Nurse, HCO Medical Intern
It's taken some time for me to wrap my head around Thursday, June 21 and the days following.
The Haitian physician who works here at the HCO clinic was in Port-au-Prince, having just arrived from the US. Once word got out that Americans were in Peredo, I had a line forming outside the clinic starting at 5am Wednesday. It didn't matter that the American group was here to do a VBS for the kids - which was very successful - but it was assumed the clinic was open. In three days, I personally saw over 250 people (probably more like 300).
I couldn't turn away these people. Some had walked for miles just to be seen for a respiratory infection or high blood pressure, to get their blood sugar taken, and to receive prenatal vitamins. All these things, plus treating worms and malaria, I could handle. No problem. I was armed with a detailed medication list from a nurse practitioner I traveled with to Haiti in October, my personal knowledge, and some preparation I did prior to coming to Haiti.
Everything was going pretty smoothly through Thursday morning. I was in my consultation room wrapping a wound on a 56-year-old man's foot (he had sliced it with a machete) when I was urged to come see a woman who had been carried in. She had given birth to a son 6 days ago at home up in the mountains. The cousin with her said the birth was "normal," whatever that means here. But now the mother had been bleeding profusely for 6 days straight. She was conscious and moaning, but obviously in extreme distress. I quickly checked her abdomen. The cousin said she had stopped bleeding early that morning. RoRo was notified of her condition and was pulling around a vehicle to take her to the closest hospital which was at least 45 minutes away. I attempted 3 times with no success to get an IV in while I waited for the truck to come. Her veins were worse than the malnourished 2 year-old I successfully got an IV in the day before. Her vitals were out of whack and her pulse was thready at best. The truck arrived and someone picked her up and carried her to the truck.
Outside all the Haitians started shouting and swarming the truck. I still don't know what was being said. It became chaos. I stood by and watched the woman intently as the truck was turning around. And then I started yelling, "Stop, stop! Everyone stop and move out of my way." I don't know if was the tone of my voice or the fact that every Haitian there considered me the authority (they have all been calling me "Doc"...and I always try to correct them...but it doesn't work) at the time. I pushed my way through to the back of the John Deere Gator. Saw the woman's eyes roll back. Take a last breath. Felt for her pulse only to find nothing. Pulled out my stethoscope and frantically tried to hear a heart beat. I ripped open her shirt and was getting ready to perform CPR when I stopped myself.
I had nothing for her. I never did. The best I could do was try to get her to a hospital in time, but it had been 6 days of bleeding and not eating. All I would have done was break a few ribs if I started compressions. I had no one to intubate. No code team. No machines to hook her up to. No OR. No blood to give.
I had nothing. I watched that woman die right in front of my eyes on the back of a Gator. I covered her up and started yelling at RoRo through tears, "She didn't make it."
I locked myself in another room for a couple minutes just trying to catch my composure. I still had over 50 people waiting on me. When I finally came out, my translators Destiny and NoNo, both gave me some much needed encouragement. Destiny said that while I was crying in the room all the Haitians said, "The white people are good people because they are crying. They are feeling for her." NoNo said, "Carey, sometimes Haitian people, especially on the mountain, they don't know when they should go to the doctor. They don't know the right birthing process. She came too late. All you could do is be with her. And you did."
I met her 6 day old son that afternoon. We bought him formula and gave the cousin (who will now take care of him) some baby clothes and wipes. I didn't know his name, or if he even was named, so I've been calling him Peter. Holding him, I kept quietly apologizing that he will never know his Mama and that I pray he will be a strong, strong boy.
Even writing this it is hard for me to write down how I am feeling. I'm not sure what I am feeling...but maybe a little bit of this...
Frustrated (because in America she would have been at a hospital on day 1).
I think I said, "I wanna go home!" at least 20 times to Mike that day. The expectation of my ability, the pressure, the responsibility was not what I expected to encounter. This was certainly not what I thought I was going to be doing.
RoRo told Mike that I, as a nurse, have done just as much as a single doctor could have done here these past few days. And I am reminded: this isn't the United States. THIS IS RURAL HAITI. You don't have what you're used to having. You have to make it up and hope it works and get them to the closest hospital as fast as possible over bumpy road and rivers.
After a day of rest, I woke up to multiple Haitians gathered at the clinic waiting for me. My confidence was shot, and I wasn't sure I could make it through a whole day. But God is good. And he helped me serve again.
The first patient of the day was a 7-year-old girl with an abcess on her left forefinger. Her entire hand was swollen too because of the infection. Once again I did what had to be done. Luckily I had some lidocaine and was able to numb her hand a little. Just me touching her hand gently made her cry and scream. Once the lidocaine set in she was easily distracted with stickers. She was so brave and didn't even flinch when I cut open the abscess and drained all the pus. Afterward she hugged me and smiled and walked out happy. She will come back and see me Monday to check on the hand.
And that was what I needed to get back in the game. I was only going to see patients for 2 hours, but it turned into all day. And somehow, somewhere I had the energy. We had a very dehydrated patient to whom we gave medicine and some peanut butter/banana, which helped her start feeling a lot better. And we had a lot of blood pressure (tension) issues.
Tonight at devotions Emily played her guitar and led the Ohio team in worship one last time. We were so blessed to have them here this week. Being able to worship in song (in English) was exactly what I needed at the end of a long week.
With hearts abandoned
All I am is Yours
All I am is Yours
Less than 2 weeks in Haiti, and I have already seen and done more than I thought possible or even wanted to.
I Must Do What I Can
One of my first patients here was a boy with a motocycle burn. The day after I cleaned his leg he came back for me to look at the dressing and change it. He told me, in English, that he spent all night writing me a note. This is word for word what it says:
Good morning.Yesterday I am very happy cause us (he means you) protect me. Well that's for the reason I say thank you very much. I love us (you). God bless us (you). Yesterday we (you) gave me a good service. Don't worry. Everyday I'm gonna pray for us (you). Okay. I love us (you) very much.
I keep looking at it. Reminding myself that I must do what I can. God has given me abilities. I can do some things. Just not everything. I'm not in this alone. He is right there by my side.