Thursday, April 08, 2010

Medical Clinics in the Camps

In addition to going out to Chambrun, our medical teams got to spend time offering clinics in the IDP (internally displaced people) camps. My team spent a day at a smaller IDP camp where there were probably about 100 or so makeshift tents. We used a school bus to transport us and all our stuff around; the bus also served to provide some shade. This is the bus...When we backed the bus into the middle of the camp, within a minute a line had developed. Our translators and a couple of the guys worked on organizing the line and keeping people back so we had room to set up and start working. The Haitians were amazingly patient - once the line had formed, the majority of people were content to wait their turn, even if their turn was a few hours away and they were standing in the sun in 30+ degree weather for that whole time. This is what the line looked like at the beginning...Both nurses and doctors set up stations where we could see patients, in an effort to keep the line moving. Each station also had a translator. I didn't expect that I would see patients as independently as I did, but the doctors were fantastic - any time I had a question, they were happy to come over and see the patient as well. I saw mostly kids and babies, because my specialty is pediatrics and I was definitely more comfortable with them!! (I don't know what to do with adults anymore...)

The patients that I saw during the clinic had pretty unremarkable medical problems - lots of colds and coughs, mild dehydration, and tons of skin infections (usually ringworm). No injuries from the earthquake - most of those had already been dealt with at other clinics/facilities. There were definitely a lot of conditions that were caused or worsened by the stress and trauma people had experienced, though, especially for the adults. Quite a few kids and adults came in with complaints of not being able to sleep since the earthquake. We had a trauma counselor available, and she spent the day talking to people about their experiences during and after the earthquake.

One experience that I had during the clinic sticks out to me. I was seeing kids all day, so this older lady (maybe in her 60s) comes over with a girl who was about 4. She sits down with the kid on her lap at my station. Through the translator, I ask what the problem is for the girl. The lady and the translator get into a long discussion at that point. The translator then tells me that the lady doesn't know the girl and doesn't know if anything is wrong with the girl - she just wanted to be seen quicker so she found a kid in the camp who would stand in line with her.

I felt really frustrated at this point - it was late in the day, I was hot and tired, and I was feeling taken advantage of. I told the lady that I really only know about children, and I might not be the best person to treat her, but she could tell me and I would try. She told me her complaint, and while I don't remember what it was exactly I do know that it was minor. She then starts to tell me that the girl is sick with a cough, which I had a hard time believing since I had just been told that she didn't know the girl! I was getting more frustrated, so I got up and took a break. One of the doctors, Dr. Parkin, was much more graceful than I was and he told me to send the lady over for him to see.

Afterwards, once I had rehydrated, showered, and cooled down (literally and figuratively), I did some reflecting on this situation. I found my response to this lady interesting...her actions may not have been right, but at the same time, I also didn't take the time to look at her situation a bit more holistically - what had she experienced, and what were the reasons for her actions? She was an example of how easy it was for me to forget, in the midst of seeing patient after patient after patient, that all of these people had experienced significant trauma and perhaps needed an extra bit of compassion or understanding from me.

I could keep describing the mobile clinic in writing, but I think pictures might do a better job...