Overnight

Forgive me if this post isn’t too coherent--I worked overnight last night from 6PM to 7:30AM. I was working in the ED, as well as covering 25 Pediatric ICU beds, 20 Pediatric step down beds, 10 NICU beds, 15 patients in the malnutrition ward, and 20 patients in the adolescent ward. I’m a bit too spent to try to mess with pictures, so I’ll give you a verbal tour of the hospital, and follow it with pictures later. For those of you who’ve worked internationally this will not likely be a surprise, but this is my first medical trip abroad, so it’s all new to me.

I’m not really sure how to describe what exactly I do here. It is so far removed from anything that resembles medicine that I’ve practiced in the past that I often feel like I’ve had no training at all. Last night I almost delivered a child in the street (which would have been the 4^th this week) because there were no physicians in the maternity ward. Not to worry though--they’ll be back on Monday.

In the ED, the things I see regularly here have only been exotic names to me back home--malaria, polio, typhoid fever, tetanus. In the States, these would be taken care of by a team of infectious disease specialists, diagnosed with thousands of dollars worth of tests, and treated carefully with hospitalization and expensive medications. Here it’s me, my WHO handbook, and whatever medications that we currently have in the ED. I sometimes have to find someone who can read German or Italian to find out what medication I’m looking at.

The inpatient “wards” are woefully understaffed and undersupplied, often with one Haitian resident and one Haitian nurse taking care of all 90 inpatients in pediatrics for 12 hours at a time. Xrays are available, but only if the patient is accompanied by a non-Haitian (otherwise it could take all day just to have the Xray taken). I have been here 4 days, and have only seen the results from one blood test. You can order whatever you’d like, but you will likely be long gone by the time the labs come back. I know 3 volunteers here who have donated blood directly to their patients, as that was the only way they were going to get blood. Last night I was informed that the ICU I was covering had run out of oxygen. The ICU was out of oxygen. The absurdity of these words was completely lost on my Creole interpreter (a third year medical student). It was just a fact, like “It looks like it’s going to rain tonight“.

I’ve been told by at least 3 Haitians that this is the best care they’ve ever had.

While it’s all a bit overwhelming, I don’t want to give the impression that our efforts are futile or useless. We can’t do everything, but we can and do help literally hundreds of patients every day. The volunteers are a fantastic group of people, both those with my organization, as well as those with the other NGOs that I’ve met here. They work tirelessly to make the best of what they have, sharing supplies, meds, expertise, humor, and food to make life a little easier for these people.

I’m off to eat. More tomorrow…