When Grandma is Gone....

Maria and I left for Haiti on July 19, 2006. The main objective of the trip was to move Luke in with us in Port-au-Prince, complete his adoption, and bring him back to Peoria with us. We had no idea we would be in Haiti for the next 7 months. (The entire adoption took 20 months.) 

Port-au-Prince was extremely dangerous in 2006 with kidnappings occurring daily. No one was exempt from being taken. And ransom was what it was all about. 

Due to the kidnappings, Maria, Luke, and I rarely ever went anywhere. We had no car and so when we did venture out, we walked and used public transportation. And we tried to change our routes often. 

However, while Maria and Luke were getting to know each other and reading "The Big Red Dog" became a daily ritual for them, I was able to work in clinics--which is what I loved to do. 

The post below is about a day in clinic in Port-au-prince. Maria was with me this day in clinic. But this may have been the last day she worked with me because we picked up Luke the very same day and became a family.

Tuesday, July 25, 2006

When Grandma is Gone....

July 21, 2006

We are working at a clinic in Port-au-Prince right across the street from the hospital where we admit the sickest kids. We walk to this clinic in the morning and pass three Haitian police. The officers, one with an automatic rifle, stop the oncoming traffic to check the registration of the vehicles and verify the driver’s license. Several weeks ago a Haitian lady was attempting to stop a carjacking just outside our clinic in the middle of the day and was shot to death in the street by the thieves.

In recent weeks, the kidnappings have increased in the capital and all the Haitians tell us the “streets are bad”. Many warnings on the internet talk of the renewed chaos and violence in Port-au-Prince. Dozens of kidnappings apparently occurred this month. Deposed President Aristide’s birthday was the other day, so he was blamed again for the violence, even though he now lives in South Africa. We were warned by an American friend, who was kidnapped last fall, not to walk the streets in this part of PAP, and he offered us a vehicle he sent down for our use. But we feel safer on foot and taking public transportation.

Today was a potpourri of pathology in the Haitian pediatric clinic. All pathology is bad especially if you are the one who has it and lives in Haiti.  

One of our first patients today was a baby girl named Tamaika who weighed about ten pounds and was nine months old. She had been having vomiting and diarrhea for one week and had a temperature of 105 F. Her mother stressed the fact that she has no job or money and could not take the baby to the doctor before today.

The baby was obviously very dehydrated and severely malnourished. Her eyes were sunk and her skin tented when pinched. Her arms and legs were sticks—almost completely devoid of muscle. But, as a true Haitian would, she would swing her arms at me and fought when I attempted to examine her.

A baby like this can be septic along with being dehydrated. We brought down Rocephin and gave the baby a big dose immediately and admitted the baby to the hospital for IV antibiotics, fluids, and work up.

A five-year-old girl, Cynthia, came with chief complaints of two weeks of shortness of breath, fever, lack of appetite, and crying with abdominal pain at night. Her attentive father and mother offered the history at the same time. The girl looked well developed but would scream out in an irritable fashion and then almost fall asleep the next second. Of note were the bounding carotid pulsations on the left side of her neck and the hyperdynamic pulse at her right elbow. This meant that her blood was so thin it was causing her vessels to expand and collapse quicker than normal thicker blood would do. Her conjunctiva was white (instead of pink) and her tongue and mucous membranes were very pale. Cynthia's liver and spleen were enlarged and intimately involved with her anemia. And her heart rate was only about 100 which told me that she had compensated for her anemia. In my opinion, Cynthia had been this way for a while. Sickle cell is most likely with some iron deficiency contributing to her severe anemia.

So we admitted her to the hospital. And when her blood was drawn it looked like pink Kool-Aid. Her hemoglobin returned very low at 2.5 and her white count was very elevated at 59,000. Cynthia's father was told that he will need to go to the Haitian Red Cross and donate blood for Cynthia.

A beautiful five-year-old little angel was one of our last patients and was brought in by her grandma who appeared to be about 60. According to grandma, the child’s mother had died one and one-half years ago when “she had abdominal pain and became thin” in a city 12 hours from Port-au-Prince. Grandma is now doing another family’s laundry in Port-au-Prince to support the little girl. The girl’s checkup was pretty good except for anemia and pneumonia.

At the end of her exam the little girl kissed my wife Maria when she got a piece of gum. As grandma and the little girl left the room Maria wondered what would become of the little girl when Grandma is gone.

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Thoughts in 2021--

• 2005 and 2006 were bad years for kidnappings in Port-au-Prince. 
• And in 2020 kidnappings resurged again. I am not sure if the primary idea now is to kidnap for destabilization reasons or for ransom like it was 15 years ago. Either way, kidnappings unnerve the population to a great extent. Last year parents were walking their kids to and from school. Haiti does not need this trauma.