Haiti diaries #4: Cité Soleil – Part 1 (THE CLINIC)

Cité Soleil is one of the poorest, and most dangerous parts of Port-au-Prince. The trash, waste and living conditions are so poor in this area that no water is suitable for drinking except what MICECC provides. Cité Soleil is also where the H.O.M. clinic is located. Hidden behind the high walls of a gated compound, the clinic is made up of several exam rooms, a triage area, a treatment room and the pharmacy (which I was in charge of). The clinic was very organized, and everything was set in place for our arrival.

Our day usually started off with a prayer at 8am and ended between 3pm and 5pm, with a quick lunchbreak in-between. Patients sat in the waiting room, and were triaged whenever it was their turn. They were then directed to one of our 3 pediatricians, who diagnosed them and sent them to the pharmacy to fill their prescriptions. Severe cases were usually referred to the hospital, but the most common diagnosis given at the clinic were: Dermatological (Tinea capitis aka ringworm, scabies, rashes, skin sores), GastroIntestinal (GI) distress & GERD, Overall Body pain, Respiratory illness, Sexually transmitted disease and Malaria. We also had several cases of dehydration, which is the leading cause of death (especially in children) and is often due to diarrhea and GI illness, so we treated those very aggressively.

Here are some pictures* from the clinic (we gave out mosquito nets to families with children who came in for malaria, and also gave out some soccer balls)

In four days, we saw approximately 250 patients (75% of which were children) and for the sake of “crowd-control”, HOM pre-charged each patient 10 gourds (approx $0.25) before they came to the clinic. Even with that, several people could barely afford the visit e.g. A lady who couldn’t pay for her set of twins and only brought one. Our team tried to apply initiative in cases like these, so we doubled the amount of medications dispensed because we knew she would go home and split them in half anyway.

What I found interesting was how most patients refused to leave without a prescription (just like patients here in the U.S.). They wanted a prescription for every symptom, even when we told them we were treating the cause, and the symptoms would be resolved accordingly. e.g. A gentleman who demanded a prescription for dizziness, even after we addressed his dehydration with an IV and some Oral Rehydration Solution (ORS) packets.

We also had so many interesting cases such as patients with blood glucose in the 400’s, unknown and unwanted pregnancies, child abuse cases, rotting body parts…to mention a few. However, there were two cases that particularly stood out to me:

The survivor: A 22 month old little girl, who was carried in by her mother looking limp, listless, with her eyes rolled back. Her symptoms were high fever, chills, severe diarrhea and vomiting, and she was diagnosed with severe dehydration and malaria. We kept her with us at the clinic for the whole day, while making several unsuccessful attempts to start a re-hydrating IV. Since she was actively vomiting, she also was unable to keep any of the ORS down and we just didn’t feel comfortable dismissing her without seeing some improvement. Her mother must have sensed the urgency, because at some point she asked “Will my baby die?”….and my heart broke into several tiny pieces. All we could tell her as we sent her home at the end of the day, was that she had to make sure she kept up with the oral rehydration therapy and she needed to come back in 2 days (we didn’t have clinic the next day). That night during devotion, we all said a prayer for our baby girl, that she’d be alive when next we saw her.

No words can explain the joy we all felt when we saw her first thing on Friday morning. She was even sitting up on her mother’s lap and smiling! She must have felt like a celebrity, because all the cameras were flashing!  Here are some pictures* of our survivor baby. In the second pic, Shelby is making sure she got a good amount of ORS before leaving the clinic to continue therapy at home

The ‘Gangsta’: A young man in his late 20’s stumbled in from the streets asking for wound care for an amputated horrific looking jagged-edged middle finger. His story was that it was severed in a machine accident, so of course we gave him prioritized and immediate care. However, we found out later that he was involved in a gang incident about a month ago where his finger was severely injured. He was advised to go to the hospital at the time, but he refused since he’d be recognized there as a gang member. He therefore self-treated the finger to point of gangrene, and had to saw it off himself. Well he obviously didn’t do a good job of being a self-surgeon because the area became infected and was bleeding both blood and pus (gross!…sorry if you’re eating). We sent him off with wound care, some oral & topical topical antibiotics, and some prayers (which he smirked at). Unfortunately he refused to have his picture taken, so I don’t have any pics.

Part 2 of Cité Soleil will feature my experience at the pharmacy, so don’t forget to subscribe for updates! I am unable to include every single detail of the clinic experience in this is a brief overview, but please feel free to ask me specific questions in the comments section. Thanks for reading 🙂

*All pics were taken with permission