The number of people we saw with hypertension was staggering. It was in excess of 90% of the adults. And we're not talking about anything even close to normal B/P. In nearly 30 years of EMS, I've seen fewer people with pressures over 200 than I saw in those four days. Most of those EMS patients with B/Ps over 200 were suffering a traumatic brain injury or a stroke (hypertension is a common response to brain swelling); the Haitians were just walking around with it. The highest I measured was 264/130. We talked about it but we're at a loss for why this might be so prevalent and so severe.
Dental patients were in abundance and this was expected. Dental hygiene is non-existent and tooth decay is rampant. Our dentist, Dr. Joy Jordan, was one very busy lady.
Just before noon, two people - one male, one female, both elderly - were dragged (literally) into triage within minutes of each other. Both went down while waiting and were victims of heat, dehydration and probably low blood sugar. The guy had a seriously decreased level of consciousness and was cyanotic around his lips. He gave the distinct impression of a man actively trying to die on us. Both were taken to an area in the middle of the clinic that had a couple of beds, which became known as "The ICU" because that's where we took and treated all the seriously ill people. We started IVs on them to buff them up and worked with Dr. Vania Francois to get them back to their baseline. (Vania is Father Yves' sister.) (His sister as in biological sibling, not his sister as in a nun.)
There was a steady stream of kids headed to see our two pediatricians, Drs. Sarah John and Beau Laguerre. We didn't do triage on them as all aspects of kiddie care was being done by the pedi people.
In all, we saw over 600 people and told 500 to come back tomorrow. This was actually a low number as we got off to a late start due to having to set up.
After triage was finished processing the last patients of the day but they were still waiting to be seen by the physicians, Father Yves took me next door to show me the house his mother is building (his mother as in Mom and maternal progenitor, not mother as in a nun). It's a nice place and Mrs. Francois seems like a very nice lady. To turn out kids like Yves, Vania and Sondi (who was translating and helping out in general), she must be. It's also evident where they get their brilliant, ever-present smiles.
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| Sondi and Mrs. Francois |
Father Yves and I then went back to the school and I got another look around without kids this time. He told me that the school is going to have to be demolished and rebuilt, not because it was damaged or decaying but because it doesn't meet the new Haitian government earthquake codes.
Father Yves also told me about the deal that the government has made for the clinic. If a complete clinic is built (a new, purpose-designed building that is medically equipped), the government will provide two physicians to staff it full time. (Each person whose medical training is paid for by the Haitian government owes two years of service, so that's how it would be staffed.) The cost: $300,000.
When the last of the patients left the clinic, we headed to dinner. The food was, as described in an earlier post, tasty and satisfying. Father Yves also provided us with cold beer (!!!). Prestige beer is Haitian and a very nice beer. We didn't expect it, so it was that much more delightful. It also brought to mind Benjamin Franklin's saying: Beer is proof that God loves us and wants us to be happy.
After dinner, we debriefed, going over what went right and what could be done better. We also learned that the team would be split for the next two days with half going into the mountains to a village called Canon.
Greg and I talked it over and he would be the medic going up on the first day and I would go up on the second.
After the debriefing, I went to the Barracks, wrote my journal entry for the day and fell into a deep and easy sleep.
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