Boston and Covid-19 (but not the Boston you are thinking of….)--July 2020

 

Community Health Agent, Boston–July 21, 2020 (Photo by John Carroll)

Cite Soleil is a large slum in Port au Prince. The estimated population is several hundred thousand.

Soleil is divided into zones/sections with names such as Boston, Brooklyn, Beleko, Bwa Neuf, Project Linto 1, Project Linto 2, and Little Haiti. 

This morning I went to Boston and visited a clinic staffed by community health agents and a nurse who live close to the clinic. The two Haitian doctors who normally work in this clinic have not been at work for several months due to the serious gang violence in the slum. 

I asked the chief health agent if he was seeing patients with coronavirus in Boston. He replied that during his home visits he was seeing MANY patients, both kids and adults, with signs and symptoms consistent with COVID-19.

The following are the most salient points he made regarding COVID-19 in Boston–

The most common signs and symptoms of COVID-19 are fever, headache, and cough.

None of his patients have had the confirmatory PCR test since the pandemic started. 

He treats fevers with paracetamol which is a miracle drug according to him. For people with reactive arthralgias from the virus, he treats with acupunture. (Not kidding!)

Sicker patients who have high fevers and fatigue get IV fluids. He has no access to remdesivir or dexamethasone. The cubbards in his clinic are bare. His patients drink home made tea at home.

He is unaware of anyone in Boston dying with coronavirus-like symptoms.

His patients are comfortable with him in their home as he encourages them to get better.

As we all know, COVID-19 has many INDIRECT health effects throughout the world. The supply chain to clinics can be broken. Babies go without vaccinations. There is a higher incidence of malnutrition/wasting in low and middle-income countries. And maternal mortality rates can go up for many reasons.

But in Boston and all of Soleil, there are significant negative indirect effects of gang violence, too, and this may be more important than the indirect effects of COVID-19.

For example, the Boston clinic only had one patient this morning. A young mother brought in her 7-month-old baby who had fever, vomiting, and diarrhea. Mother stated that the baby had been sick for a “long time” before she braved the streets to bring the baby today.  There are hundreds of babies like this in Soleil who have had little to no treatment during the gang violence.

At the end of the day, we will never know how many people will have had Covid-19 in Haiti. This good community health agent in Boston will continue to press forward doing all he can to help his neighbors and friends with their illnesses.

And we need to remember that the indirect effects of Covid-19 as well as violence on the streets both negatively affect the health of millions of people around the world.

Cite Soleil–July 21, 2020 (Photo by John Carroll)

 

John A. Carroll, MD

www.haitianhearts.org