Haitian proverbs for the day:
Deye mon, gen mon.
(“Beyond the mountain is another mountain”, i.e. what can be seen is not necessarily all there is)
Yon sel dwet pa manje kalolou.
(“You cannot eat okra with one finger”, i.e. we must all work together to succeed).
Bonswa, tout moun! Today was yet another jam-packed day of public health activities in and around Jeremie!
After a hearty pancake breakfast, we gathered our duffle bags filled with supplies and hopped sardine-style back into the Land Rover. Our first stop for the day was the nursing school in Jeremie. Interestingly, the building serves as the town’s nursing school by day and law school by night. We were greeted by the French nun who runs the school and introduced to 1st and 2nd year nursing students. The third (and final) year nursing students were out in the field doing public health work with the national tuberculosis program.
Cezanne, Anthony, and Meghan served as our French-English translators for our discussions. The students are studying familiar topics: pathophysiology, anatomy, psychology, and pharmacology. Tuition costs $15 per month, which is significant considering that the average Haitian family earns about $365 per year. The students informed us that nursing positions are rare in Jeremie, and that they will have to move elsewhere to find positions. Given that the nurse-to-patient ratio in Haiti is 1:1,000, they will no doubt be put to good use. They were particularly interested in asking us about scholarships and jobs in the States… We were grateful for the opportunity to visit and see what nursing school is like in Haiti.
After the school, we then headed to the public hospital in Jeremie. The hospital’s one luxury is its breath-taking million-dollar view, set atop a hillside overlooking the ocean. Compared to other hospitals in the developing world that we’ve visited, we agreed that this facility was relatively calm, quiet, and surprisingly devoid of crowds. This is probably because of the prohibitive cost of care, the distance from villages, and general lack of supplies (including running water and medicine). Many of the providers are Cuban doctors, who travel throughout the developing world providing health care service to those in under-resourced communities.
We visited the pediatric unit, where we saw an infant with jaundice (recovering well) and another with possible bacterial meningitis or malaria (and a poorer prognosis). We then visited the maternity unit, which has a tiny delivery room with two beds for delivering and catching babies. (Most Haitian women deliver at home with lay birth attendants; Haitian Health Foundation and KOMBIT health workers aim to identify women with pregnancy risk factors so that they can deliver with skilled providers).
At the hospital, we also saw the post-surgical recovery area for women post C-section. Unfortunately, we learned that most women forgo pain medications after C-section because of the prohibitive cost of medications.
After the hospital, we piled back into the Land Rover and headed off for a lively drive along bumpy dirt roads to the remote village of Douraton. If you closed your eyes, you might swear you were on a ferry, not in an automobile. The unpaved roads had obstacles such as big rocks, ditches, and a river, but our trusty Land Rover (and driver!) ensured that we made it safely. The 1.5-hour drive to the village was breath-taking—passing through dense groves of palm and mango trees set amid rolling hills and occasional ocean views. Traveling through this remote and verdant department of Haiti, it can be hard to believe that the rest of Haiti is so deforested and dry.
We arrived at the village health post around noon and immediately started assisting the health workers with pre- and post-natal visits. We measured fundal heights, used a Doppler to detect fetal heart tones, checked blood pressures, tested hemoglobin levels (for anemia), and weighed newborns. After assisting with maternal visits, we got to work setting up for our THIRD health screening with the HHF village soccer girls! We conducted this screening entirely outside in a setting atop a hill overlooking rolling green hillsides beyond. With help from our Haitian translators BaBa, Mundi, and Missus, we performed our first aid and choking skit for the third time to an attentive group of teen girls. At this point, all of us in Team Haiti can all teach basic wound care and the Heimlich maneuver for choking in our sleep!!
After the skit, we provided anemia, blood pressure, and BMI screenings for 59 girls and tested their retention of what they had learned. Like yesterday, most were able to remember key teaching points from the skit. We provided iron supplements for the three girls identified as anemic. Happily, we had a lower number of girls with anemia in this screening—perhaps the mountain air and remote village life is protective?? :)
After packing up and saying our goodbyes (Bye-Bye in Haitian Creole), we piled our sweaty—but content—selves back into the Land Rover, and headed back to Jeremie… Tomorrow, we’ve got a day off for the national holiday of Corpus Christi. We’re celebrating by heading to a festival in town and then the beach, of course! Should be another interesting day in Haiti, bon chance!
Alo, nou fatige! Mesi, tout moun!
(Now, we are tired. Thank you, all!)