In Their Homes--March 2021

In Their Homes--March 2021

One of our Haitian Hearts employees (I will call him "Rony" for this post) texted me this morning from Port-au-Prince. He has helped me a lot during the many clinic days in Soleil during the past 20 years. 

Rony told me that his half-brother's mother, Nadej, was not feeling good this morning and so he went to her home to check her. And he carried his digital BP monitor with him.  

When he got there he noted that 45-year-old Nadej's left arm and leg were weak.  

Her blood pressure reading was 191/121. So with that information, he put her on the back of a little motorcycle along with his half-brother and they moved her to Rony's home so he could observe and treat her.

He had bought blood pressure medication off the street in the past and so he gave her some hydrochlorothiazide and enalapril that was lying around his house.

I am sure Rony does not know the difference between a "hypertensive emergency" and a "hypertensive urgency". He just knew Nadej was not moving one side well and he thought that since she had very high blood pressure his job was to lower her blood pressure. Which he did.

After several hours he rechecked her blood pressure and obtained 187/107. And she started moving her left side better with just slight weakness. Rony told me that she is alert and denies any pain anywhere. I told Rony not to give any more medication now. 

So why is this noteworthy? Well, Rony did a good job with this lady who was having a stroke with extremely high pressure. I would have been happy with these results if she was hospitalized in an ICU in the United States.

When I talked to him on WhatsApp, he told me that since Haiti is adrift and chaotic now with violence and dysfunction everywhere, Haitians need to do things on their own "in their own homes." They cannot depend on the State to do anything except impede their efforts and make things worse.

Nadej should be in a hospital today. But there are none nearby and the streets of Port are dangerous. Plus, Rony has no money in which to hospitalize her in a functioning hospital.

I will do my best to help Rony maintain her pressure in a good range while he cares for her in his home. (Lowering her pressure too much in situations like this can cause her to extend her stroke and that would not be good.) 

So, once again, sick Haitians are treated in suboptimal ways. We think of Haiti's violence with gangs and police doing bad things. And that is true. But the violence in Haiti more often adversely affects "average people" like Nadej and Rony who are pushed to do things in their own homes because that is their only real choice. 

Video of Nadej this evening. She could not move her left leg earlier today, but she is now walking without help.