Tuesday, July 17, 2012

It’s my last day in Haiti, so it’ll be my last blog post here!  I’ve been thinking about all the things I normally do or see in Haiti that’ll just be weird to adjust to back in the states (or thankful to have back):
  1. Not sitting on a porch 24/7 on a laptop or reading and finishing a book within 2 days.
  2. Not seeing chickens and goats everywhere I go.  That includes not having chickens lay eggs in our room (the total most recent count is at 3).
  3.  Not having people stare at me, some people who laugh and others, namely children, shouting “blanc.” I’ll probably also never have children play with me like I’m a little doll, not the way the children here poke and prod me.  I’m like an Asian female version of Justin Bieber here to Haitians, where children are so enamored by my strangeness.  I used to like children so much in the beginning but sad to say, with all the harassing and name calling, my adoration for them has significantly declined.
  4. Not having children follow me everywhere I go, or just in general not seeing naked children… because half the children here run around naked.
  5.  Resuming back to having traffic rules which will be a blessing, because cars here definitely don’t follow them if they even exist.  Swerving to avoid speed bumps is common.
  6. Following #5, not fearing for my life every time I walk on the side that I’ll get hit by some sort of motor vehicle.
  7. Not having a tap-tap as my main mode of public transportation.  Plus, not having a booming bass vibrate underneath me as I lose all sense of hearing from being inside a car.
  8. On the note of #6, paying more than $1 for a 30 minute ride on public transportation.
  9. Having room in a car – whenever we’re in the hospital cars, we’re squished to no end with no wiggle room.
  10. Not having to Purell my hands right after I wash them with soap.  Clean tap water is going to be such a blessing.
  11. Being able to use tap water right out of the faucet and not having to use chlorinated drinking water to brush my teeth.
  12. Not fearing I may get some diarrheal or tropical illness any second.
  13. Waking up refreshed and with no bug bites, although I got used to the bug bites here and having little bugs crawl anywhere and everywhere.
  14. Sleeping in an open bed with no mosquito net draping over me that I somehow become wrapped up in when I wake up.
  15. Having a ceiling again – not sure if I said this already, but where I’m staying, the mission house, there is no ceiling, just a roof so all the rooms are essentially connected, and you can hear conversations everywhere since they just travel over the nonexistent ceilings.  I die.
  16. Having my own room again with real privacy, as well as having a ceiling again.
  17. Paying more than $0.15- $0.20 for a mango or any fruit for that matter.
  18. Not having the ability to haggle anything I buy.
  19. Not being surrounded by the same people 24/7.
  20. Realizing all this time that I probably didn’t get very tan, but rather it was just a “dirt tan,” and after a real shower, I’m actually still pasty.
  21. Not feeling dirty 24/7 and appreciating the feeling of cleanliness.
  22. Wearing normal clothes again – I’m already excited to return to my Anthropologie and DVF wardrobe!  I think Marc Jacobs is calling back to me.
  23. Not downing a 1 L bottle of water within 2 hours.
  24. Having regular internet, that although has been pretty amazing here, will actually be high-speed and no limit to bandwidth.
  25. TV AGAIN!!!!!  That means watching the Food Network as background.
  26. Getting a solid night of sleep without being woken up my roosters at intervals of 3 hours, including at 3 AM.  Do roosters EVER sleep??
  27. Being able to chat on the phone and text to my heart’s content.
  28. Seeing white people everywhere I go.  We noted how whenever we see other white people around, we slightly panic because it’s such an anomaly.
  29. Speaking English on the streets and having people understand me.
  30. Carrying on a conversation with someone random beyond 2 sentences.
  31. People not offering me their babies, albeit they’re very cute.
  32. Not seeing machetes which is pretty normal here.
  33.  I realized I do a lot of just staring off into space on the porch which is entirely normal… and now people will think I’m a freak if I’m just staring off into space.

I think this could go on forever.  I think it’ll be a culture shock for a full 5 minutes, and then I’ll be glad I’m back in the US.

My suitcase right now is so much emptier than what I started out with.  I’m barely bringing back any toiletries, leaving behind most of my clothes except what I’m wearing back so I’m not naked in the airport.  We just sat in a circle and did the full photo exchange.  It was actually endearing to finish our trip reminiscing on all our times here, and laughing about all the stupid ones.  Plus, it meant I got all the photos I didn’t have to take while I was here.

