won’t pass them on the test unless they are ready. Initially, the most common issue is they start CPR too soon. I remind them prior to the test that CPR is usually not needed if you follow NRP. It’s a tiring day but before I know it, its 2pm and its time for the students to go home and for me to eat lunch. The lunch bell has been rung.
Inside, a lot of the staff are dishing up. There must be at least 20 people eating. Its cornmeal, beans and a meat and okra dish. Fresh passionfruit juice too. Very yummy food. It’s nice to sit around the table with the staff and chat about things.
After lunch, Perrine and I head out to do a home visits and to visit the Mom she has been helping. She wants to see the baby and bring some supplies like formula and clothing. Winter and I join her on two moto’s and head out towards the outskirts of Hinche. We arrive at a very poor home with a big puddle of water outside of it. We walk into a VERY small area. Their home is smaller than my master bathroom. The baby is laying on a bed, purchased by Perrine. A while back, the woman had left her baby and went to the market. A candle was lite and on the bed. Big sister heard baby crying and came into find the mattress on fire! Luckily, the baby survives…again. I do an assessment on the baby and it looks well. I have a couple bracelets I made and some matchbox cars donated to me by some little boys. I ask if I can give them one and Perrine asks the woman. She said it’s okay and I give them to the boys. They are very happy and they call out to the other boys around to come get a car! Umm, no, I don’t have enough to go around LOL. I give one more out and tell them I don’t have any more. The little girls like the bracelets I gave them. I ask if I can take a picture and the woman agrees. I take the photo and show it to the kids. They think it’s funny. I’m not sure how much they have seen themselves.
We say goodbye and head off to the next house. Houses in Haiti don’t have addresses. The have regions. So, Kelby calls the next woman to find out where she lives. We get the general area and head there. When we get there, we stop and a man knows where the new baby is. We get off the moto’s and walk to the house. We are greeted by the maternal grandmother of the home and welcomed in. We are in a little bit larger home and there is a tv! We ask for permission to assess both mom and baby. Unfortunately, the baby has lost a lot of weight. We assess how the baby is feeding and it isn’t the best. We teach good breastfeeding techniques and tell the mom to breastfeed frequently and until the baby is finished. We tell her we will be back to weigh the baby in a few days but in the meantime if the baby gets lethargic she needs to bring it to the hospital. She agrees and we leave.
On our way out of her area, our moto gets a flat tire. This is the second time in 2 days we have broken down! It’s kind of comical! Perrine and Kelby had gone ahead of us and we have no way of contacting them. So, we walk alongside the bike for a way and finally our driver tells us to stay where we are and he will be back. Shortly after, Perrine shows up and we tell her what happened. We catch up with our driver and he has found someone to fix the flat. I guess it’s quite common around here. We wait about 30 minutes and the tire is fixed and we are on our way to the next home visit. Unfortunately, it is getting dark. Kelby has called ahead and some family members are waiting for us at the end of a hill. We follow them to the home and are invited inside.
This mom is suffering from postpartum depression. She isn’t caring for her baby much at all. In fact, she hasn’t feed it all day. She is complaining of constipation for 12 days and pain in her perineum. I ask her to lay down and palpate her abdomen. It feels normal. It’s too dark to assess her laceration so we decide to come back the next day for that. In the meantime, we do good breastfeeding teaching and explain to her and her mother that she needs to feed the baby every 2-3 hours or it will die. I tell her mother that even if the patient doesn’t want to she should place the baby to the breast for her. The baby’s anterior fontanelle is very sunken from dehydration. He is also listless and difficult to arouse. We get the baby on the breast and he eats very well. He has thrush and we plan on bringing back some meds for that, constipation and Tylenol for pain. We say goodbye to the family and head back.
Dinner is waiting for us when we arrive. Although it is cold and no microwave to reheat it. Haitian pizza! Perrine, Winter and I all sit down and chow it down. We were pretty hungry after a long afternoon.
The girls and I are tired and call it an early night. Malorone and oils are placed on. I attempt to get caught up on my blog but I just can’t do it. I’m exhausted. Good night Haiti!
