By David Serota
Today was our first proper heath fair, in the impossibly remote town of Baille Tourrible, and it was a day I will remember forever.
After a hearty breakfast of mais Moulin we packed into trucks and traversed a 2.5 hour mountain road to the health fair location. I did not know cars existed that could drive over such extremely rocky, steep terrain. With sore necks and stiff legs we were greeted in the beautifully quaint Baille Tourrible by hundreds of people waiting patiently in an organized line to be registered by the Health Agents. I was consistently impressed with the patience and cheerfulness of the patients, most of whom had waited months and traveled hours by foot for a meager few minutes to state their case in front of a doctor.
After a day where we saw over 200 patients in less than six hours, I cannot stress enough the incredible compassion, dedication, and understanding of the doctors and medical students for each and every person they interacted with. With just a few minutes before we had to pack up and get home before sundown, a very beautiful and young woman came up to Dr. Augustin and I at the adult medicine station. Her main complaint was fever but our first observation was a large pregnant-looking belly. When questioned, she replied that she was not pregnant and had gotten her last period a few weeks before. Upon interacting with her for just a minute, we noticed something different in her than any other patient today. No matter how ill all of our other patients were, they all beamed with life, energy, and smiles. This woman was completely emotionally flat and undeniably depressed. She could not open her mouth very far, but shining a light in, we saw thrush on her tongue, a strong indicator of HIV infection that has already progressed to AIDS. While most patients were content with being told a diagnosis and given a treatment plan, it was clear that this patient would walk away neither happy nor cured.
Her depression was not unfounded. Haitians know as well as physicians that oral thrush strongly suggests HIV infection, and infected patients are highly stigmatized. While this was surely the saddest case I saw today, the attentiveness and care provided by Dr. Augustin was equally inspiring. He took her aside and inquired more about whether or not she was sexually active, also asking again if she was pregnant (which seemed likely). He spoke to her as an equal, never speaking down to her like many of the physicians I’ve seen in the US.
This was a patient that we could not cure, and that we could not even prescribe medicine to, but the doctor still took the time, under an immense time-crunch, to listen to her. I learned that even in a situation where we want to identify problems and administer fixes as fast as possible, it is perhaps even more important that we provide an ear to listen to problems that nobody else will listen to. Even though we didn’t permanently fix many of the problems we saw today, we gave people the confidence and assurance that their problems were important and that they could live a productive, happy life.