For the final week, we’ve been pointing out all our final things here.  Particularly for me, last Wednesday, it was my last fried plantain, yucca, and sweet potato dinner which is undoubtedly my favorite meal here, and probably the only meal here where I eat beyond what I should normally eat.  But, I allowed myself to be the most disgusting person at the table because I’ll never have this meal again.  Monday was the last French toast for breakfast which is my favorite breakfast served here.  Life is full of (food) heartbreaks.

Friday we had our last class for the community health agents.  They got certificates for taking and “passing” all the quizzes.  They seemed to really enjoy the class and were so fun to work with.

Julian had a deal since the beginning of the trip, where he had to catch a chicken.  I forget how it all started, but my PI for my project who was also here the first couple of weeks, Dr. Hyde, was part of this as well.  Anyway, the same chicken that laid an egg in our room – actually it laid a total of 3 eggs, wandered into our room so he used that as an opportunity to trap the chicken.   We closed all the doors and had the chicken trapped in the courtyard and my god, this was possibly THE funniest thing I had seen this entire trip although I did feel bad for the chicken which seemed really scared.  I recorded the incident, although half the time I was dying laughing or screaming when the chicken came near me and thought it would peck me.

Now there’s evidence that Julian fulfilled his promise.

Island life has continued since Friday.  Sunday was the last beach day to Cormier.  We were there for 8 hours, and guess what I did for 8 hours?  Sleep and read.  It was GLORIOUS.  I fell asleep for most of the day, reading Perks of Being a Wallflower in between.  Thankfully it was short so I finished it at the beach.  I had the most delicious pina colada made with actual pineapple that was blended in front of me, not some crappy mix.  The day was finished with a cheeseburger and fries, then a mixture of papaya, pineapple, and melon sorbet.  Greatest day ever.  This picture Elaine took pretty much summarizes what I do at every beach trip.

The "magnificent 7" as the electricians called us.  I did kind of love us.

For the past couple of days as well, I’ve just been relaxing, walking around Milot and enjoying the scenery one last time.  It’s my last 24 hours sitting on the porch, so I want to make the most of it.  Basically this is what I looked like for all my afternoons.  I'm only wearing a jacket because it was raining and the rare occasion I was actually a bit cold.

I'm finally saying goodbye to the CRUDEM compound and Hopital Sacre-Coeur... can't believe I'm spending my last hours right now.

This is it for me, so thank you all so much for reading my blog!  I hope everyone enjoyed reading all about my adventures in Haiti.  It’s been a life-changing 7 weeks for me and something I will never forget, from the clinical experience and visits to the village, to the culture shock and adaptations I’ve had to make.  I’ve learned so much, and it’s been incredibly humbling.

Love and can’t wait to see everyone back in the US!

Wednesday, July 11, 2012

I'm officially in the middle of the single digits countdown, exactly one week left!!  I checked the weather in Wayne, NJ, and I got so excited inside to finally see that I will be home for the last days in the 10 day forecast.  Yahoooo. 

Last Saturday I had my first cheeseburger and fries since I’ve been here, plus my Diet Coke (obviously), and it wasn’t too bad.  It was at the hotel, and no food poisoning resulted thankfully.  It was no Shake Shack though, but the burger hit the spot exactly.  The fries were too mushy (I miss crispy fries, especially the rosemary fries from Clover), but the group was happy to clear them off.   I finished off Little Bee on Saturday and Sunday, not bad for a 260 page book.  I recommend it to everyone highly.  It’s a great book and a quick read, in that you keep wanting to read it.  I also read Water for Elephants a while ago which was fantastic, so I recommend that as well.

To get to Cap-Haitien, we rode on a tap-tap which was blasting music right underneath my butt.  Logan and Julian purposely chose to hang off the back, which I thought about, then realized: 1) my parents would die if they knew I was hanging off the back of a van driving at 60 mph.  2) I think I’m too short to actually reach the bars to hold onto while the car is moving… the difficulties of being 5 ‘2”.  Julian is enjoying the ride hanging off the back though.

I ended up buying a snack-size pack of Pringles and Oreos which I was going to save but the food cravings set in, and I just devoured them both yesterday.  Woopsies.

I don’t think I’ve posted pictures of what Cap-Haitien really looks like.  This is the river that runs through the city, heavily polluted and trashed.  It’s sad to see a place that has such beautiful greenery as Haiti this dirty just a few miles away.

The ride back to Milot on the tap-tap: It’s just so much more calming and cleaner, greener than Cap-Haitien.

