Every morning when I am standing in front of the clinic during Paste Willy’s devotions, I enjoy the view. On market days there is a steady flow of traffic on foot, on moto, on donkeys, and some vehicles into town. The sky is a bright blue with a view of banana plants and gardens beyond the walls and in the back Pic la Selle. It truly is a beautiful setting. The clinic is busy on market days but our staff manage the patient flow smoothly. Our nurses are very comfortable in their roles and call me less often as they can manage care on their own. Sometimes I almost feel unnecessary because of how well the staff is managing. One big change you will notice on the monthly report is the section marked intestinal parasites. In the past the nurses only checked this box if the patient had noticeable worms. However, due to the high probability of intestinal parasites and the negative effects this has on a population already inclined toward malnutrition, we provide antiparasites to anyone with the slightest possibility of parasites. I decided we should mark for everyone we treat for parasites.
One of the reasons we can increase the treatment of parasites is due to a generous donation of mebendazole, an anti parasite, among other medications we received 2 weeks ago from L’eua de vie, a clinic in Fond Parisien. They had received a large donation of medications and were not sure they could use them all before they expired. So they loaded up the ambulance when it was in Fond Parisien with an eclamptic patient. I am happy to report the ambulance is finally working again.
It also made another trip Friday night successfully. This time with an older patient who seemed to have had a stroke. She had been fine the day before, but in the evening was not able to talk or react appropriately. Due to the sudden onset of the symptoms, I was quite certain of a stroke. However, the family wanted to take her and since I couldn’t be certain of my diagnosis, I didn’t have a good reason to say no. Here a stroke is not an emergency because we have no way to treat it. Even Port au Prince doesn’t have stroke care. Either way Port is not accessible. The patient was delivered to the hospital in Fond Parisien but they couldn’t do anything for her and she passed away. I was pretty certain of this outcome, but how do you tell a family no?
The situation in this part of Haiti took a dramatic turn for the worse last week. The gang in Croix de Bouquets attacked Ganthier, the town between them and Fond Parisien. The gang overran Ganthier and destroyed the police station and killed a lot of people. They made violent threats against Fond Parisien and promised a massacre. The police tried but couldn’t push them back. But a group of reinforcements were able to come up the road from Port and the police were able to reestablish a presence on the outskirts of Ganthier. Ganthier, from what I hear, is a ghost town, but for the moment Fond Parisien is safe. I was able to go there and buy medications, food, and fuel. So we are OK on supplies for a while. The reinforcements from Port went back to Port and the gangs blocked the bridge outside Ganthier so they will have a much harder time coming back. Produce from the gardens here in the mountains is carried by trucks to markets in Croix de Bouquets and Port au Prince. To pass through gang territory, they had to pay the gangs. I heard the gangs were collecting as much as $40,000 a day! Not sure how reliable this information is. After the gang attack, Fond Parisien blocked all truck traffic as they didn’t want the gang to collect this money. The gang is furious and blocked all traffic for any reason. So we are truly cut off from Port. We can still get medication from the Dominican and we have a good supply, but if this situation continues it will affect our level of care. Security in this area is still OK as the locals are blocking all the roads and checking all vehicles. When the ambulance last went they had to pass the checkpoint and pay some money. Since the people manning the checkpoints are volunteers, I don’t begrudge them the money.
This blockade could not have come at a worse time for the mountain people. Their gardens were just starting to produce and now they have lost everything. All roads are blocked and their produce they rely on selling is rotting. I don’t know what the future holds or how they will have money to replant. Truly dark times for Haiti. What this all means for the clinic and for us remains to be seen. We are still safe enough, but it is a fragile situation. We help in whatever small way we can, but the amount of people begging for help is increasing. Pray for us and this poor country. They desperately need help, but the rest of the world seems uninterested.