Mamba clinic, tap taps and collossal clutter

 
More than 100 patients checked in at the Centre de Santé Nouvelle Jerusalem since 6 am. By 1:21 pm, 75 were still waiting to be seen by a nurse or doctor. 

The numbers alone were discouraging. As much as I am an aspiring med student, I don’t have the credentials to step in and help see patients. I know I am needed in other areas, but helplessness pains me.

The clinic is understaffed, especially on Tuesdays and Thursdays when the Mamba clinic is open. I helped Katie and Mis Joanne, the RN who runs the malnutrition program year-round, weigh babies and check-in children (aged 4 and under) who qualified as malnourished to participate in the 8-week program.

This little pink house is perched on the hill above the clinic. Empty, but with an amazing view.

Depending on the child’s weight that week, they receive lime-green plastic pouches of Mamba: essentially peanut butter and vitamins. It was disappointing to see some graduates of the program once again returning as malnourished.

It’s absolutely crazy to me, but the program never worries about peanut allergies. There are none. Katie told me that when the babies are malnourished, they have no immune system. Without a functioning immune system, there are no allergies.

Christian Aid Ministries (CAM) made a delivery of medicine, which lifted our moods and even made the stern pharmacists smile. Katie left for an hour, and I took some infant patients on my own. Scary, in the sense that I was expected to pick up the process immediately, but also exciting!

The communication barrier has crumbled a bit today, too. I’ve picked up little phrases in Creole, and Christiane, one of the girls from Canaan, translates at Mamba each week. It was immensely helpful when explaining the program to the new Mamba initiates. Sister Gladys got back from the states yesterday evening, and she has promised to start daily Creole classes for the American staff. I’m starting to feel at home here, and I’m so encouraged to have a willing teacher.

When I finished taking vitals and checking patients in, my final number resting around 104 with people still registering. People are usually turned away at number 80 or so, except for children and elderly. But today that’s all I saw – mothers cradling their babies too sick to cry. An old woman curled into the fetal position on the concrete slab of sidewalk, ending abruptly at a field where goats and chickens wandered.

I heard one of the nurses whisper in exasperation, “We have an old woman outside, dying before she sees the doctor!” I felt so frustrated that there was no way to speed it up.

The shaded waiting area was too packed with others, like the old women, sick and waiting. They possess a disturbing patience with the slow-progressing consultations, something I hardly see at the Baton Rouge hospitals.

I suppose it’s better than the alternative: Nothing.

Today was also the start of a colossal inventory of the clinic’s supply room(s).  The clutter was overwhelming. Katie and I spent a few hours of lunch digging through boxes of IV fluids, bandages, 52 pairs of crutches, and misc. medicine bottles (some in Hungarian!) among other things.

The storeroom is a classic example of how a plethora of cluttered medicine and supplies can actually limit resources. The staff often has no idea what medicines are available to treat patients. Katie told me that last week, there were several instances of antibiotic creams and medicines found only days after patients were sent away empty-handed.

There are stacks of surgical equipment and specialized machinery delivered in CAM shipments useless to the rural clinic. It might be better off donated to a Haitian hospital than gathering dust and bug casings.

If there’s a shortage, it’s in organization. I need patience if Sister Gladys passes this job onto me when Katie goes back to the states Sunday.

Here are a few photos of the chaos: 

On Monday, I finally had the chance to check over the EKG machine that’s been gathering dust in the X-ray room at the clinic. With the X-ray stuck in a shipment of necessary medical supplies in customs at Port Au-Prince (2 years as of this summer!), the room is used for spillover storage of supplies. It’s missing leads and the clinic has no electrodes to use. Unless they find parts, it’s useless. I would love to see the clinic receive a gently used EKG machine for the clinic. There are a lot of heart patients in Montrouis.

Burning garbage is becoming a familiar smell in Haiti.

Although the clinic was busy, I tap-tapped with the three staff women into St. Marc, about 30 minutes of lush land and sweaty bodies squashed together, thigh-to-thigh. We needed cleaning supplies for our non-flushing toilet, and I needed to exchange some dollars into Haitian goudes. The sickly sweet smell of burning plastic smoked the streets. The entire population spilled onto the streets, selling every kind of car part and mattress size and cell phone charger and bootlegged French film imaginable.

I mostly walked with my head down, watching my feet as the sidewalk became a sludgy ditch, a potholed reserve of rancid water, and a muddy slope of garbage. We walked, in line formation, straight to the grocery store and back from the tap-tap station.

Horrible green facials from our impromptu spa night.

I enjoyed St. Marc, but felt like a circus act with my loose blond hair. Strangers reached out to pat my head, poke my arm and pull at my plastic bag of snacks. I would not have felt very safe without Jacques, a 19-year-old from Canaan who went along to translate and chaperone. We returned and immediately treated our blackened feet to a dip in the paraffin wax machine. Impromptu spa night, complete with masques one of the missionaries left behind!

The sun has gone down and I’m getting mauled with mosquitoes right now, so time to reapply nasty deet to my body. The “all natural” repellant doesn’t work for me against these tiny heathens (they really are smaller than any ones from Louisiana!). Katie and Amy baked a chocolate bundt cake, so we invited the doctor Jean Robert and a couple of the older boys to help us enjoy it in the garden next to our house.

It could just be the scenery talking, but chocolate tastes so divine here.

Enjoying cake in the garden, while I hid behind the camera!