Health Clinic in Pilette

by Megan Cavanaugh

What a day! Such an amazing thing to be a part of. Three different non-profit groups joined together with Haiti Marycare today to do a clinic in the town of Pilette, where there has never been a doctor before for the town. There was a clinic building built but unfinished there- and we used that building.

The journey to Pilette from Father Dorcin's house in Roche Platte was an adventure, as all traveling in Haiti is. The rain had made the road a huge slick of mud. We bounced down a little path through the jungle in Father Dorcin's jeep. And I'm talking Disney jungle, the lush green that goes on forever, thick and strong. The car barely fit on the "road" at all and where there was a steep bank and a pretty swiftly flowing river I thought for sure we were stuck.

But no, this jeep should have been in a commercial the way it went right down the steep embankment and through the river, charging up the other side. Gripping my seat and planting my feet. We reach a road that's all mud and puddles and fishtail our way through it, sliding side to side but still progressing forward. Honestly, it was fun.

However, some of the people who came from a different group today to meet us were not in such an impressive vehicle, and they got stuck in the mud about three miles away and had to get out and walk. Which wouldn't have been too bad except for the mud - and the three rivers you have to cross. So our team gets there and sets up. We use benches from the church and put them in patient rooms. We walk around the empty clinic and imagine it full and running and serving the people in this town. We worry because no one else has shown up and a huge mass of people are starting to gather. We fidget with cellphone and satellite phones and it's just no use, we are in the mountains.

But finally we hear that they are coming, but have been delayed due to said lazy truck. So we start off without them. Jim and Mary Lou see pediatric patients and I see the adults. My first patient is 57 years old and went suddenly blind 13 months ago. His eyes look full of cataracts and the right one is clearly infected, most likely a secondary infection to his condition. He insists that he was working in his garden and a bit of cactus juice (it takes awhile to figure out the right translation) fell into his eyes and he went suddenly blind. Papito confirms that there is such a cactus in the area. I'm at a dead end. I don't know how to treat cactus eye poisoning, we don't exactly see a lot of that in Boston. But I still debate cataracts and then open angle glaucoma, from the way he describes the incident as very painful with a headache.

Luckily we have a team of eye doctors coming to Jakzil at the end of the week. I ask him and his daughter if they can get there and they say they can. So I flush his eyes and teach his daughter and treat his infection and pain. It's all I can do for now, and I wish I could do more for him. He seems weary and tired, but gentle and very grateful. They leave but promise to come to Jakzil on Friday.

The other teams arrive. Wow, we have a lot of medical personnel! It is awesome. The clinic becomes pretty crowded with us all. Everyone is buzzing with excitement to get to work and to be here. We set up more medications and rooms and after a little tweaking, triaging and the normal amount of chaos we have a system down and we are a machine.

We see at least three hundred patients. Pregnant women, babies, elderly, the acutely ill. I work with Dr. Maklin, one of the Haitian doctors who bounces between a lot of the clinics in the north, including ours in Jakzil. We see a patient who complains of diarrhea for 9 months and an episode of extreme illness a few months ago. He looks dehydrated, emaciated and he has a fever. Dr Maklin suspects HIV and we have a rapid test done (courtesy of Ted Kaplans team) and the man is positive. The weight of the diagnosis is huge. My heart hurts for him. It's not exactly easy to get HIV medication in Haiti. But it's not impossible either.

Dr. Maklin tells me about the cultural issues and politics around the diagnosis of HIV in Haiti and we talk with the patient about it, telling him he needs to go to Tru de Nord to have more tests done but that we are very concerned. You can't technically diagnose someone with a rapid test. We give him a letter to bring to the doctor he will see in Tru de Nord. There are HIV treatment programs in certain cities, Tru de Nord being the closest to where we are, but traveling back and forth to get medications, and dealing with the horrible side effects when you are already malnourished and frail... I am so grateful when his wife's test comes back negative.

She is a nurse mid-wife and understands the gravity of the test. Father Dorcin meets with us all and we make a plan to help the man get to Tru de Nord for his testing. We treat his fever, give him oral rehydration packets and treat him for pneumonia, give him vitamins. It's the best we can do for now. We are a whirlwind.

Everywhere I look patients are being seen, being cared for, being given the medication they need and instructed on how to take it in their own language. The translators are amazing, patient and compassionate. Kris Beckman is able to set up and perform tooth extractions for those people who have rotten aching teeth. Anyone who has ever had a real toothache knows how important this is. Dr. Maklin and I treat a few patients for malaria, pneumonia, infectious diarrhea, worms, UTIs and otitis media.

We see some unusual cases, including a boy who has never gotten any vaccines and has a face so round and swollen it should be in my Bates text book next to "mumps." I've never seen mumps, neither has Jennifer, the NP from one of the groups who has joined us. We dont see it in the States, but that is undoubtedably what it is. It goes on for hours, the continue stream of patients being examined and treated but there is always a huge crowd waiting to be seen, never ending. At 4 pm we have to stop, we make sure we have seen all the truly ill people, but we need to pack up and help the team get back to their broken down truck and everyone needs to get back to their home bases by dark. We have all comr from at least an hour away today.

We all agree that if it weren't for the pitch black night that comes so quick, we would like to continue seeing patients. It is a successful day by anyones standards. I am impressed by, and grateful to, the other medical staff and interpreters that joined us. Everyone worked together so fluidly, all wanting to help as many as we could, the best we could in the short time we had. We repack and take turns getting driven out of the jungle to a road, through the rivers and fields of cattle and horses.

We are dropped off at the end of thr jungle path and start walking down the dirt road while Father Dorcin goes back for more of us. It's a cold day by Haitian standards, never more than 80, and it has been cloudy but now the sun is breaking through the clouds above the moutains. I'm telling you, the view is pure Disney, magical. I think I am in The Jungle Book.

We walk up the road slowly taking pictures and as always, we gain an entourage of beautiful, half-naked, brightly smiling and giggling children. I take their pictures in the road and then show them their photo on my digital camera and they squeal in delight pointing at themselves. They touch my hands and skin and hair curiously, shyly. I take pictures of the cute stick and mud houses with the brightly painted doors, children peering out the front door at me, goats sticking their heads through the cactus. They are all curious about the strangers strolling up this remote dirt road through the jungle. The pictures do not do the beauty of this place or the children justice.

I'm so content, I don't know a more satisfying feeling than this. To know I was able to be part of something so good todsy, to help some people who really needed it, to have been given that ability - it is a huge honor and blessing. I know there are people at home who want so badly to be able to do more to help people here, and I try never to take the fact that I am here and able to do that for granted. It's been a really good day. I hope everyone who reads this and donated knows that you made today happen, and it was was real miracle to see.

Thank you, thank you, thank you.

Megan