Wednesday, December 16, 2015

Day Two

Very different day. 

The inpatient service is much the same. Busy and noisy. The acoustics in the hospital are terrible. The walls and floors are concrete and the fixtures are metal. There is nothing to absorb the sound except the families, who are social and talk a lot. Sometimes the families are not so social. Last night a fight broke out on the ward and security had to intervene. 

The halls are crowded with patients on stretchers because the rooms are full. 

During end-of-day rounds a church group visited every room on the ward. They danced and sang religious songs. Many parents have a bible by the bedside. Religion is a very important part of this culture.  

Gerard, my interpreter, continues as a great help. I learned today he has five children and no regular job. His work as an interpreter is sporadic. He really appreciates this work. Like every man he wants to provide for his family. I am advised that the wage for an interpreter is $10 per day. During my first visit to Haiti in March 2010, the NGO I worked with paid the interpreters the same amount. The poor wages have not changed in six years!  Gerard looks chronically tired and often puts his head down to rest between patients. Yesterday after lunch I noticed that he ate two hard candies. Curious, I inquired if that was his lunch and he confirmed it was. Ouch! Today he came back to the house and ate with me. He ate at least three or four times as much as I did. He was very hungry. This worries me. 

Gerard tells me that life was better under the Baby Doc regime! At that time, notwithstanding the dictatorship and the political oppression and corruption, there were at least jobs available and men could provide for their families. There was money for food. Now, he explains, there is only "misery." I certainly see the despair in the families in the hospital.

The outpatient service today was quiet and I was able to see my share of children. No one was seriously ill.  

A very young looking Mom brought in her one week-old baby. The Mom looked 14 but told Gerard she is 16 years old. She presented as overwhelmed by motherhood and breastfeeding. The baby looked fine but unless Mom can sort out the rhythm of breastfeeding, the baby will not thrive. She will come back in two days to be weighed. I reviewed breastfeeding basics with the Mom and watched her feed to insure she has the basics of position and latch. She and the baby live with the maternal grandmother, which is positive. There are no breastfeeding nurses in the hospital. Mother nature, my advice, and grandma will have to do.

Half of the inpatient service are infants less than one or two months of age. Prematurity is common, likely due to less optimal prenatal care. Malnutrition is common. Most of the babies are admitted with sepsis. 











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