Daniel--Update 3--March 2014

Daniel--Photo by John Carroll

I stumbled into Drouillard again today, made it to Daniel’s flat, and sat down and talked to him about his life and his prospects for repeat heart surgery.

Daniel is 33 years old now and was born in Port Salut, a seaside village on Haiti’s southern peninsula. He said that when he was growing up he had many bouts of fever with painful and swollen knees that put him to bed. Like many rheumatic fever patients he does not recall having sore throats as a child. Untreated strep throat is the main cause for rheumatic fever in the developing world.

Daniel told me that in 2001 when he was 19 years I examined him for the first time at Hopital Lumiere, which is a little mountain hospital several hours from his village. His exam was consistent with heart failure from a very leaky mitral valve which was caused by his rheumatic fever.

We brought Daniel to OSF in Peoria where he was successfully operated in 2001 and had his diseased mitral valve replaced with a porcine tissue valve. 

Daniel did well postoperatively and returned to his village. He continued in school and made it almost through high school in nearby Les Cayes, Haiti’s third largest city. 

However, due to his health history and their extreme poverty, Daniel’s mother insisted that he and six of his brothers and sisters move into Port-au-Prince so Daniel could be around “the doctors” if he needed them.

So about five years ago Daniel and his siblings moved into this terrible slum–Project Drouillard. This huge cement maze is located right next to Cite Soleil and Daniel describes the slum as “twop dezod” which means “totally disorderly”. And by that he means there is too much shooting, stealing, and gang activity that always surrounds them. However, other than Daniel being held up at gun point on one occasion a few years ago, he and his siblings have had no problems with the “bandits” in Drouillard.

Daniel told me that one of his sisters who was 34 years old became pregnant in 2007. She seemed to be doing fine but one morning when she was eight months along she reported that she did not feel well. So the baby’s father and some of Daniel’s siblings took her to a private hospital and the doctor told her she was anemic. One of Daniel’s brothers donated blood and she was transfused and moved into the operating room. Daniel told me that she had an emergent C-section but the baby was dead and his sister died on the operating table.

As mentioned in the other posts, not long ago Daniel started becoming short of breath. He sent out e mails that he was sick and we were able to get an echocardiogram which showed his porcine mitral valve is now scarred down and almost completely closed. Daniel needs heart surgery again to have his tissue mitral valve replaced with a prosthetic mitral valve.

Daniel and I were seated on white plastic yard chairs in his flat directly over where his four brothers and sisters sleep each night on the cement floor next to his bed. Only one of the five of them has a job–one sister is a teacher. (Another sister lives two doors down with her husband.)

Several weeks ago I gave Daniel baby aspirin, lasix, potassium supplement, and penicillin tablets. He has them neatly organized on a table and he states that he feels much better now and that he is breathing well. And he told me that the multivitamins have given him “strength”. I think much of this is placebo effect but that is ok. We will take some happiness here.

I asked Daniel if he thought that I was going to find a hospital in the United States to accept him. He told me, “Don’t worry and don’t be afraid.” I asked him if he was “worried or afraid”. He smiled and looked me right in the eyes and said, “Never”. Daniel then slightly touched the back of my left hand with his finger and said, “Jesus works for you and me.”

At that point I told Daniel that I may be leaving for the States in a few days but that I would keep looking for a medical center. He said that he would be fine “because you left vitamins for me”.

Daniel helped me quite a bit today. So I think I need to go back and check on him again tomorrow.

John A. Carroll, MD

www.haitianhearts.org

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Daniel--Update 1--January 2014

Daniel--Photo by John Carroll

Daniel continues to hold on in Haiti and appreciates all of the concern for him in the States.

Daniel had his mitral valve replaced with a tissue valve at OSF in Peoria in 2000. But this tissue valve is now scarred down and needs to be replaced.

We still have not found a medical center to accept Daniel for heart surgery. And we are looking hard.

I spoke with an out of state heart surgeon this morning. He asked me if OSF had accepted Daniel back for repeat heart surgery. I told him that they had not and he commented that medical centers do not want to operate on “international patients who have had heart surgery elsewhere”.

This is a common sentiment by medical centers. And it is all the more reason that OSF should re-accept Daniel and live their Mission Statements.

John A. Carroll, MD
www.haitianhearts.org

Daniel--Update 2--

Daniel--Photo by John Carroll

I checked on Daniel again the other day. He lives in a slum in Port-au-Prince called Project Drouillard which is considered to be part of Cite Soleil. The abject squalor of both places seems the same to me.

I carefully climbed the steps to his second story flat and entered the dark room which he and his five siblings share. Daniel looks better to me than he did in January and he proudly showed me his new Haitian passport which had been issued to him the day before. It took a month of hard work to get this and he keeps the passport tucked inside the front cover of his Bible.

However, we still have no medical center to accept Daniel for his heart surgery. We have contacted about 15 excellent people and medical centers but still don’t have a definite “yes” from anyone. I told Daniel I have no place to take him with his shiny new blue passport and all he did was calmly nod his head yes. He seems like an innocent man on death row who is still optimistic that his execution will be put on hold.

I remember the day in 2001 that Haitian Hearts had a group of five or six kids gathered and ready to go the next morning to the States for heart surgery. I put the kids and their family members in a guesthouse so I would not “lose” any of them in the chaos and mayhem of Port-au-Prince. We had a private jet arranged to come to Port-au-Prince to get all of us the next morning and everything needed to proceed smoothly for us to make it out.

The night before we were to leave I received a message from someone in the States involved with the flight that there would not be enough seats on the plane for all of us to fly. One of the kids would not be able to go. And so I had to decide which one would not go.

Daniel was the oldest “kid”. I factored in all of the various cardiac pathologies and the social conditions of the children involved and chose Daniel as the one who would NOT be on the plane the next morning. I remember telling him that he would not be making the trip and that we would try and bring him on a subsequent trip. Daniel took the news just fine and did not complain one bit and neither did his older brother who was staying with him.

When morning came I received another message that the pilot would make an exception and he did have an extra seat after all. (I think it was because an adult could hold one of the sick babies on her lap during the flight, but I can’t remember for sure.) I excitedly told Daniel the good news that he would be flying with us and would have his heart surgery. He responded with very little emotion.

Daniel hasn’t changed much since 2000. He is now a courageous Haitian man who is unafraid and takes each day as it comes. We need to give Daniel another chance. He has much to teach us.

John A. Carroll, MD
www.haitianhearts.org

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