Today, my four colleagues went out to do a community clinic, while I stayed at the clinic in the can, just down the road a few feet. It was a routine, uneventful clinic with the Haitian doctor. We saw about 30 patients, mostly sick babies, and elderly with chronic conditions. There is so little we can to about the chronic conditions, but because the clinic in a can (a trailer building, built in China and 'mailed' here to it's current location), is more/less permanent, folks can come back to get refills on their high blood pressure medication (lots of hypertension and heart disease). Today was a very eventful day, however, not because of the clinic. We finished up around 1:00 and I headed home to the maternity clinic for lunch. Soon after, my peers returned from their clinic as well, and we also decided to take a walk with our interpreters, George and Mose. George and Mose are 21/22 years old, the typical age of interpreters, young, strong, handsome, and outgoing. As we walked, nurse Linda told me about her most challenging case of the day:
Linda saw a pretty, petite Haitian young woman of about 20 years of age. She administered a pregnancy test to the girl and it was positive. When she found out she was pregnant, she became upset because her parepnts would be angry with her. She said that she would seek an abortion. When Linda tried to talk to her about it, she would not be dissuaded. Even the interpreter told her the girl was determined to do it. Linda gave her birth control information and discussed other options, but in the end gave her a course of antibiotics and made her promise to take them after the procedure was done. Hearing this story was heartbreaking, and Linda was obviously still shaken by the encounter. I'm so glad Linda thought to give her antibiotics. The greatests risks with abortion are hemorrhage (which will kill you quickly) and infection (which will kill you slowly). In a country like Haiti that is very undeveloped and very Catholic, I think she will have a hard time finding a safe practitioner to give her an abortion. Most hospitals are owned by religious organizations which won't offer them. She told Linda she would do it herself if she had to, by pills or by 'other means'. I teach about abortion as a part of my OB lecture so depending on how far along in her pregnancy, pills won't do the job after between 9-12 weeks gestation. If she uses an instrument on herself she is at very high risk of hemorrhage or infection or both. In other words, there are no good forseeable outcomes for this young woman. Attempting an abortion could very well be a death sentence for her. A very sobering thought indeed. Tomorrow I'll ask Dr. Denton (our host) about this. I'd like to know the frequency of abortion here and what options she has to get it done safely.
As our walk continued,we wound our way around the 'neighborhood'. It was quite unlike the view from the road in a tap tap. As we walked we saw up close and personal how people lived. Even after a previous trip to Haiti, I found it shocking. People living in tents and shacks along side their cattle, goats, and pigs. How they lived this way was inconceivable to me. No electricity, no running water. I felt as if I were seeing the real Haiti for the first time. All the people came out of their houses to see the 'Blancs' walking by. No doubt very few whites/westerners ever see what we saw. George and Mose greated all their neighbors graciously and if I smiled and said "Bonsua" they smiled and said it right back, We passed lots of new wooden small shacks that various organizations had come in and built, they were tiny little houses but far superior to a pieced together tent. George took us to his home to meet his family which included a grandmother, a cousin and her three children and another cousin, sister to the first. George's mother died when he was young, and he lost his father in the earthquake. George and his cousins and grandmother lived in a tent outside their home which had sustained lots of earthquake damage and was being repaired by several men walking around and hammering on the roof. 'The men climbed into the trees to get us coconuts, which George's cousin slashed open with a machete and we all drank fresh coconut milk and ate the coconut out with spoons. We stayed about an hour and George and I talked a long time. He wants to go to school in the US and study law and then return to 'do something great for Haiti'. I believe that someday, George will do just that.
We had other adventures on the walk, including seeing an abandoned sugar cane factory, that George says will open in October and employ 2,000 Haitians (may it be so). I lost a flip flop during the walk, and could not continue, so George hired a motorcycle to drive me the rest of the way back to the clinic. I was very nervous, (folks use motorcycles for taxies here, and it was not unusually to see four or five people on a bike zooming by in one direction or another) but as I was the only rider on a privately rented bike, and Mose did the driving (the driver stayed behind with our group) and he headed my admonishments to 'GO SLOWLY MOES" it went pretty well. Remember there were no paved roads where we were, only dirt and rock streets (that's why my flip flop didn't hold up) and of course full of huge holes! So there was Mose driving slowly with me on the back, while he weaved in and out of traffic and gigantic pot holes. That was my adventure for the day. I got back in time to wolf down dinner (a potato, carrot, and greens stew, flavored with meet of an unknown origin, and served with (you'll never guess) beans and rice. All delicious. Then I accompanied Dr. Denton to the hospital to visit a post op patient, which I will write about tomorrow.