Bonswa (or good afternoon/evening.....the near
extent of my Creole haha),
Saturday at the hospital has been pretty
chill....not many people came in to the clinic and most of the hospitalized
patients are well stabilized and taken care of by their families. We had
one woman come in who was 39 weeks pregnant and the doctor showed me how they
assess the position of the baby and listen to the fetal heart tones --
assessment is done entirely by feeling the woman's stomach, which I could do
only after she showed me where the back, hands, and head of the baby
was....maybe with some practice.....and listening to the fetal tones was with
this metal cone essentially, but I'm not sure we actually got that to
work.....def not as high tech as Rush's OB equipment :)
Last night was a rough night in the hospital, I was
unaware but apparently there was a huge accident and the badly injured were
brought here to attempt stabilization before bringing them to the bigger
hospital in Port-au-Prince. From the look on the doctor's face this
morning, she got little sleep and things did not go well. I'm not
entirely sure, but sounds like they were able to do very little and I don't
know if the patient's survived their trip to Port-au-Prince. She was
telling me this morning how she doesn't like practicing medicine in Haiti and
cannot wait to leave because the medicine is so limited and what she can do for
her patients is so minimal compared even to what she could do in Cuba, let
alone in America. I'm realizing that even with the skills necessary to
help the people here in Haiti, a lot of it comes down to the resources
available, or lack thereof. When we were working with the pregnant woman,
who came in because she was having vaginal pain, in America we def would have
done an ultrasound before sticking our hands in there to make sure there wasn't
a placenta previa or anything else that could potentially kill the
baby....here, there is no such option. I can't imagine how many times the
babies do not survive due to the limited technology, which from what I've been
told is actually fairly common sadly. For me, it just reinforces the need
for me to continue to learn to practice in areas of limited resources and gain
experience as I am now.....my American training will definitely serve me well
for knowing how I could work to improve the availability of care around the
world, but I need to understand rare diseases and "old school"
techniques just as well. They will make sure to let me know from now on
if there are accidents in the middle of the night. She said she wanted to
come and wake me, but didn't know if she had permission, which of course I said
that it was totally ok.
The hardest part of being here alone is really just
having no one to talk to....so I've been doing a lot of reading in the spare
time and at nights, which has been good as I haven't had much opportunity to
simply read non-medical books during med school. On my previous mission
trips I have been accompanied by many other friends and am used to being able to
sit around and talk about the opportunity, recap the day, speak English lol,
anything....so that's a bit difficult at the moment, especially on a day like
today where there isn't much going on in the hospital, don't even know where
the doctors are, and actually I think they're in their rooms sleeping in case
some accidents come in later. That's the thing too that's very different,
there is one doctor here who works all day and is on call at night -- she
basically works 24/7, so that's brutal for her. The medical director is
here everyday and potentially would come in at night for a major emergency, but
he doesn't live as close by. Minel, the director of the whole hospital,
he speaks English as I've mentioned, and we eat each meal together and we can
chat about things during that time....lately his wife has been joining us as
well and they like to ask a lot about my training and life in the US and I ask
them a lot about the culture, cities, lifestyle, etc. here in Haiti. So,
I shouldn't say there is no one to talk to, but maybe no one that I can talk to
with ease haha, so it's a daily challenge, and I don't have the constant access
to wifi I'm used to so learning Creole is challenging. If I could see the
words, connect a spelling to them, they would stick better....didn't have time
to get a creole-english dictionary, though I'm really wishing I did. Next
time....I will definitely do my best to learn for the future.
Tomorrow is supposed to be a pretty quiet day as
well, as on Sunday not many people come into the clinic and most of them will
be in their churches. Lots of Catholic influence here, but a good amount
of Protestant as well, and everyone believes in Voodoo, at least to some
extent. Doesn't seem like that influences the medical culture too much
though, at least not that I've seen thus far. Not sure though as the
medicine is very primitive....they would possibly object to the more American
way of doing things though, not sure really. I will be joining Minel in
the morning for church and he has offered to give me a tour of the area
afterwards. The goal will be to go back into the hospital after that and
make our daily rounds, which usually just consists of checking in on the HIV
patients, our one stroke patient, checking if the fevers have broken for the
children, etc.
Just went back down to the hospital this evening
around 8pm and spent a couple hours checking in on patients with the doctor.
We had a boy come in that we diagnosed with cholera, so that was good to
see.....we obviously don't see that in the US, so I made sure the doctor
explained everything to me that she was seeing in the patient....mostly the
white, very watery diarrhea with obvious signs of major dehydration -- hard to
miss, but I suppose if I had never seen it before on initial presentation I
might miss it in the future....so happy that I'm learning. We also spent
a good amount of time this evening comparing notes on different presentations
of pregnant women and finding out how they would diagnose a placenta previa, which
is basically just wait for them to present with bleeding after 20 weeks.
We potentially had a patient with TB today as well....he came in coughing
and vomiting up lots of blood, and along with his obvious malnutrition and
weight loss, it made it likely. They ordered some sputum cultures and we
will check for the acid-fast bacilli to confirm......it's hard with these
patients because if he does have TB, it's not like he was isolated or I even
had a chance to grab a mask....but I guess this isn't terribly different from
the free clinics we work at in the city. Granted, he wasn't coughing
really at all when I saw him, so should be okay, and if he has TB he'll be
transferred over to their TB center for treatment, but realizing that lots of
people around me could potentially have it.....overall though I hear it's hard
to catch in passing, so let's hope :)
My e-mails are getting longer I think, so thanks
again for reading. This one I have added to throughout the day whenever I
had a chance, so if it's a little spastic, it's not just one smooth thought,
and that's why.
Prayer requests:
- I'm still feeling a bit under the weather and my
cough has slightly worsened....basically a re-start of my cough from a few
weeks ago, and of course I somehow left my cough drops back home, so still
hoping the antibiotics knock it out
- The ongoing heat is also starting to re-trigger
my migraines, even with the medications, so I had to come up and take a small
nap today to help knock it out. Luckily there really wasn't anything
going on with patients so I could afford to spend the time and do that, but on
any other day it could be tough. So, please pray that I can push through
the migraines -- heat always triggers them and it's like up to 90 degrees
hotter than it was in Chicago haha
- Pray for the staff that I'm working with.
It's very evident how taxing it is on them to be treating these people
with limited resources and often they feel like they aren't doing enough.
Honestly, it's amazing what they do pull off with what they have and I
respect them immensely. I am beyond privileged to be learning from them
right now and am really getting a great experience first hand of third world
medicine and how doctors treat within that system. Dr. Josef is now
introducing me as "her student," with immense pride -- everyone
laughs a bit when she does, and I just smile and have no clue if they are
making any other jokes as I can't understand them. Most other people
refer to me as Dr. Aaron, and if I even tried to explain to them where in the
process of medical school I was, it would probably just confuse them.
- These people here are so communal and thankful
it's astounding. They spend most days trying to sell just enough of
whatever to buy food for that day, and then they go to the next day. It's
interesting, watching people live day to day, people who should be filled with
worry on American standards, but who are not. They are
remarkably....content.....which baffles me as I struggle on with my quest to
understand what being content means and requires, so these people have
something to teach me for sure. Regardless, they have great needs, and
the needs are beyond what I can provide for them in this moment, but I trust
that he has his hand on them.
Thanks again for reading and for your support.
God bless.
-Aaron Tabor
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