Today started with advisement not to return to PAP until afternoon. The Ministers decreed to give themselves a raise plus a "gift" by taxing the middle class and poor (not the wealthy) to the tune of $50,000US per Minister (43 of them). So, the people of Haiti fought back with a strike. As the US State Department says "Even peaceful protests may turn violent..." So we were mindful to return when things started to calm down. We made the trek back after noon and started clinic at about 3pm in Port-Au-Prince. Over 100 people had been waiting to be seen since 7:00 in the morning. They were patient and smiling, nonetheless.
There wasn't any electric lighting in the church where we worked. However, with only 2.5 hours before sundown we still saw 30 patients. Patients who were bilingual volunteered to translate to help their friends and family. What an inspiration to see people who had spent all day waiting and then continue to stay to help their community.
Hypertension was by far my greatest concern. Some pressures were over 220/120. With no anti-hypertensive medications, the best I could do is educate them on dietary changes and follow up with a doctor if they could afford it. Several of these people had prior strokes.
I also had several little ones with allergies and sniffly noses, but one little girl (8yo) had chronic pain from sickle cell crises. I gave her some Tylenol and educated the family on hydration. She was beautiful and brave.
I also had a very sad case of a woman that was cachectic, shrunken to skin and bones, short of breath. She had gone to a hospital but they were unable to discover the cause of her illness. My guess is cancer, but where it is hiding is anyone's guess. Her lungs were clear, however, TB or HIV are very possible differentials. She had significant conjunctival pallor and clubbing of her fingers. I could only give her something for pain and iron pills.
I didn't have a lot of time to take pictures today, but I would have loved to have pictures of my son working the suitcase pharmacy and my friend Sharon (a super nurse) working her arse off trying to keep up with the triage of the deluge of patients. By the end of the evening, we were using a tiny Coleman lantern I brought and people's cell phone flashlights to see patients. As tiring as it was, I am happily exhausted and ready to go to sleep.
Tomorrow we have two clinics to visit. Wish us luck, pray, think good thoughts. It all helps.