Monday, I was in the ED with Lisa which was empty the entire morning which I guess is a good thing, means that no one needs urgent medical care right?  Instead, we decided to go to the wound cleaning clinic which was nauseating.  It’s about $1 US to have the wound cleaned and redressed.  Again, one case included a diabetic foot which smelled terrible, especially in the hot room.  I had to step outside to clear my head because I thought I was going to pass out from the heat and the smell at any second.  I will never get used to the smell, and if anything I think I get more nauseated by it.  Some of the hydrogen peroxide that was being squirted out of the syringe landed on me, but at least that’s sterile.  Seriously, this is a huge incentive never to get diabetes like I mentioned before.  I also saw what looked like 2 hydroceles, though I wasn’t sure.  It pretty much looked like something no guy would ever want – a giant, swollen scrotum filled with fluid.  It’s supposed to be harmless, and I think both were drained – a hydrocelectomy (I think that’s what it’s called), since there was an incision and sutures placed, but they still looked unusually large… glad to say that I worked in the wound clinic once, but I don’t want to do it again, nor will I have to.

On my last day in Carrefour des Peres, I was so impressed with one of the women that I interviewed for my survey.  She’s actually a community health agent, so I expected her to be knowledgeable but they don’t have any formal training like a healthcare professional in the US would, nor are they meant to be healthcare professionals.  They’re community members who are liaisons to educate people on general health and recognizing when someone should go to the hospital.  Their level of highest education varies a lot.  She actually tested the chlorine levels in all her drinking water to make sure that it had the right amount of chlorine (too much and it tastes bad, while if there’s too little, it’s not enough to kill all the bacteria).  She’s a great example to the community, and I’m so glad she’s a community health agent so that she can set a good example of what people should be doing with their water.

One of the homes had a pineapple plant!  I hadn’t seen one of these yet, so I was baffled haha.  I felt like such a loser that I was so amazed by the plant.  I had no idea pineapples grew like that.  I really am a loser.

Tuesday night, Amelia was freaking out because she noticed that a chicken had laid an egg on the bookshelf next to her bed.  It was disgusting, and for some reason bloody.  Then we were wondering if chicken eggs were bloody after they hatched… which only confused us more.

Alec picked it up and started chasing us around… then he proceeded to smell it and made the most disgusted face possible.  I almost choked from laughing and also from how gross it was.  Then, he tried to put it in front of Amelia’s face which only nauseated her more.   Good thing we only have 1 more week left right? 

I had my last day in the clinic today.  I thought about not doing anything, but it's my last chance to do something, so I hauled my lazy butt off to the hospital.  Last Monday, I didn't get out until at least 2:00.  Today, we were so quick with patients, and we were out by 11:30!  Sweeeeeeet.  None of the cases were that exciting, but at least I feel productive, even if it was just for 2 1/2 hours at the hospital.

Now it's time for me to be lazy for the next 7 days!

Thursday, July 5, 2012

It’s raining right now, and actually very cool and pleasant.  I just saw online that it’s in the 90s in Wayne, and supposed to get to 100 again in a couple of days.  Yikes, I never thought that it would be hotter in the northeast than Haiti.  It’s probably in the low 80s right now.  Only in Haiti would I think low 80s is pleasant and cool.

Hope everyone had a happy 4th of July!  July 4th was a personal day for me from an exhausting Monday (detailed below), and also I wasn’t feeling too good since the morning when I woke up.  I was so sad to miss the fireworks and BBQ back home, but I at least tried to be as patriotic as possible.  The last few 4th of July’s were in Boston and DC, both of which had spectacular fireworks… can’t believe I missed them.  Instead we BBQ-ed chicken, and fresh chicken, which I guess is nice and healthy but also kind of a bleh,  meeting its demise 10 meters away from me.  We also had cake which was all I needed, and like the disgusting person that I am I started scooping the frosting from the cake plate.  Kevin mentioned that I talk about food a lot nowadays hahahaha which is not surprising.  I've already told him the places we need to go to in the 4 weeks I have back in NJ and NYC.  The list definitely includes Laduree, Eataly, and Shake Shack.  It’s all I think about I guess.

This is my dinner on a Styrofoam plate.  We also got fried sweet potato, yucca, and plantains which is my favorite dinner meal here.  BBQ chicken and fried delicious things?  Sign me up any day.  On the right is cake being cut up.  I already want another piece sighhhh.  If I'm craving cake here, I'm just thinking about the number of Paris Baguette trips I'll want to make.  I hope my parents are ready for all the pastries I'll be craving!

