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Haiti-My first Medical Mission I'm helping Midwives for Haiti to educate skilled birth attendants. Haiti has the highest mortality rate in the Western Hemisphere. Here is where I will write daily journals of my adventure.

Day 10

HAITI | Thursday, 26 October 2017 | Views [131]

Day 10~ Hospital, Relax and Azul Feeding Center

 

It’s time to wake up but I’m really tired. I don’t want to get up. I want to sleep. But I drag my butt out of bed and go get coffee. I’m not really hungry so I skip breakfast. I have a bunch of snacks packed in case I get hungry. I get ready for the day and walk out to the moto waiting for me and Megan. Today we are assigned the hospital. We have our interpreters waiting for us at the hospital and arrive and set our bags in the midwife room.  There isn’t much going on in the maternity unit.

We walk over and check on the ICU lady. She is doing much better and can talk clearer. She is sitting in diarrhea, from the antibiotics we are giving her. We complete an assessment and try to come up with a plan on things that are needed or not needed. We encourage the patient to speak up for herself and not allow the staff to treat her poorly. She shouldn’t be sitting in diarrhea and while we are there, they are getting ready to give her a bath. So, we leave the ICU so that she can have her bath.

After we check in with post-op and postpartum. Megan assesses a baby and finds it to be in respiratory distress. The baby is taken for a closer look at the NICU. I assess a baby and Mom and she has severe hypertension. I tell the midwife, but her reply is ‘she doesn’t have hypertension.’ I tell her ‘well she does now. She needs some medication’. The baby has 6 fingers on each hand. This is common in Haiti. Sometimes they just tie off the extra digit to let it die and other times they leave it alone. As a matter of fact, one of the little boys I gave food to yesterday at the park hand an extra finger near his thumb. When I handed him the food and he grabbed it, the extra digit surprised me and through me off cuz I wasn’t expecting it.

Megan starts to assess another mom who has been readmitted for a wound infection from her c/section. Perrine has told us that just about every woman coming out of the OR is developing an infection and they have been trying to figure out what’s been causing it. We decide to do a dressing change since the dressing is completely saturated with pus. Megan invites the midwife and the student nurses over for us to show them how to properly do a dressing change. While I was cleaning her incision, a large amount of pus starts coming out of it. She has been in the hospital for 2 days now, on antibiotics and I would think by now it would be getting better, but it isn’t. I tell the midwife she may need a different antibiotic if this stays this way. We also tell her to change the dressing if she sees any pus or drainage on it. If she doesn’t see any, it should be changed every 12 hours.

We head back to maternity and still nothing is happening. So, we go to the prenatal clinic. Megan and I divide up and I head into where they are doing prenatal checks. Woman are lined up to get inside. I’m not sure on how the process works but there are 2 waiting areas and we walk past both of them and go into a room. One of the male midwives is in there doing clinical care and prenatal checks. They have had their vital signs checked already. He asks them questions about their history and how they are feeling. I doppler the fetal heart tones and do fundal heights. One woman is due to have her baby soon and hasn’t had her labs drawn yet. When question why she hasn’t done it, she says she can’t afford it. I ask how much it is and Isabelle says $8 US dollars. I tell her I will pay for it. But the problem is the hospital doesn’t take American money. She will have to take a moto into town and exchange the money and come back. We give her strict instructions to do it and to not steal my money I’m giving her and use it for something else. I even give her 50 gourdes to pay for the moto taxi. I hope she uses the money for what I gave it to her for. But if not, I’ve still helped that woman in one way or another.

After about 8 or so woman seen by me, 3 nursing students came into the room. They have been seeing patients somewhere else. It’s not a good idea for me to stay there because its only one patient at a time and a lot of people there to help. Isabelle and I pack up and head back to the maternity unit.

