Day 4
Another day in the clinic. As mentioned, the clinic is free and an outreach of the mission. Some common things you see here are as follows:
1) Headache. Probably the most common complaint and can be related to the bright sunlight exposure very day, poor non-corrected vision, oppressive dust that is present in this country, and exposure to smoke from cooking over charcoal. We can refer patients to the eye teams that come in three times a year, so I did that a few times.
2) Stomach ache/"acid". Frequent complaint. Tums usually helps. If not, we start them on Pepcid then move to Prevacid.
3) Vaginal infections, UTIs, STDs. We see this all the time. We have a lot of Diflucan now we can give for yeast infections, and antibiotics we can give for the infections.
4) Breast lumps/mastitis. Common with moms who Breast feed to get an infection. Most lumps even in the States are not cancer. Can be successfully treated with antibiotics.
We use antibiotics in Haiti that are often not effective in the USA because most here are antibiotic naive because of poor healthcare. It's not a good thing that many ailments go untreated, but it is good that the older cheaper antibiotics work well here.
Sometimes, patients will have ailments we can not fully treat because of lack of materials and supplies. A woman yesterday claimed no BM for 6 weeks

she was seen 4 weeks prior with the same complaint and given stool softeners, but those had not helped. She was having bad abdominal pain, and I wanted to give her an enema, but we didn't have it available. I gave her a big jar of Miralax and had her drink some in front of me. We instructed her to come back the next day if she had no BM, and I didn't see her here today. Hopefully that means she was able to go, but I'm not sure of any outcomes unless they come back. If she presents again, I'll figure out something else to do for her. Sadly, I would guess she probably has some sort of colon/rectal cancer. UPDATE : This lady came to the clinic today just as we were leaving. She was still in incredible pain. We still had no enema, and there is no where within 6 hours to get one. We did find some children's glycerin suppositories. We put her in an exam room. I examined her, and she does not have rectal cancer or any sort of distal blockage like I thought she might. After the suppositories, she was able to go a tiny bit, and I think she will be able to go more later. I feel much better about that situation now.
Another patient presented with joint stiffness and severe pain. He had a slight fever. We are pretty sure he had a mosquito-borne disease called Chicquengaya (no idea how to spell this one and can't reference at this time as I am just writing on my notepad). Since this is a virus, the only thing to do really is supportive care (Ibuprofen for pain and drink plenty of water). It's usually better after 10-14 days.
I brought some medicines. One I brought was Flomax. It belonged to a friend's uncle who is a sort of hoarder. She gave me his medications to sort thru, and he had almost 200. In Haiti, we always are having contact with middle aged/elderly men who can not pee or complain of frequency. This is a perfect drug for them, and it was perfect in this situation. Hopefully he will follow up, and it will help him.
Voodoo is a powerful force in Haiti, and it is no joke. One of the missionaries shared last night, and I'll try to include some of the things I learned. When she first moved to the Mole and they were finding suitable land to buy, many local voodoo practitioners came to her house. They had with them almost 200 animals. During the night, they slaughtered these animals, and literally, the street in front of her house ran red with their blood. They banged their drums over 24 hours straight and finally left without scaring them off.
She went to a voodoo service once. She said the service started with the voodoo priest biting the head off of a dove. He swallowed the head then slung the dove around showering the close members of the crowd with blood. His assistant then did the same thing. This was supposed to be a good thing for the crowd members. She said there were many children at the service in a similar way that we might take our own children to church. Near the end of he ceremony, the priest told the crowd that if their family was in need or sick or hurting they should sacrifice their youngest child (to some particular god; there are many gods in voodoo). The next day, the community had 4 dead children.
Curses "work" most of the time often because the voodoo priest will hire someone to physically harm the person who is cursed. I have been in a voodoo house more than once, and the pure oppressive evil you can feel there is overwhelming. It can't be described. Voodoo priests do some healing at times too. They have access to malaria medicine in particular, and they are often skilled with herbal remedies and treatments.
The children endure some very scary things, and some will even immediately wet their pants when they hear the drums. There is also some terrible abuse in Haiti. There is child slavery. There is child prostitution. There are many instances of terrible child abuse. Sometimes tourists will exploit the children, and if the parent has given permission, it is considered a legal contract, and there is no recourse. Children as young as 8 are forced to make money by selling themselves. One child told her that each time a tourist took advantage of her she made a dollar and her mother told her she could not come home until she had $4 in her pocket.
Special needs children are considered outcasts and very often exploited. She talked about one child they would see in the village who was severely handicapped with cerebral palsy. Her parents would not clothe her, and she was often left to wander the street. The parents see the child as a curse from God because they did something very bad to deserve it. The child is often exploited physically, sexually, and emotionally. This particular child was rescued from a neighbor raping her in the front yard and taken to their orphanage.
One of the mission employees was punished as a child by being stripped of her clothes and made to sit on her stoop from 10 am until 5 pm with no water. The local people would walk by and spit on her and make fun of her for being naked. She thought she would die from having no water and being exposed to the sun. Another mission employee told of being beaten until she agreed to let the man have sex with her because beating a woman incurs only a day in jail while raping a woman has stiffer penalties. Since she agreed (after being almost beaten to death), nothing could be done to the offender.
As an outreach, the mission here decided to hold a cookout on the beach at dusk with a big bonfire and free food. Nobody came. The reason was they were scared the Macondas would snatch them up and take them to hell because the Macondas frequent the beach at night. Macondas are a kind of evil spirit. The mission also shows movies at dusk fairly often either in the town or at the mission. A boy came up to one of the missionaries after the movie and thanked her. She told him he was very welcome, and he told her that because of going to the movie, his daddy would not touch him that night (Haitians go to bed early because there is no power and get up early to start working when it isn't so hot).
The mission here has made a huge difference in curtailing many of these horrible acts and hopefully will continue to do so. I'll try to write later more stories that I have been told about. One group of 10 that is here is doing a VBS (Vacation Bible School) for the local children. I have a picture of one of the men working with that ministry being mobbed by the kids. Another group is working on some construction projects. We will be doing clinic tomorrow and then possibly going by boat to a nearby fishing village to do another clinic.
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