This is part two of two. Click here for part one.
Thursday, March 20
Today was our final day of clinic. We ran clinic with two fewer physicians as Drs. Donald and Diane Levine returned home early this morning due to other schedules. It was a particularly exhausting day - and maybe knowing that we had to turn patients away at the end of the day made it that much more difficult. Walking back to the guesthouse for lunch, many of our team members were approached by Haitians desperate to be seen by the medical team. It's hard to look these patients in the eyes, seeing their need and expressions of true desperation and oftentimes, helplessness.
I had two particularly interesting patients today, and yet again I was reminded of the huge gap in medical care that exists here in Haiti and the United States. My first patient was a newborn boy, just two weeks old, whose mother came in worried about the yellow discharge coming from the baby's eyes. After obtaining a history and physical exam, we suspected that the baby had acquired neonatal conjunctivitis due to secondary gonorrhea/chlamydia infection from the mother during labor. It was particularly sad to see, knowing that had that baby been born in the U.S., he would have been giving antibacterial eye drops at birth to prevent such infections. The baby will be treated with the appropriate medications even after our team has left. The local nurse will administer shots to the newborn for the next three weeks. The baby also had polydactyly, born with 12 fingers and 12 toes. Of note, here in Haiti the common belief is babies born with extra digits were supposed to be born as twins, but the other twin died in the womb. We were able to tie nylon string around the extra digits so that, hopefully, the extra digits will fall off with little consequence.
My other patient was a 40-year-old single mother of five. As I was taking the patient's history, her chief complaints were itchy, watery eyes and knee and joint pain. I figured this was just a regular 40-year-old female with the consequences of living in dusty Haitian conditions and being a mother of five cranky young children. On physical exam, Dr. Jeffrey Vanlaere and I auscultated a particularly loud systolic murmur that radiated to the neck and abdominal aorta. It was also prominent on auscultation of the lungs. Suspecting possible aortic stenosis, we asked the patient to perform the Valsalva maneuver (exhaling with force against a closed airway, as if to clear ear pressure), upon which the sound of the murmur decreased. Using ultrasound, we attempted to view the aortic valve. However, without the cardiac transducer, it was hard to definitively say yes or no to a bicuspid aortic valve. The patient also noted she had frequent bouts of fainting, particularly on exertion. Realizing the gravity of the situation, we found ourselves between a rock and a hard place. We could pay for the patient to receive an echocardiogram and an appointment with a cardiologist (rare in Haiti) - but then what? Besides the fact that this woman couldn't afford any of this, even with a confirmatory diagnosis, there is no doctor in Haiti who would perform the required surgery. After a long discussion with the patient, we decided to try to help her. We scheduled the patient for an ultrasound. Pending the results of this exam, we hope to pool resources and funding for a possible surgery for this patient in the U.S. Although there are many obstacles to overcome, we are hopeful that perhaps we may be able to change this patient's life for the better.
As I write, I've realized this has turned into a longer entry. If this trip has done anything, it has made me more excited for what the future holds. It has given me a glimpse of what third year will be like (the good and the bad), and we've truly witnessed that medicine is so much more than what we read in our course packs day in and day out. It isn't just about knowing the pathophysiology, but knowing the who, what, when, where and why. It's about having patience and taking time to explain concepts we find easy to understand, to empathize during end-of-life conversations and to find ways in which people seemingly so different from each other can relate to one another.
With our five clinic days finished and more than 450 patients seen, we have our fun day left tomorrow. We'll be returning to Port-au-Prince with plans to sightsee around the city, shop at the art markets and spend a relaxing afternoon at the pool.
Friday, March 21
Today was our designated fun day. We started our morning with a trip to the Iron Market in Port-au-Prince. The market sells artwork, woodcrafts and various souvenirs that are all handmade by Haitian artisans. We practiced our bargaining skills and all walked home with some goodies to remember Haiti. The team then went to the Palm Inn Hotel, where we enjoyed lunch and a relaxing afternoon by the pool. We stopped by the DeliMart (a large and modern grocery store) to pick up snacks, coffee, pickled cole slaw and spicy peanut butter to take home with us. The air-conditioned grocery store was so different from anything we had seen and experienced all week long.
For our final night in Haiti, we stayed at the Notre Maison guesthouse, which is run by an amazing woman, Gertrude. On the first floor, Gertrude runs an orphanage for roughly 45 children, many of whom have special needs. The second floor is the beautiful guesthouse where we stayed. All funds she raises from the guesthouse help take care of the children. The team ended the night with an exciting game of Cards Against Humanity and many celebrations to conclude our wonderful trip.
Saturday, March 22
After a long day of travel, the team has safely returned home. Minus a can explosion in one of our supply bags (which led to everything smelling like beef jerky … oops, don't ask) and a long, long layover in Fort Lauderdale, Fla., the trip home was filled with fun, laughter and nostalgia. Even though at times it felt as though the week would never end, in the end, I'm sad to say goodbye to M2 Haiti 2014. Perhaps it's because I know all the work, time and effort our team put in to making this trip happen.
The Haitian life we've been living for the past week is so starkly different from what I woke up to this morning - a comfy bed, a hot shower, etc. I figured I'd wake up thinking, "Yeah, this is the life…," but instead I woke up missing Haiti. There's something about the simplicity of life in Haiti that makes you realize having nice things, smartphones, modernized technology, etc. doesn't always equate to happiness. Life in Haiti lets you enjoy each and every moment, and makes you appreciate even the smallest of things.
Special shout out to the M2 Haiti Team if you're reading this - "thanks a mil" (just for you, Jennie) for making this trip so amazing. I miss you all already.
With that, the M2 Haiti Trip Blog ends. Until next time, Haiti!
Terrie Ahn is a Wayne State University School of Medicine second-year medical student volunteering in Haiti through March 22 with the school's student-run World Health Student Organization. WHSO's medical mission trips are funded by donations. To donate, visit http://waynewhso.org/donations