By Christine Farley
Baille Touribe, HAITI–Since last January, I have been looking forward to this trip. The thrill of spending time tucked away in the mountains of Haiti, away from the Miami hustle has helped me survive two semesters of nursing school. While our clinical experience in the States involves contemporary technology, the laboratory tests and diagnostic screenings can easily become our crutch. When delivering healthcare with Project Medishare one must rely on a stethoscope, an observant eye, and a keen ear. As we venture into the countryside to perform assessments, immunizations, and education we must pause to consider our client population. The majority of health dilemmas that trouble the people of Thomonde are not the same as those from which south Floridians face. Running water comes from a river, not from a faucet; energy costs physical labor and personal ecological resources, not a generator and sanitation must often yield to practicality.
Yesterday we traveled about an hour down rocky mountainous roads to the remote settlement of Baille Touribe. The village is cut off during the rainy season so the prevention and treatment provided by the mobile clinic is essentially the peoples’ primary source of licensed health care. The mobile clinic team consists of four doctors and our group of six nursing students. From morning until late afternoon the doctors met with over 150 men, women, and children. The clients patiently waited in the church on handmade wooden pews, in the Sunday school room, or in patches of shade while the doctors spoke first with those who appeared most ill. The nursing students walked from person to person taking blood pressures or helping with physical assessments of clients too young to voice their ailments. Most peoples’ problems were related to malnutrition or lack of clean water. Anemia, parasites, and gastritis were some of the common diagnoses among the adults. Several people also presented with hypertension and atherosclerosis, both diagnosed without looking at more than their blood pressure and listening to their physical complaints. Most of the children suffered from diarrhea or dermatologic complications related to parasitic infections. Clients were then given the appropriate medications, as well as, instructions on lifestyle modifications (eg: drink less or watered down coffee if one is hypertensive) and refilling their prescriptions. Even though there is no time to build rapport, the provider/client conversation must be as candid as it is concise. By the end of our day the team had assisted a population equivalent to a small hospital.