A friend in haiti died last week. I’m not sure I even qualify to be called his friend, but he seemed like a friend. I saw him only a few months ago. He was a quadriplegic man who had been homebound for 15 years and had total care by his family. Dr. Phelps and I performed a toenail removal on him on our last trip and were amazed to find him in good health otherwise. Now he is gone. That is the reality in Haiti. Most likely he, like so many in Haiti, died of infection. As soon as we walk back to the orphanage, there are more sick children to see. We keep going.A friend in haiti died last week. I’m not sure I even qualify to be called his friend, but he seemed like a friend. I saw him only a few months ago. He was a quadriplegic man who had been homebound for 15 years and had total care by his family. Dr. Phelps and I performed a toenail removal on him on our last trip and were amazed to find him in good health otherwise. Now he is gone. That is the reality in Haiti. Most likely he, like so many in Haiti, died of infection. As soon as we walk back to the orphanage, there are more sick children to see. We keep going.
I am sitting in 90 degree heat next to Guiga. We have arrived in Haiti, survived the crush at the airport, have played with the kids and have started getting ready for bed and Guiga is STILL working. She is uploading photos to Facebook. Guiga really is the glue that keeps us all functioning. It’s almost as if Guiga was born, among other things, to serve the people in Haiti. She is tireless. I admire her strength and resolve to no end.
Our first day of clinic was held at Abraham’s (one of our interpreters) village. We were going to an orphanage in Port-au-Prince, but, the day prior, 25 of the kids came down with Cholera and now the surrounding community is afraid to come to a clinic at that ‘infected’ location. The doctors set up their area, Tammy, Jill and Guiga set up pharmacy; Lydia and Maria set up triage with Karen, Cathy and Elainey as ‘float’ and crowd control. I am impressed by both Dr. Vakesh and Dr. Mark. Neither of them has done pediatrics in years and they pick it back up in less than an hour. By the second hour, we all settle into our positions and the team starts going like clockwork. Seven hours later, we have seen a whopping 400 patients!
For our second day of clinic, we head to a new location. It is a just a short drive from the orphanage. Then a 30 minute hike into the mountains. This is, by far, the most rural location that PFH has gone. We are seeing children who are 7 years old coming to the clinic alone. Imagine going to the doctor’s office alone at 7 years old. Then going to the pharmacy alone and having the pharmacist explain your script to you in a different language. This is the reality in Haiti. We see about 325 patients and started running out of pediatric medicines. At one point, Dr. Vakesh turns to me and says, “Rob, we have a problem. He’s really sick”. He has diagnosed a boy, Nicholson, with meningitis, a potentially fatal disease. Nicholson cannot stand on his own. We weigh our options: If we leave him there with oral meds, he will, likely, not live more than a day. We could send him to a hospital, but they may send him away and who knows if they even have the antibiotics he needs. We do. We decide to bring him back to the orphanage to care for him there. One issue: meningitis is very contagious and we are planning to take him to a place with 50 orphan children. We still believe we are his best option. We arrange to have him separated from the rest of the kids and we start injections of strong antibiotics. Karen sits with him, getting him to take small sips of water and we finish clinic. Half of his ride back is on a donkey. My first patient/donkey experience. In America, he would be in the ICU. In Haiti, he is on the back of a donkey. It is surreal.
Another reality in Haiti is how thankful and respectful the people are to us. I go to clinic in khaki cargo shorts and they come dressed in their ‘Sunday best’. They are a very religious people and follow our clinic with a church service and we are invited to stay. During the sermon the pastor acknowledges they have nothing to offer us, so they offer us their prayers. How moving this was to me. While they recognize they have no material things to offer to us, people from the richest nation in the world, they can give their most sacred gift, prayer. We are humbled by them.