Group picture minus Alec.  This dress was the most patriotic item of clothing I had which surprisingly worked out pretty well, sans the little pink strawberries on the dress.  Actually, then we just added Nadia to replace Alec, and Jackie as well (he’s a Haitian who works around our compound and was amazing enough to set up all this).

We enjoyed some dancing in the gazebo to American music, including but not limited to Bruce Springsteen, Billy Joel, and obviously some Party in the USA.  The guys all almost killed themselves from Miley but the girls thoroughly enjoyed it.  Dancing involved some sprinkler, car waxing, and the duck.

Since we didn’t have fireworks, we settled for a fire on which we put some work in.  Put the 2 together, it’s kind of like fireworks right?  Amelia, Logan, and Julian earlier had gathered some sticks, and we managed to pull it off.

This past Sunday, as a celebration of reaching July 1, we had our “airing of grievances” after dinner.  We headed to the soccer field nearby, and I had an absolute blast with the group.  We brought Oreos, Cinnamon Toast Crunch, and beer, sat in the middle of the field (where I’m pretty sure we also encountered some ants in our pants, oh well), and went around in a circle as we each would air a grievance.  We surprisingly shared fairly similar ones, some of which included the foods we missed although we definitely praised the food we do get here, because it’s actually good and much more than I ever expected.  Other than that I’ll keep the rest of the airing to within the group.  We did end on praises, many of which reminisced on some of the best mentors that we’ve had.  Mine was the tightness of our group.  The mix works perfectly, and we all add something different to the group.  Some Cinnamon Toast Crunch remained, but the Oreos were all killed.  I’ve eaten all the cereal by now, not surprisingly.  I may need to make another trip to the American store and get more to sustain me for the remaining 13 days.

Monday was possibly the most exhausting morning I’ve had since I’ve been here.   I was in the adult outpatient clinic with one of our mentors Selin, who is an ER physician at a hospital affiliated with Tufts.  Normally, we get 6 patients to see, 7 at most.  We received a stack of papers for 17 people.  To see 17 people in 3 hours is ridiculous, and each patient’s interview and exam takes double the time it normally takes, since we need to use a translator.  We didn’t finish until 2:00 , no breaks at all between.  Some patients had, no joke, 6 chief complaints, and because we had so many patients, we had to ask what the absolute most important problem was, because we just did not have the time to address every concern.  We also had a good feeling that most of these people were overall exaggerating their problems and actually didn’t have all these issues.  I can't even really remember what cases I saw.  The only one I remember is the one about cervical arthritis.  Otherwise, I think I was trying not to pass out from heat and not eating.

The afternoon was fairly cool (relatively aka in the 80s), so we decided to hike to the ridge.  It only took an hour round-trip but it was straight up hill, and there was no real path.  I’ve got scratches, the battle wounds to prove it.

The struggles of the uphill hike: 

We made it to the top!  We're in shock I think.

Look at how far up we are!  You can see the soccer field in the back, and our compound is right next to it.
This is my pretend smile where I look happy, but internally I was trying not to die as my heart is feverishly pounding against my chest.  Surprisingly, the way up was better than the way down.  Well, there was a trade-off.  On the way up, my heart was pounding against my chest as I tried not to pass out, but at least I never slipped.  On the way down, I slipped and nearly fell at least 10 times.  But, I felt very accomplished.  Whoever expected me to be this hiker now?  Oh who am I kidding, I went hiking maybe 5 times here just to force myself to be active.


The survivors of the hike!

Not to worry my parents, but you know how I just mentioned that I wasn’t feeling too good since yesterday morning?  Well, guess who woke up with her first case of diarrhea since being here.  Me.  I’m surprised I’ve gone 5 weeks without getting sick so really, this isn’t too bad.  I’ve avoided most foods today aside from some French toast and pineapple in the morning, and Nature Valley bars for lunch.  If I don’t eat, there’s less to come out right? 

Unfortunately, though I was feeling pretty nauseous all day, I forced myself to go out to Thibeau.  It was our last village visit to Thibeau, so I needed to get more surveys done today.  Now, we only have 2 more days in the village.

One of the homes was amazing.  The daughter’s father has a nursery, where they sell tree seedlings that have started to grow.  They had mango, cashew, orange, and a ton of other types.  I wish I could bring one back to the US.  We bought 2 for $1 to plant at the compound.