Still not much going on there. A TOLAC, trial of labor after c/section, a 14-year-old girl not pregnant and another woman in labor. The 14 year old had been brutally rapped while she went to fetch water. Unfortunately, this is a common thing here and this is the 2nd girl I have seen in a week who had been raped. She has scratch marks on her neck from the man holding her down. The doctor assesses her and find no lacerations or other things in her girl area that needs to be addressed. But now she needs to be tested for STIs, pregnancy and given antibiotics. This poor, young girl. I just wanted to hug her.

The woman in labor delivers and one of the skilled birth attendants students does the delivery. She does an amazing job and I am really proud of how well these students know what they are doing. She does the complete birth; baby, placenta and laceration repair. While being watched by her preceptor, Esther.

Only person left is the TOLAC. She has a long way to go still and its 1pm. Winter has come to the hospital because the students got done for the day. Megan and I have nothing really to do now instead of watch, so we ask our interpreters if we can just go home now. They agree, and we grab our things and head back to the house.

Lunch isn’t quite ready, and I am really hungry because I didn’t eat breakfast. Lunch is served at 2pm which is kind of late I think but I don’t make those decisions.  We usually leave at 8am in the mornings so breakfast is ate by then and then the next meal is in 6 hours and dinner follows very quickly after. I’m sitting at the kitchen table and I’m very hot. Megan places an ice pack on my head and it feels amazing. Soon, lunch is ready and it's early. A soup with corn that has the consistency of potatoes, a little meat, carrots and then you place avocado in it. It reminded us a little like gumbo. We all want to eat it quickly but it’s hot, so we can’t. Plus, we are so hot ourselves and eating hot soup is hard to do cuz it just makes you hotter.

After lunch, Winter and I are scheduled to go to Azul feeding center. It’s not a great place to go because it really pulls at your heart. It is definitely a needed thing to do because these kids need the love from people.

We grab our things and head out. I be sure to bring the volunteer phone just in case we need to call Stecy again. We walk in and feeding time is finishing up. I walk right past all the kids and head right to where the burned little boy was. He was sitting in a chair waiting to get his snack. A porridge like drink. It looks and smell yucky, but the kids drink it and I’m sure it’s full of all the nutritious things they are needing.

The boy looks and me and he looks so much better. No more oozing or bleeding, the skin is less swollen and most of it has fallen off and not just hanging off. The lady tries to hand him a cup of the porridge but he is unable to wrap his fingers around it. So, I take it and feed it to him. Kiddo just drinks it right up. I go and get him some more. He finishes that, and I sit and talk with him for a while. He doesn’t mumble a word and just looks at me with these pitiful eyes and I just want to love on him. But I can’t because I know he is fragile.

I start to divert my attention to other kids I notice may need help with feeding and I help them get more food or help them to drink it. The lady that works there points over to a crib with a sleeping little girl in it. She must be between 2 and 4 years old. I walk over there and start to wake her up to help her eat. I notice that her right butt cheek, thigh and foot have also been burned. It is looking like it’s been a few days since it happened and its healing nicely. I can’t see what her foot and ankle look like because they are wrapped in gauze. I attempt to take her out of the crib once she has woken up, but she starts crying because she is hurting. She doesn’t want to stand nor sit on my lap, so I place her back in her crib. I start to give her the food and she sips it. The worker lady hands the young girl a spoon and the girl goes to town and eats it all in less than a minute. She is very hungry. I go and get her more and she eats it fast as well. But, she is finished and doesn’t want any more. I help clean her face and then I move on to the next group of kids.

The baby room, kids under two I would guess, has the most malnourished of the kids. These toddlers must weigh less than 10-20 pounds and their arms and legs are so skinny the skin is hanging off them and wrinkled like old men and women. Their bellies are protruding and rock hard. The typical look of the ‘starving African children’. It is very tough to see and be around. Some of them are suffering from other illness and we notice a lot of kids with fevers. I approach the nun about it and tell her, but she says that at 4pm she will be passing out the fever medication to all the children. All of them I ask? She says yes…oh my. One little girl has Band-Aids on each foot and hand as if they were attempting an IV start. Winter points out that she is looking drugged cuz her eyes are doing weird things. They place wet wash clothes on her abdomen and head and the nun tells us she has a fever. I think every child in the room has an upper respiratory infection. Coughing and snot dripping out of just about every kid. This was the same situation last year. They don’t use good hand hygiene and share washcloths from child to child. No wonder they are all sick.

