By Katie Lee
HICAGNE, Haiti—While I haven’t spent Thanksgiving at home in quite a few years, this was the first that I’ve spent in a country that doesn’t celebrate Thanksgiving! Today was the last day of clinic, and it was a perfect end to the week: I got to follow a patient from triage to transfer. She was a 17-year-old girl with a tiny lethargic five-month-old baby. The baby’s lethargy scared me.
If there’s one thing that’s been reinforced this week, it’s that screaming babies are a good thing-it means they have enough health to realize when they’re not feeling well. This baby was listless, merely staring at us through eyes covered in a white film as we took her blood pressure, temperature, and pulse. Her mother’s chief complaint was that her daughter was vomiting so much that she couldn’t eat anything, and she was losing a lot of weight. When we asked her if she breast fed, she said a doctor said she couldn’t because it hurt her too much. Physical exam revealed lethargy, no tears when crying (a sign of severe dehydration), and a couple of rashes on her cheeks and buttocks. The doctor working with us discovered that the mother was HIV positive. This could have been the reason the doctor told her not to breastfeed, since the HIV virus can be transmitted through breast milk. The mother was a restavek, an orphan who relied on strangers to take her in, and it would have taken her eight hours to walk to the nearest hospital. We decided to take her to Cange at the end of the day.
The hospital in the town of Cange was started by Paul Farmer, an American most famous for the book Mountains Beyond Mountains about the creation of Zanmi Lasanti (Partners in Health). This organization strives to improve overall health conditions in Haiti through acute hospital care, community health care workers who directly observe therapy at the home, and preventative services. After spending the past five days in Haiti, walking into the Zanmi Lasante compound was like walking into Disneyland. Everything was clean, concrete, and huge. Inside the infant unit, the walls were painted white, there were hand sanitizer pumps at every bedside, and in the corner I even saw a television.
We presented our case to the doctor working the unit, who agreed to admit both mother and child. We had to leave after she was admitted, and I’ll never know what happened to that mother and that baby. Zanmi Lasante is known for their social support network, and hopefully they can provide some assistance to a girl who literally has no one. All I know is that although this one case obviously did not change the dire state of health in Haiti– or maybe even changed the course of this woman’s life, we were able to help her as much as we can for as long as we saw her. That individual attention to care is why I’m a part of Project Medishare, and eventually part of the international health community.
Katie Lee is a first year at Emory Medical School. This is her first trip to Haiti with Project Medishare.