Altitude Sickness

Brace yourself...this is a long one.

I was in a fog.  It was early November, 2012 and I had just seen the tragic aftermath of a brutal attack on a Haitian.  However, this fog was physical.  Having finally completed the primary objective of the last week of my month-long journey I now found myself standing among the clouds.  Rachel and I spent the entire morning climbing #MountainBeyondMountain with Dr. Leo and our "bodyguard" to reach La Fite (pronounced LA-feet).  La Fite is an extremely remote village in Northeastern Haiti, near the Dominican border.  Dr. Leo had actually seen an eclamptic lady from the La Fite area in the Gran Bois clinic days earlier.  Her family and friends had taken shifts during the 5 hour hike carrying her seizing body on top of an old mattress .

My body was sore, out of breath, and muddy but I couldn't help and take peace in the scene I found myself in.  It truly seemed like something out of a Lord of the Rings movie.  Everything was green.  I was on top of a mountain with scattered wooden homes dotting the landscape.  We were greeted by an overweight gentleman who claimed to be in charge of the "mission."  He was passionate about his community and about trying to secure a commitment out of the blan to help.  He formed a committee of local leaders to develop a plan to secure community access to healthcare.  Word carried across the mountains to Dr. Leo and while he tried mightily to make the hike monthly he realized that he was not properly equipped to handle this remote clinic by himself.  ServeHaiti is our older sister in the Haitian NGO game and the sponsor of Dr. Leo’s clinic.  The leadership discussed this need for La Fite and decided to involve their younger sister, Community Health Initiative to see if they could manage semiannual clinics. 

After a tour of the clinic building he showed us to a gathering of Haitian villagers who had come to receive medical care.

Rachel and I were not alone at this place.  There was a small group of blan there working on their own projects.  A small group of Canadian men were doing carpentry on the clinic building and there were two South American nurses holding clinic in the church.  Now, I will never say a bad thing about a nurse.  I have had my ass saved innumerable times already in my young medical career and I know that I will continue to have my ass saved by nurses as I continue to practice medicine.  However, these two very well-meaning ladies were in over their heads with this clinic.  They had few medicines and the ones they did have were being completely misused.  As an example, they were prescribing a form of Benadryl as both an antibiotic and a prenatal vitamin to different patients.  Granted the "Treat What You Can" mantra often leads to diagnosis bias, but that isn't anywhere close to being appropriate.

We quickly set up shop to help in seeing patients.  We have one translator between the two of us and he isn't used to being a medical translator.  Needless to say I believe that Rachel and I were also guilty of providing sub-standard care.  You can get the gist by key words, "Gripe" means cold.  Cough, runny nose, fever, etc.  Same illness in Haiti as in the U.S.  Listen to the kids' lungs and depending on nutrition status you might lean a little closer to treating with antibiotics than in the U.S.  And just like our normal CHI clinics, everyone got real vitamins and albendazole.  Dr. Leo recognized early that we didn't have the infrastructure in place to provide proper care to the patients, though Rachel and I felt bad about throwing in the towel.  As soon as you start thinking about the alternatives for these patients you recognize how important this clinic visit is to them.

These villages have no clinic near them.  The closest clinic is the Gran Bois site that we left from that morning.  The path to reach this oasis was not easy.  We departed after a satisfying breakfast, one probably never experienced by a Haitian in those parts.  We launched with a vigor as I knew that we would be making a return trip that same evening.  The path was a combination of climbing the Mega Crag in #GUTS and completing the #PhysicalChallenge in #DoubleDare...times a million.  We climbed three mountains, forded two rivers and traveled over five hours...each way (for realsies, all those tall tales by parents about commuting “uphill both ways” were becoming all too real). There were narrow paths that had turned to mud in the mountain rains with soda can sized stones for stepping.  One false step on the slippery rocks could mean a nasty spill into a mud and animal excrement mixture #TwoThumbsPointingAtThisGuy.  Incline grades easily topped 60% in places.  It was a struggle made even worse when you realized that the villagers out here do it on the reg #HaitiFit.

It became painfully obvious that the only reasonable solution for providing healthcare to the upwards of 15,000 Haitians living in La Fite and nearby villages was to have medical teams come to them at regular intervals.  #Duh.  This was something Dr. Leo already knew.  He had been trying.  But monthly trips were increasingly difficult for him to do as the patient load at his clinic grew and his resources stretched thin.  

CHI has knack for providing healthcare for rural Haiti.  The quarterly clinic model has been successful as far as initial data reports can tell, and is something that can work in most places given enough resources. Both human and material.  CHI has a body of volunteers from across the country who drop their lives for a week to come work as a clinic team. People with backgrounds ranging from cosmetology to cardiology, all with willing hands and able bodies.  Each volunteer pays their own way, and donates $1,200 to contribute to the costs of purchasing medicines, translators, meals, etc.  We are very fortunate to have this financial support, so we never have to use outdated medicines, share interpreters, or have understaffed clinics similar to what we saw in La Fite.  Seeing such disparities is extremely frustrating when we know that there are feasible solutions on the table.

         

Before we departed on our trek back, we reached an agreement with the community committee. They provide a roof, treated water, and one hot meal a day and we do what we do best: pull together a team of medical volunteers and use our talents to provide standard of care.  We made a promise to go back, and now Rachel and I are honored to making the return trip with an enthusiastic team of volunteers, Dr. Leo, Cindy the mule, medicine to treat pain, infection, worms, hypertension, diabetes, etc…and most importantly show these people of La Fite that humanity hasn’t forgotten them.

While we have been blessed with many eager volunteers to come, we understand it is not feasible for everyone to up and leave their lives, and come up with the money.  More than bodies, it takes cash to make this operation run.  I’m not big on hitting up people for donations, but if you are reading this, and feel compelled to contribute to the cause, 100% of your dollar will go towards financing this clinic.  The details are below.  Just $10 can buy a bottle of antibiotics to treat a dozen kids for pneumonia. I cannot thank you enough for reading my blogs and giving us support for our work with CHI. I have already seen many positive changes within the country, and simple demonstrations of love and caring, in the form of medicine, money, or just time, will make all the difference in Haiti’s recovery, so again, thank you.

To donate: please visit www.chihaiti.com.  When donating via Paypal please put "La Fite" in the comments section or when writing a check do the same.  That way we know that the donation is for this trip.  This population has already done so much to accommodate us that we would hate to not fulfill this medical void.