Monday, December 11, 2017

A Week in Haiti


During the month of April, Lauren Dwinell, M.D. from our San Clemente office spent a life-changing week in Haiti.  As part of a team of eight Southland health care professionals, Dr. Dwinell volunteered her time and expertise by providing medical care to those devastated by the earthquake.  Here Dr. Dwinell shares her story along with personal photos of her experience…

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Sadness…..If I had to pick one word to describe my experience in Haiti, it would be sadness. Sadness for the lack of health care, sadness for the unthinkable conditions in which the people live (no electricity, no sanitation and often no clean water) and sadness for the sheer chaos and disorder of a country in ruins. While the earthquake certainly worsened the conditions in Haiti, the lives they lived before were not a whole lot better. It is hard to imagine that a world like theirs can exist just a few hundred miles off the coast of the U.S., where we all live in such excess.

I traveled with a wonderful team of 8, 5 physicians and 3 nurses. Two other local pediatricians, two ER docs and 3 pediatric and labor and delivery nurses rounded out the team. I knew only two members of the team prior to going, but I feel I have seven new lifelong friends since returning. Our destination was Port-au-Prince, the nation’s capital. The population of Port-au-Prince is 2,500,000. It is estimated that 230,000 lives were lost in the earthquake, probably half of which are still unaccounted for. When you first drive through Port-au-Prince, the images that you have seen on CNN and FoxNews are all around you. The reality of the collapsed buildings, the tangles of rebar and piles and piles of rubble are everywhere. By the end of our stay, we hardly even noticed the destruction anymore given that it was so widespread. What continued to make an impact however, day after day, were the overall conditions of the city. Trash is everywhere. Everywhere. Piles and piles of it litter the streets. They all cook with coal since there is limited electricity; therefore the stench of burning coal mixed with diesel from the cars is overwhelming.

Tent cities have been erected anywhere there used to be a park or grassy hillside. Some of these makeshift communities are home to up to 100,000 displaced people. It is estimated that 1 million people in Port-au-Prince currently live in a tent city. There is no sanitation, the limited port-a-potties are full (and have been for weeks), electricity is non-existent, and there is no running or clean water. And with the rainy season upon them, they are ankle deep in mud. This is a breeding ground for typhoid, tetanus, pneumococcus and measles. These are all diseases that are preventable with vaccines, and ones we give routinely in the U.S. Due to the lack of health care in Haiti, very few of the children actually receive any vaccines. Thus they sit in wait, completely susceptible to these life threatening illnesses.

The hospitals are primitive. We worked in one named Diquini. The ER consists of some cots in what looks like a hallway. Patients are lying everywhere. The pediatric “ward” is a room the size of an average master bedroom in Orange County. It has the capacity for 12+ patients. Cots, cribs and bassinets are scattered about the room. There is no full census; no one tells you the beds are full. You just keep finding a new corner or hallway to put patients. There are no sheets for any of the cots or cribs and there is no housekeeping that cleans and sterilizes between patients. Children may get their scheduled meds, or more likely, they may not. There is one nurse, maybe, that takes care of all the patients on the ward and one day when I was there she took an afternoon nap in the back room. Thus, you get the idea of the circumstances.

The children that get admitted do not have routine illnesses by US standards. They are sicker than the average hospitalized child in our hospitals. They have malaria, typhoid encephalitis, sickle cell crisis, status asthmaticus, intestinal worm infestation, staph scalded skin, tuberculosis infection of the bone, just to name a few. These were all actual diagnoses that we cared for while we worked at the hospital. There is a Labor and Delivery unit, although only 1 in 4 babies in Haiti are born with a health care worker present. Most are born at home. We met a woman with infant triplets that had delivered them vaginally at home….. in her tent. They were all doing great. While I am the first to admit that our health care system needs an overhaul, I realize now how lucky we are to have what we do. I get irritated when I do not have a lab back in a couple of hours. In Haiti, two days is the norm and that is only if they can find the log entry or the sample didn’t get lost.

Unfortunately, the people of Haiti suffer from a government that is horribly corrupt, a culture that does not reward hard work (50% of Haitians make less than $1/day, only 50% of adults are literate) and conditions that even the poorest Americans would find unacceptable. There are many volunteers in Haiti, from all over the world, helping out in different ways. I was humbled by the dedication of many of the volunteers that I met. Many have been in Haiti for weeks, months or longer, fighting for a better life for the people. There are many good people in this world and I was lucky to meet some of them during my trip. They have inspired me, taught me about true selflessness and showed me how much one person can accomplish.

The need is so overwhelming that at times you get a sense of futility, I felt like a tiny drop in an ocean of need. About half way through the trip I was working at a particularly grim clinic, it was long hours, 100 degree heat and 200 people waiting to be seen. I was physically not feeling well and it all just seemed too much to handle. I was ready to go home. A woman sat down with her 2 children. She engaged me in conversation with the interpreter, asked me if I was a mother, how old were my children, who was taking care of them at home. This was unusual. Most of the Haitian adults were very businesslike and often difficult to engage at all. They rarely smiled and definitely made no small talk. She was a lovely woman, full of questions about my life. We completed the visit. The children had simple illnesses that were easily treated. Before she walked away, she reached out to hold my hand, looked directly into my eyes and said a few simple words to me. A few simple words that changed my life. Through the interpreter she said, “Thank you for leaving your children behind, so that you could be here and take care of mine, may God bless you always.” Her graciousness was overwhelming. I knew at that moment that my trip to Haiti had been the right choice. Perhaps one person really can make a difference.

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