Pediatric Ponderings

Some random things from seeing kids in the clinic today…

It is really hard to put on powderless gloves when your hands are hot and sweaty. After laughing at my attempts, the nurse finally showed me the trick of shaking it out, holding wide the wrist and blowing into it, and squeezing air down into the fingers (don’t try this if the gloves need to be sterile ). It was still a bit of a challenge, but at least my fingers were starting to get in the right slots…

Much of pediatrics is the same wherever you are – kids get colds and ear infections and mothers worry about kids. The main difference here is that the moms aren’t all asking for the most expensive newest antibiotic and amoxicillin still seems to work.

Some things aren’t the same though. I have been surprised to find that most of the mothers don’t know the birth weight of their babies (even when born in the hospital) and that the clinic workers also aren’t very tuned in to what babies weigh. They had one 2 month old weighing 28 pounds. Most weights are rounded to the nearest kg (2.2 pounds)!

Power outages, while inconvenient to me while seeing patients must really be annoying to the US surgeon here this week. There is no back up generator at the hospital.

Unneeded suffering is disturbing wherever it happens. I saw what was probably the saddest case of my career in pediatrics today. A totally cachectic 2 year old girl was brought in by mom, who has one other at home and one on the way. The child was normal till 6 months ago according to mom, when she started to waste away. She was just a skeleton with pale flesh (really noticeable in a Haitian child) and horrible scaling rashes and a pitiful pleading look in her eyes. In taking the history, I was asking mom about HIV history. She handed me a paper to show that she was HIV negative, but somehow she had never noticed and no one had ever told her that also on that slip was that she was RPR positive – indicating syphilis. This child requires more lab work and more care than could be provided here, but very likely has congenital syphilis and protein calorie malnutrition. This could have been prevented! The positive is that there still is time for mom to be treated and hopefully her current pregnancy will have a better outcome. I thought of taking a photo of Julie, to include, but then decided that she is indelibly etched in my mind, and a photo here would not be respectful and caring of her dignity. Do please pray for little Julie though.

It was a tiring day – after mainly seeing the children of the staff at the hospital, the word has gotten out that there is a pediatrician here, and many are coming who have been in need of care for a while, some in need of more care than I can provide here, and sadly at times, more care than is to be found in all of Haiti at this point. Some valuable programs disappeared with the earthquake and so a country with poor health care coverage to begin with now has even more access issues and holes in vital areas of care. Pray that the various organizations working here can start to coordinate efforts and work together to provide the needed services and care and that aid goes to those who should be receiving it. Pray also that both Haitian and expatriate professionals who see the various areas where their expertise could make a difference will be willing to view this as an opportunity for ministry and for giving back indirectly to all who have made their current situation possible.

Thanks for continuing on this journey with me.