November was an eventful month for our Confidence Health Center. We treated 1,487 patients this month, including a number of children with respiratory infections. Did you know that respiratory disease is one of the leading causes of death in children in developing countries? (https://www.who.int/data/gho/data/themes/topics/indicator-groups/indicator-group-details/GHO/causes-of-child-death) Here in Oriani that definitely proves true, particularly in the winter season when viral illnesses tend to be more common. We treat many coughs, colds, and pneumonia. Our clinic does not have regular inpatient capability, but in addition to antibiotics and steroids these patients often need supplemental oxygen for a couple of days to get them “over the hump” and well enough to send home. Next to the clinic we have a little one-room house, called the ti kay, that gets used quite a bit for this. Unfortunately, our oxygen concentrators use quite a bit of electricity and easily overload our solar power system, so we run a small generator on the nights that we have overnight patients. Definitely more of a headache than keeping overnight patients in the States!
Malnutrition is unfortunately another condition we see from time to time. In children, malnutrition commonly presents in one of two different ways: marasmus, which is the more “obvious” form, involving muscle wasting and low weight; or kwashiorkor, which can be deceiving at first because the child has facial and limb edema that actually can make them appear chubby at first glance. Kwashiorkor is the most common type in this area and we have learned to identify the signs fairly quickly. Our neighboring clinic, Access Health Alliance in Forè de Pens, has a malnutrition program that we refer patients if they meet certain criteria. If the child is sick enough to warrant hospitalization we refer them to St. Damien’s Hospital in Port-au-Prince. Unfortunately, sometimes even our best efforts go in vain. This month we had a 16-month old baby with severe malnutrition. The parents seemed to be warm and caring and why the child was allowed to become so malnourished wasn’t clear. He was very weak and lethargic, although he was still able to drink. He had already been enrolled in the malnutrition program for several weeks but was apparently not responding to treatment. His legs and face were grossly edematous and his hair was thin and red colored, the hallmark sign of chronic malnutrition. We gave him fluids and nutrition, but a few hours after being seen in the clinic he passed away. Cases like these always challenge us to find more ways to help prevent these outcomes, while making us thankful for the ones we are able to help.
Continue to pray for the work here, that we can have the wisdom to face the challenges at the clinic, and that at the end of the day the patients can be pointed to the Great Physician who can heal the soul and body both.