Haiti Day Three

Ryan woke up at 6am and skipped the morning meeting to "sneak" over to the hospital. He arrived in time for the hospital's 7:30a meeting.

Note: ALL hospitals in Port-Au Prince cost money. There are no handouts for medical care! After the Earthquake, healthcare was free so part of the reason the hospitals and clinics are so packed it that EVERYONE is trying to take advantage of the free healthcare. That is part of the reason why there is a triage tent outside the hospital so that patients could be evaluated for need. Not everyone was admitted depending on the severity of their condition.

Ryan thought it was very sad at the hospital because he could see/hear people who had been discharged begging to stay because they had no where to go; however, the courtyard was already full of campers.

Ryan worked the whole shift (7:30a-9:30p) in the post-op unit. The nurse Ryan relieved was extremely tired because she had been on duty for over 24 hours. Only 1 nurse had come to relieve 2 nurses and she did not feel okay with leaving 24 patients for 1 nurse so she stayed for another shift.

The room smelled so bad!!  The bathroom kept overflowing and poop kept leaking into the recovery room. They had someone mopping as often as possible but it was not enough to keep it clean or oder free.  An American plumber was called in to fix it and he also made two more showers for the volunteers. Up to that point there were only 2 showers for over 200 volunteers and at the end of the day you NEEDED a shower. Plumbing is a huge issue in Haiti even in the mansion they later stayed in. Ryan wondered if there weren't any plumbing schools in Haiti :-)

Ryan found it very hard to accomplish as much as he wanted because their supplies were just stacked on a small cart in the corner of the room.  It took a lot of extra time to find what you needed.

Patient 1 in Bed Zero:
It was a mom who had just had a C-section. The baby was born at just 34 weeks gestation and was having a very hard time suctioning to the mother's nipple so her milk wasn't coming in and the baby wasn't being nourished. Infant formula is very difficult to get and expensive so it was very important that this baby learn to eat fast. Everyone was very worried the baby would starve to death, which is where her fate was appearing to head.  One of the OB nurses was able to make a breast pump type device for the mother to use so hopefully the baby was able to survive (Ryan does not know the outcome).

Patient 2 in Bed 1 (weird bed numbering system):
An 8 year old girl with a bone infection of the tibia. It was a puncture wound caused during the earthquiake. Bone infections are difficult to treat even in the US. Her first round of antibiotics did not work so she had to have surgery to open it up where there was tons of puss. They drilled a hold in her bone and left it open so they could constantly rinse and wash out the bone. It smelled horrible. The following day she had her leg amputated. They used a "flap" procedure where they pulled the skin over and sealed it up. So sad.

Miracle:
In Haiti they do not use safety needles (needles that are covered after they are used to prevent dirty sticks). Ryan took blood from a lady and the room was so full of people and stuff that he did not have a safe place to put the dirty needle so he laid it on the lady's leg. It was knocked on the floor and when Ryan picked it up it poked his glove (5%+ of Haitians have AIDS). He was so worried and felt so stupid. He thoroughly examined his hand and there was no puncture to the skin and no open sores on his hand!!  From that moment on, he would immediately carry the dirty needle above his head to be disposed (he had to carry it above his head because there were so many people in the room that if you carried it anywhere else you risked bumping into someone and accidently sticking them).

Ryan said the staffing during the first half of the day was good but the second half was very short-staffed. A general surgeon came with the Union group and had been doing lots of surgeries all morning so then all those additional patients were brought down to the unit.

Ryan found that it was a lot harder to start IVs in "darker skin" because you can't see the veins like you can in "lighter skin."

Patient 4:
An adult lady who was screaming in pain so loudly that it was scaring the younger patients so they gave her morpheine (sp?) for her pain and to make her sleepy.

Interesting: Ryan worked with the Korean nurse he had met the previous day. She told him that in Korea people are expected to tolerate more pain and she was more reluctant to give pain medicine (in Ryan's teaching and experience, the US administers pain medicine like candy). She taught  Ryan some other methods to allieviate pain without medicine. Such as...the little girl was complaining of a stomach ache and so the nurse taught her how to massage it which kept her busy and helped her pain and made her feel better.

Patient 5:
An 8 year old boy who had testicular torsion (twisted testicles). He had one testicle removed the previous day and they were going to remove the other one but thankfully a Eurologist (sp?) arrived and was able to save the 2nd one. The doctor jokingly offered free vasectomies to the volunteers.

The little boy needed to use the restroom but didn't want to go to the icky bathroom. I guess he had some problems with the catheter or wanted to avoid one, not sure but...he leaned over to pee in a cup and Ryan said no no he needed to stand up so gravity could help him. Ryan told the little boy he would wash his feet when he got back. The little guy went to the bathroom and was pretty pleased that he was able to do it. When he got back, Ryan washed his feet and play tickled his little toes. They had a "bonding" moment and the little boy asked Ryan if Ryan could give him a tent for his family to live in. So sad. Ryan was not able to for several different reasons: he didn't have one, they were instructed not to, etc.

Ryan had to briefly come back to camp for a meeting. They learned that they were leaving at 4am the next morning to go on a 3 day mobile clinic and they needed to get ready and go to sleep early. Ryan was super excited but said he couldn't leave his patients to go to bed early so he went back to the hospital to finish his shift.

He was done at 9pm. It had been a long/hot day. We went to the break room and filled his water bottle with "cool" water (like the culligan cooled water). He had only gone to the bathroom once that day.

When he got back to camp he had to help go through the supplies to make sure they had enough and the correct pills for the mobile clinic.

12am his day was finally over. He was sore and exhausted. He took some "drugs" and went to sleep.