Monday, April 22, 2013

The work, the wandering, the widening lens


The Work

Salutations!  If you read my last entry, the second cryogun arrived in the capital a week after my other one gently exploded,  and after being held in customs for 3 days, either because of tariffs or due to the fact that it looks like some kind of space-age weapon of destruction, I personally escorted it on the 7 hour bus ride back to the border.  When I finally screwed it to the tank of CO2 as we were loading all our stuff on motorcycles for the hills, I pulled the trigger and some nice frost appeared on the tip, GOAL!!!!! I have to remind myself not to get too "clinical" with you all, or God forbid, descriptive, when I talk about the 197 gynecological exams I did on the women of the greater Anse-a-Pitres region over the last 2 weeks.  I will leave you instead with the facts; I screened 197 women between the ages of 30-55 for cancerous signs of the cervix, treated 6 of them with cryotherapy, checked all of their breasts for lumps and bumps, uteruses and ovaries for abnormalities.  In general the women of this region are in remarkable shape despite having up to 12 children, most of them born at home alone or with a local "untrained" midwife, no running water and challenging hygenic facilities.  Although I was without lab tests to check for sexually transmitted diseases,  I saw very few clinical signs of anything pathological, and luckily nothing I would judge suspicious for HIV infection.  I was told by several Haitian health care workers that the women loved getting a comprehensive GYN exam;  they are concerned about what is going on inside them, and have a very limited concept of their anatomy, disease processes, etc so fear reigns as the imagination soars.  A number of them we found had fibbed their age in order to be checked!  Alison Parker, a childhood friend who is a nurse practitioner from Vermont,  accompanied me on the last week of my journey, we had a great back and forth on clinical impressions, she was welcome company and a good road warrior.

I had the pleasure of working with Dr. Robert Peigne, a well-trained, young, bright, compassionate doctor from the region I have known for several years now who did hundreds (I lost the count) of primary care consultations at the same time as I did the cervical screenings; your generous donations helped pay his expenses as well as for the medication we brought with us to the boondocks.  He encountered the usual array of hypertensives (many), rashes, gastrointestinal problems.  No cholera cases, no malaria or dengue, although we hear it is around.  Presently the Ministry of Health is on a campaign with USAID to treat everyone for worms and filariasis, which is caused by a mosquito borne parasite that invades the lymphatic system mostly of the lower extremities and can cause elephantiasis.  I have seen pictures of infected men whose scrotums reach the floor!!  I took my dose.
                                           Women waiting for screening in the clinic in Ansapit
Alison doing screenings in Majofre with my beloved nurse, Jeanne

Health care promoter, Jean Robert, distributing pills for vemin ak filaryoz

Me and Alison loaded for an hours' ride up to Thiotte at the end of the day

Me checking for kinks in the cryosystem, testing with an orange, in Thiotte



The Wanderings


One of the places we worked, Banane, has the gorgeous Pedernales River running through it, girls carrying water home from there at the end of the day




I guess goat heads are sold separately in Thiotte

 Le Souvenir, the post-Sandy restored boat that took us through the starlit phosphorescence from Grand Gossier to Ansapit last fall got rammed to bits yet again, now maybe forever disabled


My dream retirement home


I'm glad that typos happen elsewhere than just in this bolg


The Widening Lens


When we got to Majofre to do the final three days of cervical screenings and primary care consultations, I was thrilled to see the scaffolding up on the half-finished clinic and a team of guys skimming a smooth surface of cement on the rough walls.  This is an ongoing project for a few of us gringos and locals who want to realize the dream of having a full time functioning clinic in this remote district.  It was started several years ago and now continues with the funds and moxie of Monsieur Fritz, a Majofre native who worked for 30 years in autobody repair in the Bronx and came back here to live.  We are making progress getting the Haitian Ministry of Health to sign on, as well as forming an NGO both here and in the States to help with supplies, meds and salaries.  Dr. Peigne, who I mentioned above,  is committed to coming back to this roughed out building to do monthly consults, bringing specialists like dentists and optholmologists from Port au Prince.  I plan to return in the fall, stay tuned and thanks for the love, Louise



Clinic entry way

This is the local team of health promoters, leaders and Mr. Fritz (top right)  sorry that my early model i-phone has no flash making it challenging for black facial features at night


Patients waiting in one of the freshly skimmed rooms




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