As we started walking, a mass of children started following me, Lele who is our translator, and Donna, one of the ER physicians here.  I kid you not, I was legitimately molested by children today haha.  As we interviewed another household, 10-15 children walked into the yard as well.  While I’m standing and taking notes, they started pulling and touching my hair, also stroking my arms and legs.  A lot of them were commenting on how soft my hair and skin is.  At one point, they started poking my butt and I had to jerk away and say no no.  They then started to touch my face and ears.  I had to constantly move around so they wouldn’t touch my mouth.  It was a fairly violating experience haha (not really, well, yeah I guess so actually).   Lele tried to yell at them to stop, and they would for an entire 5 seconds.  Then they resumed touching any exposed skin surface.  When we left the home, they followed us and grabbed my wrists.  Then, they started to argue who would get to hold my hand and try to push each other away.  I’ve never experienced this until now, this absolute fascination with me.  Donna was spared the attack for the most part.  They actually chose not to stroke her, but really only attacked me.  I asked Lele why they were so fascinated by me, and he said though they’ve seen “white people,” they’ve never been so close to one, so they were touching my hair and skin to see if I was real.  To them, I was a doll to play with.

When I asked for a picture, all of them clamored to be in it, and I’m pretty sure even during the picture they were still trying to touch me.

As we walked to another household to interview, they asked me what color my blood was.  I said it was red, just like yours, that all of us have red blood.  What they said next made me absolutely heartbroken.  The children said that my blood was better than theirs because of my skin color.  I had never heard that in Haiti until now, and to hear children saying it was really upsetting.  I hope that this isn’t a widespread mindset.

Less than 2 weeks left in Haiti!  Crazy...

Saturday, June 30, 2012

Guess who just became the first member of the triple rectal exam club amongst the Tufts in Haiti group?  Me.   Well sort of triple, did another exam and then an external exam where I saw an external hemorrhoid not to gross any of you out.  Maybe that puts me in the 2 ½ rectal exam club.  In other exciting news being in clinic, I had to give a patient an IM gluteal shot, the first shot I ever gave aside from practicing on each other.  I didn’t think the first shot I’d give would be in the butt but it happened.   The patient had hematuria (blood in the urine), and given his symptoms and urine test, he either has chlamydia or gonorrhea, so we had to give a shot of ceftriaxone.  I was terrified to give him the shot.  He complained afterwards that his whole leg hurt, so I was absolutely petrified I had accidentally injected into his sciatic nerve, but I was reassured if I had, he would’ve been screaming and writhing in pain.  In hindsight, I was nowhere near where the sciatic nerve even is (not all my anatomy has been forgotten).  Even during the interview he said he had all these symptoms during the interview, and on exam he never winced.  He seemed to be generally overreacting.  The thing I really hope is that he brings his partner because she may be asymptomatic but have the disease.  We tried to reinforce that if she doesn’t come in, he has the risk of being reinfected if she has the disease.  I also don’t think he was too happy about no sex for 7 days, or it might’ve just been him being angry with me for giving him the shot, maybe a combination of both.   The infectious disease residents who also live on the compound thought it was funny that I was so excited to give my first shot haha.  Such a newbie.

The group seems to be a little burned out now that we’ve almost reached July!!  (<12 HOURS!)  A group of electricians were here since the 2nd week of June with us, but they just left on Wednesday.  It was definitely difficult for the group.  They were here the longest, and every week we say goodbye to a new set of people.  Plus, they were so much fun to be around and all around great guys.  They were mostly retired electricians (except a couple of young guys) who were here to work on the generator system here that’s basically on its last legs.  We feel constantly abandoned when people leave.  We’ve been so lucky to have such a great rotation of physicians, including Dr. K and Dean Sackey, who have taught us so much about medicine.  This upcoming week is our last week with American physicians (one who is a gastroenterologist at Tufts), so we’re running out of mentors fast.  It’s beyond quiet right now on the porch, the quietest it’s ever been.  There is another group here, natural family planning.  I’ll keep my opinions to myself on that one.

While we were in Limonade on Thursday, I took a sample of the day care center which was right next to the dispensaire.  I should’ve taken a picture with the kids because they were adorable and clamoring at me, trying to hold my hand and shouting “blanc” haha.  I think they see me as a very strange looking white person.  Talking with the locals here about drinking water, I was so surprised that even in the villages, people knew a lot about how to treat drinking water, or just buying treated water.  My suspicion though is that the villages we go to, though they seem remote, are the 3 closest villages to Milot which probably means that a lot of NGOs are around.  I’m sure if we were in the absolute middle of nowhere, that would not be the case.

