By Sarah McDaniel
TERRA, Haiti—Today we conducted a mobile clinic in Terra. The road was rough but our drivers were exceptionally competent and the vehicles were capable. Our clinic was conducted in a large school with multiple rooms. It was easy to find by the large number of people already gathered. As we unloaded and moved inside everyone began to follow us and line up. The crowd was noisy, but also surprisingly organized and patient to wait to register.
As Ferris, the local health worker efficiently registered the patients we arranged school desks to form our exam rooms. Pediatrics was busiest today and plotted the growth of all the children on growth curves. Despite a significant language barrier at the height and weight station, things moved smoothly as the children quickly got the hang of it. After a couple of children had been seen, the others knew the drill and removed their shoes as they approached the station. The pediatric team identified cases of Tuberculosis, Otitis Media, scabies, ringworm and malnutrition. They also identified a ventricular septal defect in a baby. Several cases of Marfan’s syndrome were also noted. These patients were referred to Zanmi Lasante’s hospital in Cange to be followed by the cardiologist there.
The prenatal station saw five pregnant women, including one who may have been carrying twins as her belly was large for her stated date. Without an ultrasound machine the team still determined the position of the fetus and listened to the fetal heartbeat. Since there were a small number of maternity patients this team assisted with pediatric patients and women’s health.
The adult station was also quite busy today with two doctor/student/translator teams seeing patients. My favorite patients from the adult station today were a woman born in 1915 (who may have been healthier than some of us) and a very kind and appreciative blind man. The man was hypertensive and found to have a murmur consistent with mitral insufficiency. We saw two goiters, one with physical findings suggesting hypothyroidism. These women were referred for treatment. We treated many cases of hypertension, with both dietary advice and medication. The other most common complaint we saw was stomach pain or acid reflux. In many of the elderly patients we saw joint pain for which we could give paracetamol. A woman with a breast mass was also seen and referred for further evaluation. We also saw an elderly woman with the classic findings of Parkinson’ s disease. She was referred to the hospital in Thomonde, where she has the potential to be treated with medication.
There were definitely plenty of patients in need of our attention today and it was really fun to get to know them as we treated them. We all really appreciated their calm patience as they waited and judging by their big smiles and merci’s as they left the feeling was mutual.
As storm clouds began to move in as we wrapped up our day. We loaded back into the SUVs to return to Thomonde as the sky cracked with thunder and lightening.
Sarah McDaniel is a second year medical student at the University of Miami Miller School of Medicine.