Wednesday, September 14, 2011

Haiti #4 - RIP

An elderly woman was hit by a car today. Brought into us, with major trauma and died 20 minutes later. No ID, no name, no one with her. The staff put her into a body bag and sent her to the morgue where she will be sent to General Hospital and cremated. Will anyone notice that she didn't come home?
Alexon died today. He was a 16 yr old boy who was stabbed with a knife while riding on the back of a motorcycle. He developed meningitis, improved on antibiotics but rapidly deteriorated over 24 hrs and died. His mom never left his bedside. The doctors think that there was poison on the knife.
The hospital is running out of money. All of the once daily meals for the staff have been stopped and as of yesterday, all of the patient meals have been stopped. Unfortunately, there are 7 patients in our long-term Spinal Cord Unit who have no families to bring them food, including Katiana, the 11 yr old who is a paraplegic from a wall falling on her. Several of us will start to contribute our food stipend to feed the patients.
A woman asked me for some 'glo' today, water, as I walked by her. She is the mother of one of the ICU patients, a young man who was involved in a MVA/Motor Vehicle Accident and is now paralyzed from the shoulders down. She wears the same white t-shirt every day that says, "To the best teacher, Mrs Barry, Christmas 1995, a denim skirt and a navy blue Easter Sunday type broad-brimmed hat. I have been giving her some food and water these past days but understand that in the greater scheme of things, I really shouldn't. Others see me do it and ask for some also. A scuffle can easily occur in seconds. But she was thirsty so I turned around a gave her one US dollar which will get her 4 small bags of water. Everyone is hot and thirsty here.
Rest In Peace Alexon and Little Old Lady.