Yesterday I had to give a presentation to the community health agents about water sanitation and diarrheal illnesses.  Let’s just say, the group had a great day talking about poop.  But, I was really happy that they were very participatory in the presentation.  They asked a lot of great questions so it felt great that I was hopefully giving them information that would be useful in the community.

For the last day of June, the majority of the group went into Cap-Haitien, the second largest city in Haiti and where we originally flew into.  This is walking along the pier, so it's much less busier than the central part of the city (and less dirty).

First stop was Croissant Dor, a bakery in town.  Let me just say, it was absolute heaven to have a pastry again.  I did become a fatty again and ate a cheesecake (more like custard) and something like a croissant.  I died of heaven.  Skinny bitch diet just went down the drain.

Well, I thought I died of heaven until I went to the American shop next store, and then I really died of heaven because I found these gems: Cinnamon Toast Crunch and Coke Zero, the jackpot.  It cost $7, but I was surprised it wasn’t more like $10+ so I took that happily to indulge in myself.  Nothing hit the spot like the Coke Zero.  I’m saving the Cinnamon Toast Crunch for tomorrow when I hit July although it’s staring me in the face to be eaten.


Final stop was this posh hotel in Cap-Haitien.  It was just $4 to enter, so I lounged by the pool for hours on end, reading Water for Elephants.  In just an afternoon, I read more than a third of it.  Sometimes island life is pretty sweet.

Lisa used to be a synchronized swimmer, so then Alec tried to follow her.

Nadya and Alec apparently have the same sized arms, so they decided to compete in an arm-wrestling match.  Alec did win, although he was in some pain afterwards HAHA.

Beautiful flowers, reminds me of Hawaii!!  Who can complain about island life when I get to lounge by a beautiful hotel with beautiful hibiscus flowers?  There are some great hotels and resorts in Haiti that are so under-appreciated.

All in all, I’m definitely trying to take in everything for the last 2 full weeks, since I expect to do very little work during the half week in mid-July before I go home.   I still need to do some hikes I haven’t yet explored, get souvenirs for everyone, and just sit on the porch and absorb the last bit of island life.  But, now that July is in sight, the countdown begins!

Saturday, June 23, 2012

I didn’t think I would have made it this far but I did – the halfway point.  Around Wednesday and Thursday, I felt really homesick, somewhat depressed.  It’s weird, whenever I’m in school, I don’t really get homesick often but I think it’s because I know home is only 4 hours away, and theoretically I could go back whenever I could.   That isn’t happening here.  But, after talking with my parents and Kevin, I felt a lot better.  Both reinforced that the second half will fly by, so I need to take advantage of every opportunity I have here which is absolutely true.  This is an incredible opportunity which I know I’ll miss when I leave.  Talking with them also makes me miss them (and everyone) even more!

Dr. Early was our mentor this week, and he took some amazing pictures.  I already mentioned about our village trip to Carrefour des Peres on Tuesday but he took way better pictures than I did.

This is the local dispensaire/clinic in town.  This is where most of the group will be centered for their projects.

I look too happy to be holding an E. coli and coliform infested water sample.  I forgot to mention, I had a bag of samples, and a woman was asking if she could have one for her son to drink.  I felt sad, but it was in her son's best interest not to drink that at the moment.

And take 2 of the cute baby and me.  Gahhh why couldn’t I take this little boy home?

All the schoolchildren wear a uniform.  Each town has a different uniform, but they’re all so cute matching.  I especially love all the bows in the girls’ hairs.

Wednesday was rough.  I saw my first patient code right in front of me.  Leslie (an internist who actually went to Tufts for medical school) and I had finished being in the adult outpatient clinic early, so we decided to visit the ED.  We weren’t expecting anything, but there was a 22 year old male who just graduated high school, unsure when he was actually admitted but when he came, he was comatose.  We were both shocked that his oxygen saturation was in the 70% range.  If someone is below 95%, it’s considered hypoxic.  It was absolutely shocking that he wasn’t at least on an O2 mask with the oxygen turned up all the way.  We could also barely feel his pulse.  He was jaundiced and had mottled (blotchy) skin.  He was also obviously febrile.  Even though we knew very little about his history, seeing his condition, we rushed him off to the ICU which wasn’t open at the time.  So, we had to find the chief medical officer at the hospital for permission to open the ICU, which was granted as long as the doctors here were willing to staff it (which they were of course).  We rushed him from the ED to the ICU, and we could not get a pulse on him at all.  So, we had to find a board which took some time to do proper chest compressions.  All the guys were rotating to do chest compressions as fast as they could, and everyone was just on their toes.  One of the surgical nurses intubated him to ventilate him.  A central line was set up to push fluid into him as quickly as possible.  The monitor read a blood pressure and oxygen saturation, but we could not find a pulse anywhere, not even a carotid.  We listened for a heartbeat, nothing.  I don’t know if the machine was faulty, but he was gone.  The family at least took it decently well.  They were grateful for our last attempts at helping him, but they saw how sick he was.  They live really far away, so it took him a long time to get to the hospital, so he had been very sick for a while.  I think all of the medical students were in a little bit of shock, since none of us had ever seen this.  We had a debriefing with the 3 doctors who were leading the code.  With his multi-organ failure from the septic shock, he couldn’t have been saved.

