The Tip of the Iceberg

As I stated before, although Doucette and I are living with Dwight now, we are still continuing to work with Dr. Joey and Dr. Jackie at their various free clinics. We are helping them to expand their work into areas that normally don't see medicine.

For instance, we have set up a tent clinic in one of the tent cities near the main clinic. In a previous entry I talked about tent cities and some signs posted outside of them saying "We need help! Send doctors, food, water, tents, and money". We are the doctor portion of the answer for at least one of the tent cities where they had no prior access to medicine. Going into my first tent city was a very powerful experience. There were people lined up all around us waiting to get their blood pressure checked by Doucette and I and then get in to see the doctors and receive medicine. Dr. Joey and Dr. Jackie have started a new blood pressure program to treat people with high and low blood pressure so we registered over 200 people!

During a break I was able to walk around and take pictures. As far as I could see there were tents everywhere! Ironically, the landscape looked so beautiful covered with different colored and shaped tents with beautiful mountains for a back drop. But what you won't see in the photos (once I'm able to post them) is the extreme heat from the sun beating down on the tents and tarps, or the lack of clean drinking and bathing water, the lack of a waste management system so that in addition to malnourishment the people living in tent cities are at risk for an assortment of other health problems (i.e. parasites, birth defects, high infant mortality, etc.)

In addition to the problems I briefly mentioned above, another problem plaguing many residents of the tent cities and other impoverished areas in Haiti is a lack of school. I can't speak for all tent cities or all children in Cite Soliel (another area that is extremely below the poverty line) but in the tent city we were in there was no evidence of a school system in place. In Cite Soliel there are some schools but it is my understanding that in many cases a lack of funding to buy uniforms prevents a large group of children from access to education as well.

While many kids elsewhere in the world who have education available to them have a tendency to take it for granted (myself included), the children in these areas are extremely limited in what they can do during the day to keep occupied. I found a few kids with toys that seemed to bring them joy but lacking an education is a real problem that seems to only further enforce the glass ceiling that is ever present over these kids' heads.

Additionally, adults and children alike in these areas are finding other ways to entertain themselves. As Dr. Joey put it "Their choices are either having sex, listening to the radio, or having sex while listening to the radio". While sex is a healthy part of human nature, whithout taking certain precautions, sex can cause a lot of problems. Hence, the quest to promote safe sex!

I wish I could convey how many cases of STDs and infections we see on a regular basis and tell some of the stories but due to a shortage of time I suppose those will have to wait for another day. I will say that on Friday, Doucette and I were able to go into the 2 clinics Dr. Jackie and Dr. Joey run in Cite Soliel and conduct HIV testing! It was probably one of the most exciting things we have gotten to do because before Friday there was no documented information about how prevalant HIV/AIDS are in that area. After we told people their results, Doucette or Flo (one of the nurses we work with) talked to each patient about how to protect against HIV and STDs and encouraged the individual to ask any questions he or she might have. (My Kreyol is nowhere near advanced enough to have that conversation).

We were pleasantly surprised to find almost every patient we tested was negative! We only had 2 patients with results of "unkown" and 1 patient who tested positive for HIV. (I don't know the exact number off hand of how many people we tested but if I had to guess it would be around 60 or more).

I was testing one woman, and I pricked her finger and squeezed out the droplets of blood onto the test strip just like I did with everyone else. Once the test was finished I sent her away and told her that I'd call her back when I had her results. I looked at the strip a few minutes later and it had 2 lines...positive for HIV. A sheer panic shot through my body and immediately I checked my gloves for holes and made sure there was no blood on my body or clothes. Of course there were no holes and ther was no blood because I had been careful while testing her just like I was careful testing everyone else and in general working with cuts. But the reaction was so instictive, so automatic I couldn't help it. Then there was more fear...how was I going to tell this woman that she was HIV positive? How was I going to tell her that she came in for something small and her whole life was about to change?

I called Flo over to show her the results and I asked her what we should do? She said it was better if one of the doctors talked to the woman. I hate myself for feeling this way but when I heard her say that I was so relieved. I was relieved that I didn't have to be the one to tell her that her life was about to change, I was relieved I wouldn't have to see the look on her face when she found out, and most of all I was relieved it wasn't me who was HIV positive.

I heard from Flo that when the doctor told her she was completely surprised and said she had only had sex with her husband. Instead of stating what we usually find in a lot of cases with STDs (the spouse is cheating), Flo explained that there are other ways to get HIV and she told the woman about those as well and got her information so that she could continue to receive treatment she needs.

In spite of my gut reaction, I still want to continue testing people and helping with preventative medicine because my hope is that each day that we help explain how to protect from HIV will be one less person who tests positive hopefully in the future.

Dr. Joey has proposed a plan to gain access to a giant movie projector and show movies for free once a week or so in some of the tent cities to help reduce boredom and give people in those areas soemthing to look forward to. Although it's not a perfect solution to the whole problem, it will help. Being in Haiti has taught me that while it's important not to ignore the whole picture, it's also important to break it down sometimes and take wins where you can because little wins here and there add up eventually.

Kreyol Word: Kijen Ou Ye (pronounced key jay ooo yeay) means How are you?