super relieved to come upon our clinic site on Friday. Shaded by
trees, and a second story, our four room clinic had only the humidity
and human demand with which to contend. It rained right after we
opened, but did little to slow the numbers of locals flocking to our
clinic.
Nestled in amongst homes of varying wealth, the school was across the
road from a clinical lab. When we passed it in the morning, it had had
a cinder-block fire in the front yard, complete with chicken-stew size
pot. The image was surreal. It reminded me of the home of the local
healer (read: witch doctor) I'd visited in a township in South Africa.
Chickens out front, a fire going, etc. All of the doctors had wanted a
picture of this place, but were too busy to get away. Kelly and I
snuck out the gate of the school in the late afternoon to run down the
street and snap the pic. Which will be posted after we get back to a
computer.
This clinic served a different population than those earlier in the
week. Many of the patients were Haitian, and spoke only Creole.
Luckily, there were ample young people in the surrounding community
who showed up as patients and offered to work as Spanish-Creole
translators. As many of our providers, including Lynne, are fluent in
Spanish, it didn't seem to cause much disruption.
In the morning, I helped set up our suitcase pharmacia. Which was
established in the school's kitchen. Which contained a tarantula up in
the corner of the ceiling/wall that could have at any moment jumped
down and caused grave cardiac events in those working the pharmacy. At
one point later in the day I'd gone back in, only to fond our eight-
legged friend missing. He was quickly located a short distance (on the
ceiling) from his morning position, but all working in the general
area were astutely aware of his movements. Again, picture to follow. I
couldn't resist. He was probably the width of my hand (plus fingers),
when moving. Apparently his friends also visited various sleeping
quarters around the orphanage, but we luckily dodged that bullet.
After lunch, we began registering the afternoon's patients. News of
our free clinic spread fast, and at one point the giant white metal
rolling gate at the entrance to the school was forced open by the
crowd outside, and they
surged toward registration, yelling. This lack of control caused us to
reconsider our methods of entry, and in a short time, control was
restored.
As with all clinic days, patients had to wait between screening and
seeing a provider, and then again for their prescriptions at the
pharmacy. This down time, and abundant shade allowed for some brief
education. In the morning a group of our volunteers recited the
English and Spanish versions of our anatomy flip charts, while acting
it out. It was like an anatomy version of Simon Says. The parents and
grandparents enthusiastically joined in, and the monotony of the wait
was eliminated. The same volunteers offered one-on-one instruction on
teethbrushing, as all patients received a toothbrush and tube of
toothbrush. As our other group offered a dental clinic to the
community back in Jaibon at the orphanage, and did a crazy number of
extractions, we thought it was a worthy topic. Grandmas and kids alike
motioned along with the instructors, which was super cute. As this was
going on, I was filming the anatomy lesson.
In the afternoon, a similar downtime arose. Shortly before departing
for our trip to the DR, I had received the gracious donation of two
CPR manikins from Jack and Anita Grogan of the Sudden Cardiac Arrest
Association. I had purchased Laerdal face shields from Life Assist to
allow for hands-on (actually, mouth-on) training before I left, and
Friday was the day that I got to bring them out! Other teams had
considered using them, but when school was cancelled (either a holiday
or teacher strike, it was never clear), they had to scratch their
original lesson plans. Which was to my benefit, as I was no longer
depriving them of the manikins!
Kelly and I first inflated the infant manikin, as it most resembled a
full human, and there were many babies in the crowd. We were hanging
out with our Creole translator, who was also learning English. As our
little group read from the English and Spanish booklets enclosed with
the manikin, children began gathering around, looking on in
curiousity. They too wanted to see the muñeca (dolly), so we found
some desks, and began an impromptu "baby choking" training. The kids
were really fast learners, and our little group caught the attention
of the grandparents of our participants. As I explained (as best I
could) that the doll was "un muñeca por RCP" (CPR manikin), and that
we were modeling how to dislodge a foreign object from a choking baby,
they got really excited. They encouraged the kids, and explained to
others who walked up to check out our scene. When their prescriptions
came up, and they needed to head home, the grandparents hugged me.
After our group partially disbanded, we went in search of others
waiting in line. We found the provider waiting area, two rows of chair-
attached desk units in the outside breezeway adjacent to the
courtyard. Again, baby muñeca was a big hit. This partiular group of
patients waiting were predominantly Creole speakers, but those who
could speak Spanish and Creole repeated and translated from the back
row of desks. The group was mostly mothers and elementary-aged
children, who were all very excited to learn about choking babies
(many of the moms in the general area were holding squirming
toddlers). We repeated our interactive lesson, and used a bunch of the
Laerdal face shields to let the kids attempt rescue breaths. One
little boy, whose desk top I'd borrowed to place the manikin, was very
stoic, but kept watching. As we demonstrated, and the other kids
successfully got their rescue breaths in, causing the little plastic
lungs to inflate and the tiny chest to rise, he became more
interested. I gave him a mask, and motioned that he could give it a
try. He hesitated at first, but got the chest to rise on the first try!
After a while, the line began to move, and our area became congested.
Kelly and I went down toward the group waiting to be registered and
screened. We set up shop on a blue table under a tree, and I was
walking her through the scenarios (with Weisser in my head the whole
time, "Baby's looking at you..."). A woman walked up and tried
speaking to me in crazy fast Spanish. I had her pause, and called over
Amy, one of our fluent group leaders. She explained that the woman was
a nursing student, who was drawn towards medicine when her sister's
husband and four year old child were in an auto accident a few years
prior. They didn't survive, and the woman indicated that the child may
have survived if someone at the scene had known CPR, but no one had.
She continually repeated, "it's very important, very important." I had
Amy ask her if she was familiar with "RCP," and she said she was. I
asked her about CPR training in the communities, she indicated that
the local doctors provide classroom instruction on the subject in the
primary schools, but that the training is mostly blackboard-based. She
indicated that students are instructed to find the proper landmarks on
themselves, but no further hands-on training is provided. They do not
have manikins upon which to learn and practice. The new Heimlich
training devices they advertise in JEMS would make a world of
difference in this community.
We wrapped up our training as the clinic saw its last patients, and
headed back to the orphanage to pack up for our next morning
departure. After dinner we had a round-table recognition group talk.
After the power killed, we broke out the flaslights, which were
finally replaced by generator-powered lights. However, this didn't
help the water issue in the showers, and while I was hand washing an
outfit for the plane using a bar of Ivory soap and a wonderful
headlamp (thank you!!!), two girls tried to hop in the showers. I paid
them little attention until they ran out of water. They'd soaped up
using the risidual water pressure left in the lines, but after that
was gone, and the pump had no power, the two soapy girls were SOL
without water. Two of the sinks had water, somehow, so they shuttled
cups of water back and forth to rinse off. All while holding their
respective flashlights, as we were in a cinderblock building with no
moonlight.
After laundry, I started packing, and fell asleep.
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