about time I wrote again

Last week was spent with one of the Chilean Doctor volunteers here. It was encouraging for me as I am beginning to understand alot more of the language and found myself alot more able to follow the consultations.

We saw a wide range of things from tonsilitis to massive abdominal masses, from an acute pneumonia (possible other infectious disease that begins with C) to STDs. We saw a lot more children and the variety of the level of care that children get here is amazing. Some come in with parents that are doting and willing to do anything whereas others arrive with a neighbour who does not even know the childs name!

On Wednesday I helped out in the malnutrition clinic run by the Chilean organisation here. This gave me oppurtunity to a) play with cute kids and b) see what an impact education and a good diet makes to the lives of these children. I am quickly learning here that education is the cornerstone to helping empower people to take responsibility for their health.

I had a patient today who came in for a simple high blood pressure review. Sounds simple right but a lot of these patients have not taken their medication and it is very hard to convey the importance of this to them, so these reviews can be frustrating. However this lady had brought her blood pressure right down, had taken her meds that day and knew they where about to run out so had come to get refills before they did! HOORAY!! Education! It really is the simple things in life that make me smile!

Last week I also had the oppurtunity to visit one of the orphanages here. This was set up by a big organisation in Haiti called Partners in Health. The kids were so cute and had an amazing complex to grow up in. There was one mama to 3 children which is a fantastic ratio. They work very closely with our therapists to provide the best seating and care for those children that have special needs and have very often been abandoned by parents who simply cannot cope. Many people make their living by selling goods on the street and this becomes impossible if you have a disabled child who has to be watched 24/7 because they are disabled in some way.

This week the compound is buzzing as the therapists here undertake the crazy idea of running across Haiti. If you have not already checked out the link here it is for you http://www.facebook.com/pages/Run-Haiti-Ultra-marathon/208666245893739

Please take a minute to check it out and offer your support!

Plus here is the link to my next possible adventure - thanks to Sindhu

http://floatingdoctors.com/

TaTa for now!!

the 3rd week/weekend

Last week I worked with another of the volunteer Drs here. Dr Sindhu is an attending (consultant) from America and very good at her job. It was a good learning experience for me as I was allowed to take much of the consultation by myself and by the end of the week felt much more confident in forming treatment plans and constructing a consultation. She is also a good teacher and more than willing to share her wealth of knowledge.

One patient from last week that sticks in my mind was not originally one of our patients but one of the few acutely unwell patients that come through the doors of our clinic. Mrs T was suffering from pneumonia and was acutely unwell. We tried as quickly as possible to get some fluids and antibiotics into her system but found we were limited by the resources available here. The patients O2Sats were in the 80s and yet we had no oxygen, we scrambled around for a giving set to administered some fluids we had discovered. As well as giving a couple of hits of hardcore antibiotics. Eventually Mrs T began to pick up but she urgently needed to get to a hospital. Luckily our driver was on hand to transport her to the local hospital.

The next day the Drs from the clinic + me went to the local hospital for a scheduled tour. It was so interesting to see how a hospital here in Haiti operates and we were also able to see out patient from the previous day, who was doing really well and ready to go home. The hospital itself was pretty basic but they did the best with what they had. It was clean and had trained staff running it, which is a real blessing here.

On Friday we had our first death from cholera. It was a small child well know to the clinic and the team here. It was a somber atmosphere on the compound that day but also warned us that cholera season is coming. We spent saturday clearing out the cholera room for triaging other possible cases. However we have lost the funding for the cholera protocols, this means that we do not have the ability to run a proper cholera facility which could put a lot of people in danger of contamination. We do the best we can and luckily have not seen any cases that I am aware of this week but it is a daunting thought.

Saturday evening was spent in a much more upbeat manner. Some of the volunteer Drs/therapists/midwife here work with an organisation called american solidare and are from chile. They have a house round the corner and know how to throw a good impromptu dance party. So after arriving in the torrential rain and virtually having to swim to the front door (rainy season is on its way) the night was spent dancing to spanish music, which honestly all sounded the same to me. When I finally made it home at about 4:30am I was well and truly ready for sleep and ideally a kebab. Unfortunately they don't have those here!

