Monday, January 12, 2009

Gonaives clinics

We drove to Gonaives for 6 hours on Thursday morning, arriving around 1:00pm. We ate some lunch and then went to one of Pastor Genada's feeding programs in the ghetto. In 2 hours, we treated approximately 75 kids for head fungus, scabie, diarrhea, malaria, colds, infected cuts, worms, and athlete's foot.

The next morning, we went to Pastor's church and set up clinic there. I did consultation while Mary and her daughter Janice ran pharmacy. My friend Maggie, who is a nursing student, visiting from the States, took care of the bandages and the head fungus. We saw patients from exactly 8:15 until 12:15 and then loaded back into the car for the drive back to Port-au-Prince. We were supposed to see 75 patients to assure that we would leave on time to make the journey before dark, but we ended up seeing closer to 130. I try to remind myself that they are desperate for medical care, but it is easy to get frustrated when they use dishonest means to get into the clinic or when the doormen allow extra people in under the same ticket.

It cracks me up when a mother walks into the clinic, hands me a fat healthy baby and says, "My baby will not eat." Clearly, one of us does not understand what it means to not eat. This particular kid was born the day before the flood, and by some miracle is completely healthy and beautiful.

I am nurse. This means that I was never officially taught how to diagnose and treat illnesses. Most of the time, I can figure it out or I can remember how Dr Ed or Lori at the clinic in Cazale treated someone, but occasionally, I am met with a case that totally stumps me. For example, this young woman has had these wart-like bumps all over her face for about 9 years. They don't itch, they don't burst, they don't hurt. What are they?

In a place like Gonaives where there is so much destruction and need, it is easy to overlook the beauty. But in the ghetto where we treated the children at the feeding program, we were 30 feet from the bay. This is the Caribbean after all.

1 comment:

Mandy said...

Here is my ddx for the face gal:
verruca vulgaris
molluscum contagiosum (are they dimpled little lesions?)

I can think of (and dig up) a few zebra diagnoses. However, sadly, no matter what it is, I'm not sure there is a lot that can be done for her there w/ such limited care. Poor thing. Even if it doesn't hurt/cause problems, it can't be doing much for her self esteem.

That is my 2 cents --- take it for what it's worth --- coming from a PA who hasn't diagnosed very many things in the last 7 years. I think I am far less qualified than you....