Thursday was another trip to Limonade.  It was a grueling day, and I had the whole group with me that day since they hadn’t heard back from the IRB at that point (though later in the evening everyone was approved!)

Lumarc leads the pack for our group.  Legit, I would not be able to do my project without him and Joseph, the other translator we mainly work with.  They’ve slaved over my informed consent and 7 page questionnaire to be properly translated to Haitian Creole, and walk in the brutal heat with me to collect water samples.

Ditches generally run along the side of all the roads.  Thought highways were polluted?  These are even worse.

We saw a turtle in one of the wells, so we all got very excited.  One of the locals fed it bread so it would come up to the surface so we could see it.  I'm sure all the Haitians thought we were weird for finding a turtle so exciting.

The “blancs” are here, so we had children running after us, following us for a while.

One of the homes had a well it shared with its neighbors, so I sampled that.  I noticed that there were many roosters tied up, just like this one.  Cockfighting here is actually pretty big, which makes me a little sad but what can you do…

Hard at work talking to people and collecting samples.  And yes, those are urine sample cups I have in my bag, just hoarding them as I go.

Lazy weekend again… except that while one of the maintenance men struck a pipe, and water was going everywhere.  Thankfully it’s fixed.  Otherwise, I’d be very smelly for a while.  Tomorrow though, I have to do part of the crazy hike I did my first weekend to collect samples.  I may die.

Tuesday, June 19, 2012

I’ve finally gotten IRB approval!!   So exciting =D  I’ll be finishing up the majority of my water sampling this week, and for the remaining 3 weeks I have for the study, I’ll be doing mostly surveys.  Unfortunately that means I won’t get as many samples as last year’s study, but I’m also doing two studies as opposed to the one.  I’m supposed to still take samples of water  from wells where people I interview get their water, but I’m pretty sure I’ll have already sampled the majority of these places already.  At least, these are the major ones and on roads we should stick to.

Last Friday was actually sad to say goodbye to so many volunteers who were leaving the next day.  Dr. Marc (orthopedic surgeon), Dr. Karen (internist who teaches clinical rotations at UMass Medical School) – I never found out their last names since they introduced themselves by their first names only, Dean Sackey (obviously one of our deans, and an internist), and Dr. Rosenthal (infectious diseases) all were here, so we had such a great group of teachers.  All really took the time to teach us something about medicine and their experiences.

Even in Haiti, I can’t escape the sorority squat.  Will I be doing this 10+ years from now?

Apparently I was the smart person in not going to the beach.  First off, it was pouring all Saturday evening through the morning.  I think about 14 people went to the beach in this somewhat crappy van called a tap-tap, which has an open back, music blaring.  The road to the beach is a little treacherous, with hills and rocky terrain.  Apparently on the way there and back, the van couldn’t make it up the hills so people would have to leave the van, walk up the hill, and go back on.  Then, on the way back, the driver never showed up so they had to wait.  Black smoke was also coming out of the van which is never a good thing.  The tap-tap broke down at one point too.  So, they arrived at 8:30 PM (dinner is normally served at 6:30 PM), drenched because also the pouring rain would obviously go through the open back of the tap-tap. 

Then there was me.  I actually had a fantastic Saturday to myself.  Sometimes, having alone time is the best thing especially when you’re surrounded by people 24/7, as much as I love my group and think they’re fun to be around.  I watched a lot of Curb Your Enthusiasm, read some more of Atonement, and did yoga.  I actually think from now on, I’m not going to go to these beach trips except maybe the last visit or so because having the whole day to myself was beyond amazing.

