The clinic waiting room is packed. New moms with new born babies, children, and elderly line every bench patiently waiting to be seen. They dress to impress, button down shirts, often with suit jackets or nice dresses and hats. The children dress beautifully, wearing dresses we would see at a baptismal or at church on Easter Sunday. They consider this their winter and are dressed for the cold. Some wear multiple layers and stocking caps. It’s mid 80’s outside. Haitians are very clean. Besides a gnarly wound, I haven’t appreciated any bad smells or body odor. They take a lot of pride in this. I often see many washing their feet in streams so that they are clean for their visit.
The clinic is very comprehensive. We have a lab that is capable of HIV, VDRL, Malaria, CBC and some chemistries. We have an X-ray machine that was previously used in the military. Chest and extremity films turn out pretty decent. There’s a well equipped nursing station where we keep our sicker patients for IV Fluids, antibiotics and longer monitoring. It’s a challenge to get a patients admitted to the hospital. When necessary we send the patients with all the supplies (IV tubing, fluids, bandages, meds) that we predict will be needed. It’s common to repeatedly see the higher acuity patients each day and slowly nurse them back to health rather than attempt to send them to a hospital and risk them being denied care or be treated inappropriately. Of course there are certain situations like our kiddo with the acute appy or the sickle cell patient who presented with a hematocrit of 9, where we have no choice but to send them to a hospital and pray they get treated.
Everywhere you look is a breastfeeding mother. It’s actually refreshing to see how accepted it is to breast feed in public. If you don’t breastfeed your baby, they don’t survive. Malnutrition is a huge concern. Miss Sally is an American NP that runs a malnutrition program, among many other things, at HHM. The community is thankful to have her and the resources that she provides.
So far I’ve seen a plentiful of type II diabetes and hypertension. Depression, CHF and acid reflux were also very common. These people work (physically) hard and walking is their main means of transportation. Arthralgia and LBP are common complaints. Tylenol is the main analgesic we have to offer and patients are appreciative and satisfied with this. No narcotic seeking here. Tobaccoism is very uncommon. Some drink but it was also rare. The pictures I’ve shared include a 1 year old baby boy who suffers from hydrocephalus. He had been seen once before at a hospital but never heard back regarding a treatment plan. I fear his little life will end soon. The little girl presented with a facial growth that has slowly progressed since birth. Dr. Jim looked with US and with a cranial film. She was neurologically intact and we are praying there’s no brain involvement. We sent her for a CT, results TBD. The woman in the nursing station has ascites. I drained 5.5 liters of fluid off and she will come back in a few days to do more. The well appearing little one was there to follow up for an acute gastroenteritis, obviously glowing and doing well.
Clinic is efficient and gratifying. Documentation is brief, your time is spent with the patient. It’s so refreshing to be able to just practice medicine.