Sunday was spent chilling on the compound with a quick trip to the supermarket. any excursion of the compound is entertaining and almost a rollercoaster ride as you battle the traffic and roads of Port-au-Prince.

Tonight I came home to find a massive spider outside the room next door to mine, NOT WHAT I SIGNED UP FOR!!!

the second weekend

This weekend we went to the beach in Jacmel for one of the volunteers (Jeanie) birthdays. We left early Friday afternoon on our epic journey across the country. We had to go into the heart of port-au-prince to catch a ride from the ‘bus station’. I say bus in the loosest term. It is a minivan that we in the UK would use to sit 6-8 people, well the Haitians cram 16 of you in there! Very cosy! We board this van and the local vendors seeing the group of ‘blancs’ make a beeline for the van and try to sell us everything from prescription drugs to sunglasses, water to English grammar books! We finally pull away from the station when the bus is full and start on the trip up and over the mountain. The driving over the mountain is no different to how people drive in the city. Even if you are going up a steep incline on a hair pin bend with a blind turn to follow I will still overtake you, and hooting my horn as I do makes it ok!

We arrive in Jacmel and unfold ourselves from the bus to go and find some food. A couple of the volunteers new a place to get good chicken and it was good! The owner spoke English and was so proud of the sauce he used which was his own recipe. The secret is thousand island dressing with bbq sauce – it is delicious you should try it next time you have chicken.

The next challenge was to find a tap tap to take us up the road to the hotel. By this time the sun was rapidly setting over the mountains and darkness was setting in. We tried one tap tap but it was charging too much for the ride so we walked on to get a reasonable price. We jumped on the next tap tap along but made the mistake of not negotiating price before boarding. So 5 minutes down the road the vehicle stops and Erin who was sitting in the front tells us all to get out as the driver is demanding too much money. So although we got a free ride 5 minutes down the road we were still 20 minutes from the hotel and no tap tap in sight. So as I am standing on the side of a Haitian road in the pitch black and no idea where I am I pondered my risk assessment and thought this is everything I said I wouldn’t do. But hey you have to live a little! We did finally find a tap tap to take us where we wanted to go and I have never been so happy to see a hotel sign.

The hotel was right on the beach and it was so beautiful! So we met some of the rest of the crew and sat on the beach front until we were all too tired and decided it was time to turn in.

The next day was spent on the beach! With a slight interruption half way through the day as we moved 5 minutes down the road to the beach house we were staying in that night. So we chilled on this beautiful beach which was barely populated. This is a feature of Haiti that needs to be more in the media. It really is breath-taking. I will post some photos on fb soon.

That evening we were joined by another group of people who were over from the states on a mission trip and spent the evening chatting and celebrating a couple of birthdays and the passing of my finals. Taking a walk along the beach in the dark with the moonlight shining off the ocean was just incredible! Most of you will know my obsession with the ocean so you know that I find this the most relaxing thing in the world and this is my favourite place in the world.

Sunday we spent the morning hanging out on the beach before getting a ride back over the mountain to the clinic. Thank goodness we got a ride as by this point we are all tired and the thought of riding 3 tap taps a cramped bus and who knows maybe a moto or 2 did not sound fun.

We did receive an announcement half way through the day though that we have gone to day light saving time. So I am now 4hrs behind the UK. This apparently happens in rather a haphazard manner in Haiti, being not every year and not at any particular set time of year either. At least this time it roughly fitted in with the american time change. The President just decides and announces! Very Haitian!

Overall it was the perfect way to celebrate becoming a Dr! Good food, good company, good beer and the ocean!

Just quickly

I passed finals so can now call myself Dr Ruth Johnston!!

that is all...

this is definitely worthy of a post

So experienced my first earthquake! well at least the first one that I was awake for! It was a very odd experience. At first I thought it was just the loud thump of someone falling out of bed in the room next door but then the noise carried on and the shaking of the room was a little too much for that theory. I was in bed at the time trying to download and watch this new viral Kony2012 video, I never did finish it. Anyway so I poked my head out the door, to witness the rest of the volunteers doing the same all looking slightly puzzled. There were exclamations of 'did you feel that?' and 'was that an earthquake?!'. I suddenly became acutely aware of where I was - Haiti which we all know had a major earthquake 2 years ago.