Our third clinic starts is in the orphanage itself. We have no idea this will be one of the saddest days in PFH history. I give the boy with meningitis his second dose of high-powered antibiotics and then head outside. We set up clinic in their “outdoor” church. We are baking in the sun, but no one complains. They hang a sheet to try to shade us. They are so grateful to have us and do their best to take care of us so we can continue to help. It seems like such a small gesture, but it touches me. My few hours of discomfort is nothing compared to the plight of the people we serve. I apply more sunscreen and keep seeing patients. We see a few hundred more patients and by the end, we are physically and mentally drained. But we are happy. Almost slap-happy, joking and laughing. We have seen more than 1000 patients on this trip and know we have made a difference. We head upstairs to “decompress”. Dr. Mark is on the phone talking to his son and I am refilling medicine boxes when Maria comes up to tell us a pregnant woman has come to the orphanage barely able to walk and in pain. I have a history of delivering babies in Haiti and each time I feel sick to my stomach. Having done OB in my residency, I know how quickly things can go bad and very bad at that. My deliveries so far have all had good outcomes. Today will not be the same. We find her on the ground writhing in pain. Dr. Mark checks her and we can see the amniotic sac. He turns to me and says, “We are going to have a baby today”. The patient tells us she is 6 months along. We get her to a covered area and set her up on a picnic table. Dr. Mark breaks the water and I run up to get supplies. Preterm labor means bad things for the baby and we just don’t have the equipment to deal with this. What are we going to do? There is no one else and this won’t wait for us to get her to a hospital even if they do have the equipment. I start back downstairs and someone tells me it is a breech delivery. Even worse. I start running and Dr. Mark has delivered the lower half of the baby’s body and as soon as I see the legs, I know the baby is not alive. My heart literally breaks. Our focus turns to the mother. We have GOT to deliver this baby now or she will die of massive infection in days. Without proper time for labor, the birth canal has not had a chance to dilate so the baby is literally stuck. We try different maneuvers to deliver the baby and the going is very slow. All the while the mother is screaming in pain. We deliver the shoulders, but the baby’s chin is stuck on the mother’s pubic bone. Dr. Mark and I continue to work and FINALLY deliver the baby entirely. It is a boy. The placenta comes out a few minutes later and is clearly diseased. Now we know why the pregnancy self-aborted. We have to inform the mother that her baby probably died a day or two prior to her coming in. We realize that there was nothing that could have been done even if she showed up at the Mayo Clinic. We give her an injection of antibiotics and clean her up. Less than an hour later, she walks out of the orphanage. We are walking around in a daze. This can’t be how our trip ends. A thousand patients served, all the good we have done and this just can’t be how our trip ends. We have a group debriefing. Maybe it helped. We just have to focus on the fact that the mother was saved. That’s the best we could do and we did do it.
Our final day in Haiti, I return one last time to see the boy with meningitis. He is alert, eating and drinking, sitting up and talking with his mother. I give the last shot and instruct on how to take the antibiotics we are leaving for him. He is going to be fine. He was definitely a ‘save’. Next, we go the the “Cholera” orphanage. I thought my heart was through breaking. I was wrong. While the structure itself is nicer than where we are staying, the conditions are worse. At least 80% of the children are starving. They show the big, rounded bellies of protein malnutrition. About 25% of the boys, mostly 3-6 years old are standing around dirty and naked. There, simply, is not enough clothing to go around. Guiga and I talk and we end up giving them about $600 to buy food and supplies. It is a small fortune in Haiti. It is a drop in the bucket to what they will need in the long run. We will definitely come back to provide medical care there.
We are a team of 11 whose lives have been touched and likely will never be the same.
We are a team of 11 from all walks of life who came together purely because we care and want to make a difference.
We are a team of 11 and can only do so much, but we are doing our part.
Our mission continues and PFH continues to grow. Everyone on our team is a healer in some way whether they have medical training or not. We heal sickness, we heal pain, we heal sadness and we heal broken hope. We show kindness and love and get so much more in return.
If you want to change your life and that of those we serve, join PFH. Donate your time, donate money, donate your expertise, donate ANYTHING. Get involved. We cannot save the world, but if you thought there was even a small chance to save just one person in the world, would you? This is your chance. Take it and you will not be sorry.
Robert J. Ferreira, MD