I had a productive Sunday though, took 6 samples.  Since it had just rained, I wanted to compare if the rain would have impact on the bacteria in the water.  There are probably a lot more, but I stuck with the ones on main roads.  I did feel really excited about my project because one of the people who happened to speak English told me he was really excited I was testing the water because no one does that here, and his entire family actually last night all got sick and are in the hospital.

Here are 6 samples that I took before I added any of the bacteria food and magic:

A little more than 24 hours later, here’s what they look like.  Yummmm I know.  The first 5 all have coliform (yellow), and the last one has coliform and E. coli (fluoresces under UV) which wasn’t surprising, since it was river water.  The river water is absolutely disgusting with a ton of trash and pigs swimming in it.  Everyone knows I love animals, but I don’t want animals swimming in my water.

Monday I was in the pediatric and adult outpatient clinic with Amelia and Dr. Early, who’s our faculty advisor for the week.  I’ve never worked with pediatrics in a clinical setting, so that was great.  I got to see all the typical problems kids have, like ear infections.  I learned something really valuable today, that sometimes the patient’s chief complaint isn’t necessarily the most important.  One child had scabies, but the bigger problem was the child’s left foot that clearly had cellulitis that needed surgical consult.  In the adult clinic, this woman had some constipation post-op, and as I was about to discharge her after giving her some medications, she tells me she’s had migraines for months.  I didn’t know much about how to assess of course (what does a rising second-year medical student know… nothing), so my preceptor helped with the exam.  We looked in her eyes, and she has what we think is papilledema, though we were unsure.  What was clear was that something was very off about her eyes.  She also has left-sided headaches, never on the right which makes us more suspicious.  Migraines, though people can experience them more on one side, will have pain on either side at some point.  What’s concerning is that papilledema is a sign of increased intracranial pressure, like from a mass or tumor in her brain.  She’d have to go to Port-au-Prince or the Dominican Republic to get a CT scan… likely not feasible for her.  We’re trying to get into contact with a neurologist or at least an ophthalmologist from Cap-Haitien to get a consult.

Another thing that only happens to me in Haiti: while I was in pediatrics, Dr. Early all of a sudden notices that there’s a little lizard (probably 5 inches) is on me.  I surprisingly didn’t really freak out but just tried to shake it off.  I just didn’t want it going inside my pants or something haha.

Today we were at Carrefour des Peres.  I collected 10 samples since it would be my only day of doing basically all my sampling at Carrefour.  I was walking around the town with one of the translators, Lumarc, and people were so excited for me to test their water.  Everyone wanted me to come to their household well that they share with their neighbors and for me to test it.  They’re all curious about the results of course.  The last half week I’m here, I’ll be making a handout to give to the dispensaires/clinics and community health agents that will explain what I found, and what people can do about it.  Hopefully I can make even a tiny difference, even if it’s localized to 4 villages.  A lot of these people have wells, and so they use buckets to get the water.  Here’s one of the wells, and unfortunately one of the buckets looked like this:

It’s little things like telling people they can’t keep buckets on the dirt, etc. that make a difference.  No matter how clean the well, if what you use to drink it is dirty, what’s the point?  There was another well where children were just drinking straight out of the bucket.  Ayyy….

I finished my water sampling about an hour early, so I went back to the clinic and it was crazy.  This mother could tell that I thought her baby was absolutely adorable, and so she motions for me to hold it.  Omg, I wanted to take the baby home.  Basically, I melted at his cuteness, giggling the entire time.  What would customs think if I just brought a Haitian baby back with me?

There’s also a school nearby, and all these sweet girls came up to us.  We had stickers, so we gave them out.  Somehow the heart stickers ended up on our faces instead haha, but they were all such sweethearts.  I showed them how to play Angry Birds on my phone, and one even called me pretty.  She’s too kind… in this dead heat as I sweat profusely, this is the least attractive I think I’ve ever been.

Afterwards, we went to Children of the Promise which is an infant care center.  Most of the children are under 2, though there are a few that are older.  Unfortunately when we got there, most of the children were sleeping, so we didn’t get a chance to play with them.  BUT THEY HAD NORMAL DOGS!!!  All of us were so excited to play with dogs that definitely did not have rabies (they’re all from the US, belonging to the volunteers there).  Unlike here where I dodge all the dogs...

It’s very self-sufficient, including getting the majority of its power via solar panels:

Tomorrow marks the 3 week mark, home in a month!  And for the usual, nonexciting things in my life: I continue to be bitten by mosquitoes, and food dream #3: Chinese food.  I still don’t get why I keep dreaming about foods I very rarely eat.