Yellow-Spotted Plague

There were no systemic symptoms, but the patient complained of a rapid-onset, non-pruritic rash for the past two days.  Rashes are common in Haiti.  Generally speaking, hygiene is not a priority although cleanliness is valued.  Houses are small while families are large.  Contagious rashes spread through families quicker than rumors through a junior high school cheer-leading squad #FastLikeUsain.  So, in just hearing this complaint of a rash, regardless of how it was described, infectious etiologies were at the top of my differential. 

On exam the lesions ranged from 1 mm to 1 cm plaques, or slightly elevated above the skin.  They were not erythematous, but the lesions clearly had a yellow color to them.  They were well demarcated and the patient reported that they were not tender to palpation.  The lesions involved the upper extremities, abdomen, chest, shoulders, back and face.  Mucous membranes were not involved.  The patient denied fever/chills, weight loss, nausea/vomiting, diarrhea/constipation, headache, upper-respiratory infection symptoms, and urinary tract infection symptoms.

The patient was me and I knew very clearly the etiology of my skin “lesions”.  They were drops of yellow paint from helping out with the finishing touches on the new guest rooms.  Yes, I came all the way down to Haiti to help paint.  Yes, I’ve gone through four years of medical school so I can come to Haiti and help paint.  #Overqualified?  To be fair though, my painting skills were pretty bad #Underqualified. But that doesn’t matter in Haiti.  The workers around the Matana compound are pumped to see a ‘blan’ working after hours to help them out with painting. 

Dr. Chris mentioned to me before my last trip that you can arrive down in Haiti with all these big plans, bright ideas, and will to “help” only to find out that instead of needing a clinic doctor they could really use a motivated and dedicated worker.  The example that you can set by working hard and not complaining can do wonders by providing a role model for the other workers.  During our lessons with the new health agents today they were discussing “pwoblèms” the community faced.  Number four on their list, “Having to work too hard.”  Talk about cultural differences.  

My list of projects when I came down here included: looking into water and waste disposal for a nearby community, using the microscope to study disease etiology, and investigating a possible bridge site.  What I’ve found so far is that the community is already committed to getting a pump installed, we have no microscope, and an engineer is coming in a couple weeks to investigate the bridge location.  So now I’m a painter and I found a half-constructed church that needs completed. I see patients every morning and then go about finding ways to stay busy all day long.  Today that was entirely clinic based.  Tomorrow it’ll likely be setting up for a larger clinic and buying some supplies.  But even that might change.  Frustrating?  Perhaps, but that’s also one of the joys in coming down here.  If you keep an open mind you can open your heart to more people and truly connect with them.  It may not always be a glamorous operation, but are we working in Haiti to tell stories or to help out?