Ke Nou

I have now tasted real mango.  The so-called mangos in the states are a sad impostor compared to Haitian mangos, which are perfectly luscious.  Also new and lovely to me is the breadfruit.  This heavenly treat is fried and tastes like a plump crispy potato chip with a soft fluffy center.  Well worth the trip to Haiti itself. 

Aside from being fed well, we had plenty of work to do.  During the five days we worked, we performed 9 surgeries, delivered one baby boy (who went home in a bright yellow dress), performed 32 ultrasounds and saw 403 patients.   The surgeries were difficult.  Many fibroids in locations I hadn’t seen before.  One was a retroperitoneal fibroid approximately the size of a large cantaloupe unconnected to the uterus with the ureter coursing through it.  We had one advanced cervical cancer, one metastatic ovarian cancer with the ovarian masses retroperitonealized and unable to be resected. The majority of women wanted surgery to remove fibroids so they could get pregnant.  In the states, removing fibroids to preserve fertility can be tricky, even with blood products on hand, retractors to aid in visualization, suction and general anesthesia.  Imagine performing these surgeries without any of the above on women with the largest fibroids you’ve ever seen under a spinal.  I’ve worried about every one of these women after surgery, not knowing how they would recover after the long surgeries and more-than-comfortable blood losses.  But these women are so tough.  They won’t ask for medicine for pain unless they are asked if they are hurting.  They never complain or question, only express complete confidence in the “blancs” that have come to care for them.

Prenatal care is something that is foreign here.  Most women do not come to the hospital to have their children, so coming before the baby is born seems frivolous.  For these women, a check-up would involve a long trek and money they don’t have.  Osapo is trying to change that.  They are planning to build a maternity ward and are working to develop a standard protocol for prenatal visits.  Still, an obstacle is getting women to the clinic.  For this reason, they have started a midwife program to train lay midwives (already practicing—often for a number of years) about appropriate care for pregnant women and optimizing safety for delivering babies outside of the hospital. 

This hospital has changed the lives of many people here.  It was started by a Haitian doctor, who brought on a second Haitian doctor and a Haitian surgeon to run the clinic here.  The patients are asked to pay nominal amounts for consultations; therefore the cost of running the hospital is consistently short about $2000/month.  The doctors often don’t pay themselves to try to make ends meet, which makes it difficult to take care of their own families.  Their sacrifices are great, especially when the sense of futility creeps in.  More often than not, the need seems insurmountable and the progress scarce.   But the people here are grateful and progress has been found.  There has been a decrease in water-borne illnesses since building a sanitized watering system that is free to the community.  They have also built outhouses for most families and have educated them about hygiene and the importance of drinking sanitized water instead of water from the stream where animals defecate and people bathe. They have built a house for a family here that had seven people living in a space the size of a walk-in closet, with a roof so short that they couldn’t stand.  This family had a cholera outbreak which prompted the doctors to inspect their home.  After seeing it, they walked away with tears in their eyes and the mission to change the lives of this family.  The father calls his house a “Godsend” and gave the greatest gift a Haitian can give: a goat to the doctor who changed this man’s world.  A man who earned less than a dollar a month found a way to give the most expensive gift possible to express his deep gratitude for giving his family a new life.    

There are more stories like this here.  This hospital is special because it is run by physicians who came from poverty within this country, determined to improve the lives of the people in this rural community.  It would be so much easier for them to leave the country to make a comfortable living.  While some did for a short time, this country never left their hearts.  They found themselves drawn back to make it better, even at great personal cost.  I would consider it a privilege to come here again, and hope, like the doctors here that every little bit does make a difference.  As their motto says on the entry wall of the clinic: “We must be the change we hope to see in the world.”

Jana Allison, M.D., Ob/Gyn

Joplin, MO