The air was then filled with wails and cries of the locals who were obviously sent into a fearful panic after the terrifying experience of 2 years previously. For the next hour or so the wails continued and the sound of a helicopter circling echoed around the complex. My guess is it was out to survey any damage done - which I have heard is very little and there are no reports of injury or fatalities.

Anyway once the initial adrenaline rush was over I headed back to bed. I must confess though that I packed a rucksack and had my shoes by my bed just in case a bigger one happened and I had to run. My rucksack had the most random stuff in it though I thought as I looked through it in the light of day. Things I thought i would need in an emergency included - my stethoscope, alcohol handwash, my camera, a light scarf, pair of shorts, fact 50 spf, a torch, money, my travel documents, phone, hair clip, pen, sunglasses, creole phrase book........I suppose some of that might have been useful.

On a lighter note I stitched up my first head wound today on a very drunk man. It definately feels different to the plastic models especially when your patient keeps moving and trying to kiss your hand!

the first weekend

So yesterday was kinda fun. We had spent Friday evening hanging out and making signs for the race on Saturday. (This is a race organised by a couple of the volunteers here to raise awareness of health issues in Haiti.) I really enjoy these times where we are just chilling together, it reminds a little of being on the ship. Although I am definitely still the newbie here, erin, jeanie and Sam to some extent obviously have a close relationship. I can imagine this is the kind of place that forges quite strong bonds. But me and Sindhu (the other newbie) are slipping into the way of life here and have felt nothing but welcomed.

Anyway Saturday was race day! So up at 5:45am (mum would be so proud of me!) to set up as people started arriving as early as 5:30! Ok so a word about Haitian time, everything starts as soon as the sun comes up about 5:30 and I am in bed by 9:30.

Right back to the race. There was a massive turn out and although it didn’t go completely to plan ie a lot of ppl cheated and cut corners, but everyone seemed to enjoy themselves. Especially the kids! I think next time they will plan to have a kids race and an adult race. We also took ppls bps as they registered as a matter of screening and to raise awareness. HTN is a real problem here, people are having strokes at an early age and there is just not the rehab facilities to accommodate them. Plus so much of the Haitian life is based around needing balance and core stability. Imagine trying to ride a moto or tap tap with no balance, or crouching down to do laundry with no core strength. As the PT/OTs keep saying ADLs are very different here.

The rest of yesterday afternoon was spent at the pool. A small slither of paradise in this distructed country. After being promised that there was usually no one at the pool we walk in to find a group of about 25 americans who are over here on a mission trip. But the pool was lovely, a couple of prestiges (the beer here in Haiti), good food and good company. We spent the rest of the day there and by the time we got home I was very sunburnt (my legs are so painful) and very tired. That good tired where you have achieved something with your day, had a full day and spent lots of it in the sun

Day 3 already

I have spent the last couple of days in the clinic. There was a bit of a mix up when I first arrived of them thinking I was actually qualified - a mix up between the british and american medical system I think. Anyway once that was cleared up, I started to work with a lovely haitian Dr, Dr Debbie. We really see a mix of things in clinic from acute malaria to high blood pressure, from invasive bone tumours to tonsilitis.

Clinic starts at 7:30am(!) and goes til about 3pm depending on how many and complex the pts are. It is exhausting but good fun at the same time. Language is proving to be a bit of an obstacle and I think I am going to have to learn creole fast.

The afternoon/evenings are spent hanging out with the rest of the volunteers on the complex. There is an OT, physio, physio student and Dr here all from america so I feel I have to educate them about british ways - although it is a bit hot for tea drinking.

So some observations about Haitians, there really is a lot of poverty! No one that I saw today had properly fitting clothes, and I know that sounds a little shallow but when the kids are wearing shoes 2 sizes too big or small for them it really says something. We saw a lot of children in clinic today some were just like normal kids with coughs and colds but there were a few who were undernourished and who just stare at you with a vacant expression. It makes you wonder whether they ever laugh or smile and the hardships in life that they are going to have to overcome.

However the work this clinic is doing is amazing. People are receiving the basic care that they need free of charge. There are some cases that we have to refer out, like a lady today who needed a specialist in neurology or a lady who had an abdo mass and urgently needed an USS. But generally speaking we can do something to help.