Kathleen

Sunday, September 4, 2011

Haiti #3 - Common Sense Is Not Necessarily Common

Dear Friends,

Perhaps you are wondering where the above title comes from? There is absolutely NO WAY to fully explain daily life here so Gaby, the Administrator, has created this mantra: "Common Sense is not necessarily common, Logic is thrown out the window and we strive to always be 10 minutes ahead."
Whenever I want to start a sentence with "It would make sense if..." I have to stop because those words make no sense here. I have to resist throwing my hands in the air, thinking that the Haitian people are their own worst enemies. Absolutely nothing is easy here and I am sometimes overwhelmed with the difficulties of daily life. and yet a whole nation manages to survive, barely, and so must I.
For Example:
#1: Marie-Claude, one of the long term Haitian nurses, let a very sick patient into the clinic area at 7am one morning against the instructions of the gate guards. There was no doctor in the hospital so the Triage area was closed for 1 hour until a doctor arrived and the guards were instructed not to let anyone in.
But Marie-Claude didn't want the woman to lay on the street at the clinic gate. I totally understand this and applaud her for this. But after she brought the woman in and laid her down on the concrete, Marie-Claude LEFT the hospital for 1 hr "to do something" asking the guards to watch the woman. Benoit, who I affectionately call the 'grim reaper' because he is responsible for taking the bodies to the morgue, found this poor, moaning woman and immediately ran to the first person he could find, Gaby, the administrator, who got me and we comforted the woman, etc.
The next day, Gaby and I sat down with Marie-Claude to discuss this situation and to give MC a 'letter de blame,' a very serious action that can lead to termination and revocation of an employees certification, etc. MC was obviously very upset, repeatedly explaining why she did what she did. I repeated that she had abandoned the patient and would have been responsible if the woman had died. MC: "but she didn't die." Me: "but she could have and you left her alone and left the hospital, on work time." MC: "but she didn't so it was OK." There was no way that we could explain this to her.
#2: The EKG machine was put outside because the LOW BATT light was on, just meaning that it had to be plugged in. A nurse thought that it was broken so she put it outside and out of the way. Then it rained. HARD. And then it was broken.
#3: The C-arm, an x-ray machine, is broken and needs a $21,000 part to repair it. I guess it was in the way in the OR area, so someone pushed it into the parking lot to get it out of the way. Where it was almost broadsided by the truck that empties the port-a-potties. I rescued it and had it pushed into the corner of the x-ray dept.
#4: August 15th was a country-wide holiday here. No one could tell me which holiday but they all knew that it was a holiday and didn't really want to work. After some thought, I realized that August 15th is the Feast of the Annunciation, a Roman Catholic feast day. No one goes to church to honor it, but they all want it off.
Hospitals are 24/7 institutions which has been a difficult concept to teach here but the staff is improving with their attendance on Sundays and the night shift. Two weeks ago, on August 15th, two of the just arrived volunteer doctors asked me if they could go to the beach because "nothing was happening at the hospital."
I was taken aback by this request because they had only been here for 48 hrs. I wanted to say, "Hello, you are here to be of service for 1 week and just because the operating room nurse are not sterilizing your instruments as quickly as you would like, is no reason to declare this place a disaster and go to the beach."
In stead, I politely said 'No,' and that they were needed here, especially because one of them was an Orthopedic surgeon and people are always falling out of trees/trucks/motorcycles and breaking their bodies. And we are currently the only real hospital open because the General Hospital is on strike, again! Also, there was no driver, gas or car available for the 3 hr round trip. OK they said.
One hour later, I could not find them. I would later discover that they had gone to two of the workers, an X-Ray tech and a Wound tech, offered them food and gas money and had these two employees drive them to the beach. The explanation by the employees: our work was done and IT WAS A HOLIDAY so we went to the beach. Sadly, this made total sense to me. Other than leaving work for 4 hours, without permission, and thinking that they were getting paid for it, I understood. I also assume that these doctors gave each of these men some money for their time. These men make $300/month, so of course they are going to take $50-$100 for a ride to the beach. Besides, their work was done and IT WAS A HOLIDAY! These two men truly did not think that they had done anything wrong.
As a follow-up: One of the doctor's was sent home because leaving without permission is grounds for termination from here and the two employees were suspended without pay for 1 week, a great hardship for them. The second physician the Orthopedic doc, profusely apologized, unlike the first physician and we desperately needed him to do some 8-10 surgery cases/day so he stayed.
And it goes on and on and on.
SEASONS: The kids have returned to school so there is a steady parade of different colored uniforms walking by our gate. And the obligatory matching hair ribbons that are so cute. I am told that only about 50% of the children ever go to school and 50% of those in school never complete it due to finances.
We have managed to remain relatively unscathed by 2 hurricanes but we still have a few more months of the Hurricane Season and we are still having 2-3x/week torrential rains. And nightly lightening shows with some thunder. It remains hot and humid and sometimes I am really tired of being hot and sweaty.
There is still no Prime Minister because the Parliament does not agree with any of President Martelys choices so the government is at a standstill.
There seems to be an increase in armed robberies, stabbings and gun shot wounds, based on our ER business. And two police officers were shot and killed the other night and brought here so it was a bit rowdy at our front gate.
And there have been 12 kidnappings and 1 murder of some local Haitian folks. Consequently, all of our tours for the volunteer staffs have been canceled and we are only allowed out to go to the UN in an UN car. Is there a Kidnapping season?
The other evening, a 7 yr old little girl was brought to the hospital by two men. The story was that 'TaTa' had walked to the store on her own and been hit by a car. Luckily there was only a minor cut on her forehead. Two men saw the accident, scooped her up(?kidnapped) and brought her to us. Not out of any great sense of kindness but because they knew who the driver was and wanted us, the hospital, to pay them for the information. As we are saying No, that we will not be bribed, the driver and his buddies show up at the gate and a melee ensues. One group of men wanted to re-kidnap the girl and take her to the police station to get money from them in exchange for the information. We laughed saying that we assumed that the police had much more discretionary income than us.
While the boys were rowdy at the gate, we whisked the little girl into the Logistics office where her laceration was sutured and she could be fed. She was silent and obviously terrified. Our Social Worker attempted to get some info from the little girl but it was difficult. She only knew her name and her siblings names, not her address, anyone's cell phone number or even her mothers real name.
Two hours later, a woman shows up claiming to be the mom but later admits to being the aunt, TaTa identifies her and one of our drivers sneaks them out the back gate to go to the police station to file a report. Our main concern? The aunt will beat TaTa for creating such problems for the family.
Children are constantly dying here. A four old little boy died from complications of asthma last week. His grandmother was with him when he died and went "nuts," throwing herself all over the Peds unit, hallucinating, yelling at God. She eventually had to be restrained in a chair for her safety. Two nurses drove her home to the tents where they found the little boys mom who had delivered a baby a few days before. they told the mom about the death and then quickly returned to the car before a mob collected. The mothers wailing could be heard as they drove away.
The family could not pay for a funeral so the body was taken to the General Hospital where it was cremated. I still picture two of our Housekeeping men carrying this olive green stretcher with this little body covered in a light blue blanket. Does it still bother these men to carry a body or have they done it so many times, it is just a normal part of life? I don't know.
I held the door open the other night for one of our Transporters who was carrying two rolled up blankets in his arms. They were dead babies.
And today, a woman was driven into the hospital with a dead baby half-born and hanging out of her.
This past week, a Haitian American Pediatric surgeon from LA flew here to operate for 3 days. There were three Pediatric surgeons in Haiti but they were killed in the earthquake so Dr. Ford comes here every quarter to operate on the most desperate cases.
On a lighter note, it is football season and I have decided that I will go to the UN bar every Sunday to watch some football and have a beer.
Talk with you soon.

Kathleen