In which I learn a little more about healthcare in this country

(Disclaimer 1: I wrote this on Friday and meant to edit and post it Saturday, but then I lost the device that gives me internet access and did not replace it until today. So, some of my time descriptions may sound a little off. Sorry!)             

 (Disclaimer 2: This post is super long! Not sorry.)

    

        I made three trips in and out of Port Au Prince in the last week. Our clinic has two patients who need a higher level of care than we can provide and I have been accompanying them to PAP to help them get the care they need. One patient is a four year old boy with congenital glaucoma who needs surgery to keep from losing his vision completely. We are in the process of getting him set up for surgery and an overnight stay at a PAP hospital Wednesday. The other patient is a 24 year old man who has had chronic leg ulcers for four years. The nurse I am filling in for has been treating him since January, working to get the wounds to close. He has been seen by multiple doctors, been on antibiotics and just about every wound care protocol you can think of.

       I want to describe for you all what it felt like to me getting these patients the beginning of the medical care they needed last week. Our journey starts at 6 am when we leave Grand Goave. We arrive in Port Au Prince around 8 am and get in line to be seen. A large part of getting medical care here is waiting in line. So, when we get to the hospital where we need to be seen, we sit and sit, waiting for our names to be called so that we can get in line for the cashier. Around 11 they call our name to be seen by the cashier.  After the (hour long) line for the cashier, we wait for our names to be called to be seen by the general medical doctors. The general clinic doctor sees us and recognizes that we already have a referral for a specialist. So we get in line to see the specialist. That doctor sees us, but then he wants us to be seen by a colleague. The colleague has a private practice. I exchange numbers with the hospital doctor. We are told to rush to the private doctor because the surgeon is making time in his schedule to see us today. We get directions and rush to his office. After a few wrong turns we get to the surgeon’s office. His (apparent) receptionist says he is gone for the day. We say we were told he was coming, so she lets us wait. She leaves for the day. We call the surgeon (per instructions) to let him know we have arrived. No answer. So we send a text message. We wait an hour. Call again. No response.

      In the meantime I am missing getting directions from the anesthesiologist about my other patient’s upcoming surgery. I call the referring doctor from the hospital. No answer.  We wait another 45 minutes. (Sometime during this process I realize the waiting area has a working bathroom. I am overjoyed.) We call the doctor again. Still no answer. It is now after 3:00 in the afternoon and I am getting nervous that I am going to miss the administration people I need to talk to for my other patient, so we decide to head back to the hospital.

      On the ride back to the hospital the referring doctor calls me back. I tell him the story. He says he is going to call the surgeon and call me back. Okay. We get back to the hospital. The older brother of the boy getting surgery is waiting outside and tells us that his mother and brother went in the building to talk with a doctor, but he does not know where. So we wait some more. I get awkwardly hit on. No thank you. The hospital doctor calls me back and tells me the surgeon is in surgery right now; we can talk to him when he finishes in an hour, but we need to call him. We call. No answer. I call the hospital doctor back and let him know. He says he is going to call his friend again. In the meantime the little boy and his mama come out of their consultation. It is now almost 5:00. We go to talk to administration to get prices for surgery and the hospital stay the boy needs. Everything has to be paid for before surgery. The hospital doctor calls me to tell me to call the surgeon right now about when we are going to see him. We call and decide that since he is not out of surgery yet, and it is so late in the day, we will come back in the morning. So we head off back to Grand Goave.

      The next morning we go back to PAP. We wait for an hour to see the surgeon. He evaluates the patient and decides the patient needs to have a test for the circulation of his legs. We get the prescription for the test and directions to THAT doctor’s office. After some more wrong turns we get to the doctor’s office. He’s not in today. Any other day, so long as we get there by 7 am. Just not today. So we go back to Grand Goave.

       My heart in telling this story is not to complain about the waiting or frustration. I have no right to complain about anything here. My goal is to begin to illustrate the layers and layers of healthcare challenges people face in this country. I have been able to face these obstacles because I have access to money and a vehicle and a medical background. The average Haitian, and most of the friends that I have made here, do not. I cannot imagine trying to get care without these things. Often, it is not possible. Will you join me in praying for my patients and their medical needs? That Wednesday’s surgery would happen without complications and that the other young man would get the care he needs? On a deeper level will you join me in praying for the healing of the healthcare infrastructure of this country, that people would get what they need, when they need it? Thank you.