The month of May was a time of changes for us here at Confidence Health Center. Our nurse Carmina got here in spring of 2020 and was a major asset to the clinic. She learned Creole quickly and was well accustomed to the culture of the clinic work here. All good things must come to an end and in May her commitment here was completed, so she said goodbye to Haiti and returned home to Canada. We wish her the best in her continuing career.
God continues to provide, and we were thankful to be able to find another American nurse to replace Carmina. Kay is a registered nurse from Mississippi who has several years’ experience working in Oriani in the past, as well as a medical mission stint spent in Kenya. She committed to spending another six weeks here this summer. Her former experience here means that she already has a concrete grasp on the language and culture and was able to jump in with both feet. We are very thankful that she was willing to come help us out, filling a short gap before a more long-term nurse is able to come.
Otherwise, the clinic has been functioning well and we are as busy as we want to be every day. We are deep into spring rainy season now, which means that everything is green and the gardens are doing well, but it also means that the hungry season is reaching a peak. The crops are not quite ready to harvest and the markets are very sparsely stocked. We are fortunate to be a recipient of rice from Feed My Starving Children, provided to us through a mission here in Haiti called Love a Child. They donate food boxes periodically and in times like these we are very glad to have a little nutrition we can give to patients at the clinic. It never seems to be enough, and it’s always a challenge to know exactly who could benefit from it the most.
Here are a few notes from our past month at Confidence Health Center:
- A neighbor came to the house one Saturday with their son, a boy around 10 years old named Mondi. His complaint was that he wasn’t speaking. Indeed, when they brought him to us he was completely unconscious, eyes closed, unable to move or speak. We tried everything we could think of to get him to wake up or to show some reaction, but the result was minimal at best. He would flicker his eyelids and occasionally swallow, and when we pulled him to his feet he was able to stand, albeit unsteadily with his eyes closed. His vital signs were all normal and the family insisted that he had not drunk or eaten anything unusual, was completely normal throughout the day until he just suddenly “became like this.” He was breathing normally and there was really nothing medical we could do for him without further testing and scans. The family said they wanted to take him to their pastor for a prayer service. That sounded like a good idea to me, so I sent them away. The next day I walked past his house and he was running around, grinning and being just as naughty as ever. He claimed he had no memory of what had happened the day before. We still have no idea what the cause was. Was it something neurological? Had he ingested some poison that they weren’t aware of? Was he under the influence of some dark magic? Probably will never know.
- One evening several people brought in an old man who was weak and not speaking normally. His vital signs were normal but he was very lethargic and minimally responsive. I started thinking down the lines of a stroke but when I bent closer I caught a whiff of alcohol on his breath. Ah ha! Maybe he’s just drunk? I asked the family and they immediately agreed, yes he likes to drink and he gets like this when he drinks too much. Well, well, not much we can do for this! He needs to stay away from the bottle! We sent them home and the next day he came into the clinic slightly improved but still not fully functional. Several liters of IV fluids perked him up and he left later in the afternoon walking with support.
- A very sad case came in one morning, a 14-year-old boy brought in by a female relative. The first thing we noticed was his extremely labored, heavy breathing. He was also very weak and unable to walk without assistance, but instead moved unsteadily and jerkily like a patient with Parkinson’s. He was awake and oriented but his speech was extremely slurred, he was restless, and could hardly breathe. He denied any medical history. Nothing seemed to add up to a clear diagnosis. Even his story didn’t make sense – he said he had lived in the Dominican Republic with his mother since he was a baby but had just come back to his birth home in Haiti the day before, alone, on motorcycle. He couldn’t really give us a reason for leaving his mother and said he had only become sick like this during the trip back to Haiti. I noticed that his tongue and mucous membranes were ashy gray and checked his hemoglobin – 1.8. Normal for his age would have been in the 12 – 15 range. We immediately realized that he was far too sick for our abilities here and began to discuss going to a hospital. Unfortunately, before we were able to finish making arrangements, he started foaming at the mouth and within a few minutes he had passed away. It’s so frustrating to us as American medical personnel to watch a case end up like that without clear answers. We would love to see an autopsy report, or lab work, or CT scans – something to give us an idea of what was wrong. He had obviously been sick for a while and we are just too far from definitive emergency care up here in the mountains. There was nothing more we could have done here, but the whole situation just leaves us sad and wondering.
- This past weekend we were kept busy off and on checking up on a woman in labor. She was from the Oriani area and came in several different times within a few days, progressing very slowly. Finally by Monday morning her cervix was fully dilated but the baby was still very high and not advancing anymore, so we decided it was time to move her to higher care. Fortunately we had no trouble finding a hospital to accept her and she made the trip down to Fond Parisien in our ambulance. The doctors there confirmed she had cephalo-pelvic disproportion, a condition where the baby is simply too big and cannot be born naturally. They did a C-section and last we heard mom and baby were both doing fine. We were very thankful we had been able to help her and her outcome was positive. A case like that without medical care would have ended up with the death of the baby and likely the mother as well.
So, life moves on here in Southeast Haiti! For months, the COVID-19 pandemic was hardly mentioned in the country and life went on as normal, but in the past several weeks we have started to see in increase in cases again, mostly in the Port-au-Prince area. So there is once again a curfew and a mask mandate in the capital city, although up here in the mountains we have not seen any confirmed cases and are continuing to operate cautiously. The political instability and gang activity in Port-au-Prince seems to be on the rise again, and we monitor news carefully whenever we have to go to the city for supplies. There are a few areas to avoid, but usually business can be conducted safely and up here in Oriani we do not see any violence.
Keep the work in Haiti in your prayers! We need them.