Tuberculin

I feel like I could just copy and paste any of an assortment of excerpts from PF's books #TheyreAllTheSameStory.  But that's probably because this story is all too common in Haiti.  In conducting my investigative work around rural Arcahaie I came across a small house where a young woman sat by her kitchen fire.  She looked thin.  Skinny.  Emaciated.  Even one of the locals that I've employed to help me conduct these surveys pointed it out, "She looks sick."  He was right.  She did.  Her face was sunken beneath her high cheek bones.  Her neck could wear a cheerio as a necklace.  You could almost see the outlines of her scapula from the front.  Do you have the proper visual?  Beyond that she looked weary.  Sadness filled her eyes.  She was pleasant and very accommodating in answering my lengthy survey, but it wore her out.

I had to ask.  I'm not sure if it is offensive, but I find myself asking the questions that I've always found myself holding back.  Can't tell you how many times I've asked a woman with a little bit of a belly if she's pregnant.  That wouldn't be tolerated very well in the states, needless to say #SlapInTheFace.  I've talked about uncomfortable topics like abortion, sexual violence, crime, and even voodoo.  My interpreters aren't often keen on the idea, but they soldier through for me.  But this was tough.  And it was made tougher by the background image of a  6 year old dumping water over his 3 year old brother's soapy head.

She was diagnosed with TB in June, according to her friend and housemate.  I inquire if she had been diagnosed with HIV as well.  No.  Thankfully, but I wouldn't be convinced until I saw the lab work confirming negative serology.  Like I said, she just had that look.

She began treatment at the local Arcahaie Health Center.  For those that aren't aware, this hospital was built by Cuba for the Haitian people.  It is staffed by a number of Cuban doctors.  Like most doctors, they are overworked, understaffed, and underpaid.  My only encounter with them was inspiring.  I direct you to this article discussing the Cuban contributions to health systems the world over.  Granted politics are always an issue with Cuba, but you have to respect the work they do.

Unfortunately, the treatment for TB is a little expensive and this patient was unable to cover the costs.  She didn't return to see the doctor.  There is a sense of pride in the people I've met that makes things like medical costs something that would rather be avoided than negotiated.  She accepted that she could not afford much needed anti-tuberculosis treatment and never even attempted to follow up with the health center.

So now she sits, sleeps, and lives in the middle of a half-dozen houses.  Kids are running around, unaware of the deadly bacteria that are likely dancing in the air around them.  Her family lays down next to her every night.  They know of her diagnosis.  They also know she couldn't afford treatment, but that's the decision that had to be made.  Food had to be bought.  Water had to be treated.  Kids had to go to school.  And her lungs now harbor partially-treated tuberculosis, the leading infectious cause of mortality in women of child-bearing age.  She is on her way to becoming a statistic.

I certainly hope that I see this lady again.  I want to see her get the treatment that she "can't afford", we can't provide, and that she can't live without.  This is one of those cases where you want to see the good happen and the bad may crush you.  Time will tell.