Today's typically, atypical day in Haiti involved going down to the clinic to offer a prayer and a little health talk to the paitents while the nurses took vital signs. Before giving my talk, I usually scan the crowd to see if there are any obviously critical or on the verge of critical patients. Today, there were a couple patients that I tried to advise, but they weren't critically ill.

Nurse's Day! Front row are Miss Carmel and Miss Annie!
When I see patients  Miss Annie and Miss Carmel help me write in french. 

On Nurse's Day, I had to take a pic of nurses with me in front of  Hospital St. Francois de Sales.

The nurses and I in front of the little room where vitals are taken.  I'm next to Miss Carmel!

I then went to talk to the head nurse, Miss Carmel. She engages me in conversation and teaches me Kreyol. Miss Carmel donned white on nurses day and gave out red ribbons for AIDS awareness the following week. We talked about the possibility of writing French book publishers to find out if they would donate books to the nurses and doctors here. I can't even find a drug book here in french for the nurses to look up med doses! We set up the one suction machine that works in the Chanm Accouchmant (directly translated: room delivery). Shortly after doing this, we were using it on a 6 month old boy who was grunting and flaring his nostrils. He was breathing rapidly and needed assistance clearing his airway prior to transport to a source of oxygen. We went to Cap-Haitian's main hospital, Justinian, and I sent my trusty interpreter in to see if oxygen was available. They have a few oxygen concentrators and one tank, sometimes they're all in use and there's no room in the inn; today was one of those days. The siren allowed us to pass through congested roads, past motorcyles, tap-taps and buses on the road to Milot, but not without some patience. Even the siren doesn't always clear the road for transport of a sick patient. I was so pleased when we arrived and put our patient on 5L NC. 

In Milot, I was able to go see Dieuly, the little baby I wrote about in my last post. He was tucked into his incubator with supplies and formula sitting on top. The nurses said the father visited last week. I left pleased to know both babies I've transported to Milot were being cared for! This took up the whole morning.

Sad news/Good news

Sad news first: The baby with the omphalocele passed away a day after I took his picture. The day I took his picture, it sounded like he was doing well, per Mom's report and considering his condition. He was passing the right amount of stools and was reacting like a normal neonate. We visited the mother, and there was no clear story about what happened, but with an omphalocele there can be other congenital defects that can be present, including heart defects. The mother just told us he stopped eating and then stopped breathing. We gave the mother some vitamins, a hug and asked her to come to the clinic for more when they were finished. Thanks to Kristina and Lisa both RNs at UNMH who were trying to investigate the best possible management of his case. Thanks also to my friend Sarah, who's son had an omphalocele when he was born. She also offered wonderful support and suggestions!

Good news: Earlier this month, a team from the U.S. visited Haiti for a week. Emma an EMT with Hands up for Haiti, came to Hospital St. Francois de Sales to help us figure out our ECG machine. Thanks to Emma, we can now use it, but that's just part of the good news!  I was showing Emma the pediatric unit at Justinian Hospital in Cap-Haitian, when we happened to see this tiny neonate. We found out he was HIV+ and that his mom had passed away a few days after giving birth. There was no family there to feed him and we pointed out to the staff that he had ants crawling on him and that his feeding tube had fallen out. We did our best to get the ants off of him and we thought the nurses would take care of him, but returned later that day to find out he had not been fed all day. No new feeding tube was in his nose, his IV was infiltrated up to his shoulder, and his lungs sounded like they had fluid in them. The doctors and nurses asked us if we could do anything. Justinian Hospital is a government hospital and has very little supplies, so we went to buy a $6 feeding tube and look for some lubricant. I placed the NG tube and the docs removed the old IV and tried to find another. Emma encouraged me to find a place where he would receive better care and of course I wanted this too. We were told we could not transfer him unless we talked to his father, so we left him a note to call me. Hospital St. François de Sales has no HIV prophylaxis meds and no oxygen so I knew I couldn't transfer him to our facility. He would have to go to Milot's Hospital Sacre Coeur. Thankfully I found the phone number of one of the nurses at Milot, from the only other time I visited. I called her up the next day which was Saturday and found out that we couldn't transfer the baby during the weekend. We didn't hear from the father until the next Tuesday. It seemed like timing was just right, since on Monday I was recovering from an extremely bad gut bug (the trots 14 times and an instance of rolfing once on Sunday). I'm so thankful that he survived until we were able to transfer him!

The rest of the story is below in pictures. Please pray/keep him in your thoughts. He's still very fragile and needs a lot of care. A few days ago I received an update from one of the nurses at Milot that he's still alive. She assured us that the nurses are feeding him.

Baby Dieuly born 4/20/2011. Emma, an EMT with Hands up for Haiti and I found him at Justinian on 5/7/2011.
Ants were crawling on him. He was 16 days old and his mother passed away 8 days earlier.

IV infiltrated up to his shoulder.

Dieuly's other hand for comparison. His skin was so very ghostly.

Emma, holding Dieuly after his IV was taken out and a feeding tube placed. The doctors  were trying to restart his IV.

Dieuly is so very tiny! He's proof that chest compressions work. On the way to Milot, he went into cardiac arrest, but with a few compressions he was breathing again! At Hospital Sacre Coeur, his POX sat was in the 90's. 

The doctor and nurses at Hospital Sacre Coeur in Milot trying to get an IV and labs. 

He's a fighter! He almost looks like he's trying to smile!

He's a cutie! 20 days old when he arrived at Hospital Sacre Coeur!

Dieuly's Dad! I was able to provide him with some money to care for Dieuly, thanks to my family who sent me funds!
I asked permission to use these photos and tell his and his baby's story.