We arrived at the hospital at 0700 on Saturday. It was our last day and we didn’t have a plan. We went over to the hospital and rounded with the doctors. We were leaving our clean scrubs, hand sanitizer, and gloves behind. The head doctor took the box of large gloves. We told a junior doctor that we had more medium-size gloves that we would bring over before we went to the airport. He asked about the gloves a few times; it was important. They work with nothing there. It’s difficult to get supplies. Haiti received vast amounts of funding and donations immediately after the January 2010 earthquake, but since then, there have been other disasters and tragedies. People have moved on.
St. Luke’s Foundation was affiliated with the NPH, a Mexican organization that was started in 1956. Geared towards helping sick and abandoned children, NPH helped St. Damien’s, the children’s hospital in Haiti. Earlier in the week, we learned that patients over 70 years of age wouldn’t go to the ICU or be resuscitated. All children were treated, but adults were only treated if they were “viable,” by the hospital’s standards. It makes sense now, here, but it’s hard to wrap your head around the idea. If these patients were in another place, they would survive.
Jeremy had not been able to teach the BLS class on Friday. The participants were too busy. “I’m frustrated with Haiti today,” he emailed me. We split up and checked the equipment. We saw a pleural effusion during another ultrasound, and Vahe explained the patient’s case to the local staff. They spoke in a mixture of French and Creole. We purchased books created by JJ, Quick Guide to Creole. $20 was a lot. We could buy just one and scan it, but we bought six. A few days ago, Jeremy fixed the ultrasound machine by reattaching the charging cable. Suddenly the machine charged and turned on. It was a big deal to them. This $30,000 machine was their diagnostic tool, their treatment course.
We regrouped in the ICU and met with the staff. We created a plan for getting them Mag and Albuterol. A 36-year-old woman had died on Wednesday because she didn’t have the medication and neither did the hospital. Typically, one’s family is sent to the Pharmacy to get the fluid or medication but this patient had no family. She was my age.
Today we saw a patient we first met on Tuesday. An 18-year-old boy with a congenital heart defect, who had aged out of St. Damien’s. He wasn’t feeling well and needed Furosemide. The drug costs $300 per year; the boy’s family made $400 annually. He had been declining over the week. Today he couldn’t breathe. His sat was low and he was on oxygen. He had vomited earlier and was very sick with a heart rate over 130 and blood pressure in the 80’s. He only had a day or so left. The doctor came out to say goodbye. He told us that the boy’s grandmother had traveled for three hours to be with him, and wanted to get him something to eat. All the street vendors’ foods were too high in sodium for the boy to eat. I walked back to our villa and grabbed four slices of bread and the Nutella my mom had given me for the trip. I also grabbed the medium gloves and the Boston Strong t-shirt we had brought as a thank-you. Vahe translated to the grandmother that we wanted to give her the bread and Nutella. She cried and said, “Thank you! Thank you very much!” The grandmother promptly made a sandwich for her grandson, who was now breathing so rapidly that he could only speak two or three words at a time. He wouldn’t be able to hold out much longer. James gave the boy Zofran for the nausea. The hospital didn’t have any, so we took it out of our medical kit.
We know that we can’t change things and save this kid, but maybe, for 10 minutes, we can make him slightly more comfortable with a little Zofran and a whole lot of Nutella. We took a photo with the doctors. He held up the box of medium gloves. He wouldn’t let go. Neither will we. We will be back soon, in June, with a plan and a relatively small amount of resources. Of course our resources won’t save the whole country. But maybe we can help these smart, hardworking doctors and nurses save another 36-year-old and another teenager. We will bring Zofran and Nutella.