What's the Point?

 

Guerdina

This morning I read an article in The Guardian about Afghanistan. 

The byline stated--

"Crushing poverty is forcing starving displaced people to make desperate choices"

The article describes how Afghans sell their daughters because they cannot feed them and sell their own kidneys for money to provide for their families. 

Can you think of anything more terrible? And the last sentence in the article quoted the mother who was allowing her kidney to be harvested: 

 

"I am happy with my own death, but I can’t tolerate seeing my children hungry and ill’,” she says.

So this is an intense and sad article to read on a Monday morning--or on any morning. But what is the purpose of this article? Will it improve the lives of poor Afghans as they battle the cold winter? Isn't this situation just too overwhelming and too far away for us or for anyone to act on behalf of Afghans and actually improve their lives? 

And this article made me wonder how do my posts over the years about the daily atrocities in Haiti improve anything? Are many of the posts depicting one Haitian tragedy after another turning readers off and away from suffering Haitians just 500 miles from our shore? Why would someone want to help Haitians after reading my posts? Who wants more responsibility than they already have when the hurdles to help seem so overwhelming?  

One recent challenge I have is Guerdina. And her father texted me last night with a new problem that she is having. 

Guerdina is a 15-year-old Haitian girl who has Rheumatic Heart Disease and who I  examined for the first time in 2018. She proceeded to have heart surgery on her mitral valve in the Dominican Republic in 2019. However, several months ago her father texted me that she was sick again and hospitalized in Port au Prince. 

From what I have painstakingly gathered over the last several months, Guerdina may have had Acute Rheumatic Fever again. She was in the hospital for several weeks with fever, joint pains, anemia, and generalized weakness. She is better now and home with her family. But her recent echocardiograms have shown that  she needs repeat heart surgery.  

Over the last several months, Haitian Hearts has sent her father many hundreds of dollars for her medical expenses, including medication and imaging studies, travel, food, lodging, etc in Port au Prince. And during this time period, I have found two heart surgeons in the United States who have agreed to operate Guerdina. However, the gatekeepers to the hospitals have not agreed. (Who would have ever thought a few years ago that heart surgeons would lose out to hospital administrators deciding who gets heart surgery.) And even if she were accepted, obtaining a visa from the American Consulate in Port au Prince for her to travel to the States, would not be easy. 

So Guerdina is stuck in Haiti right now. It is possible she can return to the DR for repeat heart surgery, but this could be  difficult. The civil unrest in Haiti is very dangerous for her to be in Port-au-Prince acquiring the appropriate documents for travel and the severe Covid outbreak in the DR is overwhelming. Approximately 40 percent of Covid tests were returning as positive in Santo Domingo several weeks ago and this could preclude timely surgery for a number of reasons.  

So what is going on with Guerdina now? 

Her father sent me a photo yesterday of her with a swollen face. This has occurred since her recent discharge from the hospital. Does she have nephrotic syndrome which can cause facial edema? Or does she have another problem closer to her heart obstructing flow and causing her face to swell? She needs a good medical workup to find out and right now she is ages away from the hospital in Port. 

So I wait and watch this young girl go without the medical care that she needs. Her Haitian physicians have done a lot for her during the past couple of months, but she needs much more. Guerdina does not have a super complex medical problem and she is very treatable. But Haiti is not the place to provide her this treatment...especially not in 2022. 

Posting about Guerdina helps me. But, like the Afghans one-half world away, I doubt it will help her get the care she needs. 

John A. Carroll, MD

www.haitianhearts.org