Epiphany

For the first time in the 8mo I have spent in Haiti I have lost a lot of hope. Before I always had so much hope that the work we are doing is good, and Haiti will change. I thought it was so important to do primary care and help the people one by one. But now I've realized we need public health education so that we can help a large number of people and make it sustainable.
This epiphany was spurred on by Ryna, AJ, Dustin and I taking a group of 9 patients to an HIV program in PPX. The gov. provides the HIV meds for free but only at certain locations, since our number of HIV patients has been increasing lately, we have decided to take a group one day every month. After arriving at the hospital program we had to wait in three different lines, followed by a trip to the lab, into an office, around the building to make a file, back to a different office, and ending in the pharmacy. Times 9 patients, not fun. Though we had informed each of our patients that they were HIV positive, each one stated that they did not they had HIV. Even though we had told them multiple times. Many of the patients did not believe or understand the HIV education they got at the other hospital. One continues to state she does not have it because she does not have a rash or diarrhea; though she has tested positive three times. Another one who's husband died a month ago in our hospital d/t HIV still states he contracted HIV because someone put a powder on his chest.
It is so frustrating!! I don't know what the problem is, either the patients don't want to learn or have a hard time learning. Haitians are not stupid but if you don't go to school it is hard to even know how to learn. I just wanted to scream HELLO!! You need to listen and learn how you get HIV and most importantly how you can spread it to others. And HELLO the government needs to be teaching the people, and enticing them to get treatment and education. I never want to go back to that program b/c it was so crazy and overwhelming. I can't imagine how the Haitians feel, I got to arrive in a car, and probably got some special treatment b/c we know some people there, but to go through that by myself without any health knowledge would be so confusing. Added bonus there is no prevention in Haiti. People don't even know about prevention, and even if they do they can't do anything about it. In Passe Catabois you can't even buy a condom. People don't even know about the importance of handwashing, or clean water, or safe sex. Blah! Haiti needs to re-evaluate healthcare in a big way. Haiti has serious issues regarding healthcare. I mean we need to start from scratch here. Can you imagine not even knowing these basic things? I am excited to go home and try to think of creative ways to teach public health in Haiti.
Updates: the clinic was pretty mild last week. We had one small child with meningitis who went home and died the next day. Of course later that day I had a hypocondriach moment and thought that I also had meningitis! Minor panic. On Saturday, I delivered a premature baby girl who had died in utero. It was the mother's third baby that she had delivered dead. Horrible. I can't imagine that pain. The family did not want to take her home to bury her because of the costs, so she went in the latrine. And we had another baby come in who had the umbilical cord fall off and was bleeding. Michel stitched it up and she is all better!!
On a truly happy note. Chaniaka, the 5yo with heartfailure went home yesterday. She is playing and dancing and singing! She is a little miracle child. So there is still hope in Haiti.