The babies are standing up in the cribs and there is a concrete floor. The railing of the crib comes up to the belly button. If the kids lean forward, they will topple to the floor. That could really hurt a baby, but they don’t do anything to keep that from happening. These kids in Haiti behave so differently than the kids in US. They aren’t rowdy and just sit in chairs quietly.

I help get the rest of the babies fed. The worker lady tells me she needs me to feed a little boy. I pick him up and he is so frail. Just touching him hurts him. I try to feed him, but he won’t take it. He moves his head and grips his lips closed. I try and try to get him to eat because this little boy if starving and he will die if he doesn’t eat. The nun walks by and I tell her that I can’t get him to eat. She says that is normal in malnourished children and I have to force it down him. She gives me a spoon and says to scoop it into his mouth.  Oh, how heartbreaking. I have to force fed this little guy. I am feeding him as best as I can when his mother shows up. I hand the job over to her and he eats well for her. Figures. The feeding center is not an orphanage and the parents are required to visit at least twice a week.

I see a little boy sitting in his crib. Maybe 2 years old and looks like 6 months. He is sitting up, resting his elbow on his knee and placed his hand on his head. He has silent tears running down his face. I’ve never seen a little person so sad before. The nun tells me that he is new, and he was just dropped off. I’m sure it’s a little like daycare or those first few days of school for little kids. The confusion of not knowing anyone and wondering where your parents are and why you’re at where you’re at. A lot of Haitian woman don’t work so this little boy probably never had a babysitter.

I pick him up and nestle his head onto my shoulder. I sit in a chair and rub his back softly. After 15 minutes or so I want to give the other children some attention, so I put him back in his crib. I really enjoy holding him and making him feel better, but every child here deserves some attention. He is sad that I put him down but not too bad.

I walk around the room and tickle kids and try to make them laugh. It is a very hard thing to do. These kids won’t smile. I try everything. They are just too sick or too sad. I got 2 kids to smile and one of them to laugh. It makes me happy to know that some can still show some sort of happiness or pleasure by having us there.

I go back to the boy and pick him up. We snuggle some more, and I give him one of the cars I brought. I show him how he can push the car and it will roll. I still can’t get him to smile.  Before long, it’s time for Winter and I to go. I know I need to put him down and that will be hard on both of us. I’m sitting there holding him and the tears well up in my eyes. I look around at all these children suffering and it isn’t right. This shouldn’t be happening. If the facility wasn’t here, these kids would die. So, I’m grateful for the facility and the chance for these kids to live. I place him back in his crib and he start loudly crying. Oh buddy, your breaking my heart. I am so sorry I can’t do more for you. I pat him on the head and beeline for the door. I can’t look back. My heart is breaking.

We walk out of the gate and our moto is waiting for us. We get on and ride back to the house. Dinner is ready, but I really want to wait till 6pm to eat.  I sit around and check my Facebook and do a little blogging. I decide to eat dinner. Shepard’s pie but not much meat. That is common here unfortunately. Winter and I have a rum and coke and we play Heads up a couple times, but no one is ‘feeling it’. Perrine comes down to the table with us and we chat for a little while. We are told that tomorrow is a national holiday, Jean-Jacques Dessaline, and we have the day off. A little while later, that changes and they decide we are going to the hospital. Apparently not a lot of staff at the hospital work on holidays and there are no repercussions for things like this in Haiti. So, they want us to go to the hospital, so we can help out if they are short staffed.

I go get ready for bed cuz I’m tired. I place my oils on, take my antimalarial and blog for a little while. Then lights out, again the last one to go to sleep. Good night, Haiti.

Tags: hospital, relax and azul feeding center

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