Part 4: Trash Town


The second week in Haiti brought a new team with a different objective: nursing.

Most of the students on this trip were studying nursing at SJC and were looking forward to working in the clinic. It wasn't until they arrived in Haiti that they learned the clinic was closed for holiday. But PID was not going to let their talents go to waste.

Over the course of the second week PID hosted three travel clinics in a neighboring town. This town was in special need for a travel clinic. It was located about 20 minutes from the PID compound. However since most people in the town didn't own cars, traveling was out of the question.

Oh, and the town was built on a literal dump.

The town, whose name I can't remember, is built on a landfill where people are constantly dumping their trash. You enter the town on one long and winding road, with mounds of disposed garbage littering both sides of the street. Most of the time, this trash is lit on fire, and you have to hold your breath as you drive in, or risk ingesting the fumes.

It's devastating to see the amount of trash littered in the town, and it's heartbreaking to think about the 4,000+ people that live there. Throughout our arrival to the town, we witnessed adults and children digging through the landfills in search of food. We watched as pigs the size of a small child roamed the streets alongside the town's residents. And we broke down seeing the life these people were forced to live.

However, as we walked through the town on the way to our travel clinic location, we couldn't help but stop and wave to every smiling child we saw passing by. How they stay so positive, I will never know.

We finally arrived upon the site of the travel clinic, a church in the center of town. The church was entirely made of tin and looked like it could fall apart any minute. Thousands of flies swarmed, both the outside and inside of the church, but it was something you quickly adjusted to.

Inside, the nurses began setting up for the day, alongside the pastor of the church. That morning he had knocked on all the doors of the people in the town, informing them that a clinic would be taking place. There was already a line of people when we showed up at 8 AM. This was the second day of the travel clinic, and many of the patients who could not be seen on Wednesday, were eager to try to see the nurses today.

The nurses began to set up the three stations they would be operating with for the day: triage, consultation, and pharmacy.

After waiting in the waiting area, the patient would first go to triage, where they would get their vitals taken and speak with the nurses about why they were at the clinic. Then they would go to consultation where they would sit down with Emily Gerardo, the leading practitioner, to go into more detail about the symptoms each person was having. Emily would attempt to diagnose the problem, and would write a referral for what the patient needed next. Finally, the patient would head over to the pharmacy where Nate Dominuge, another team leader, would distribute medicine and administer tests.

This cycle continued all morning, with the nurses seeing about 15 patients before they broke for lunch. I was hopping around from one station to the other to document, and learn, about the nursing process.

Triage was the location that allowed the nursing students to get hands on work. They were operating the station themselves and, with the help of a translator, would do their best to understand fully what was wrong with the patient. When it came to testing the vitals, however, the students ran into a few problems.

"We had one patient who couldn't grasp the concept of putting a thermometer under her tongue," one student reflected. "She kept tilting her chin up, instead of just lifting her tongue. After a few minutes of struggling with her we eventually had to just use an armpit thermometer."

"Another male patient told us he had a vaginal infection. It was probably what he heard other people saying, and that's what he thought it was."

Other symptoms were repeatedly brought up by almost every patient: headache, coughing and dizziness, just to name a few. The nurses quickly attributed these symptoms to one thing: living in Haiti.

Lauren Lecompte, a junior nursing major, reflected on this realization. "You ask them "How much water do you drink a day?' and they say 'Plenty.' And when you ask how much is plenty, they say "I drink one cup of water a day.'"

Lack of clean drinking water, especially for the families living in the trash town, is a persistent problem in Haiti. Most of the time dizziness was attributed to not eating enough food and respiratory issues resulted from the constant inhalation of the fumes of burning trash.

"You've got something that is a small fix," Emily stated, "but you can't really change the course for someone because you can't change their living conditions."

As the team took a break for lunch, they realized that a swarm of ants had found their way into the sandwiches they had packed for the day. But instead of throwing them away, the team brushed off the ants and handed the sandwiches out to the patients waiting in line.

We had already had one meal today, who knows if they had.

As the day went on the nurses saw about 15 more people, however two of those patients received special attention from the SJC team.

One boy, about four years old, came to the clinic with a huge mass behind his ear. According to his mother, the mass was painful to touch and had grown very quickly. The mass also appeared to be leaking fluid, as a dry residue had settled on the affected area.

After much deliberation about what to do next, the nursing staff decided the best decision for the boy was to drain the mass. Under the careful supervision of Emily and Nate, the students were able to get hands on experience in the small procedure.

The procedure only took about 10 minutes, but it felt like hours. The child did not stop screaming the entire time, and one nurse, who was tasked with keeping the child still, found it very difficult to fight back tears.

By the end of the procedure, as the child's crying turned into tears of relief, the nurses were very confident in their decision. The mass was now non-existent and the mother was very grateful that the nurses were able to help her son.

As the nurses began to clean up the supplies from the first procedure, two worried eyes were watching from afar. A little boy sat on the bench behind the consultation curtain and had just watched the entire procedure. And he knew he was next.

The boy, who was probably about six-years-old had come to the first day of the travel clinic, and was referred to return for another check-in on his condition. He had a small growth on each hand protruding off of his pinky finger. One of them had become highly infected and was hanging on by a thread.

Once again, the nurses were faced with a difficult decision. After long deliberation they decided the best action would be to remove the growth. With medical professionals taking the lead, they would be able to make sure the removal was under close supervision. The last thing the nurses wanted was for the boy to catch his hand on something and rip the growth off of his body, for this would only lead to more infection.

So the nursing team began to prepare for the second procedure. A dose of lidocaine was administered to the boy so that he would not feel the pain. However the child could still see everything that was happening to him, and so the fear in his eyes did not fade.

The child's screams filled the church, even though he could not feel any pain, as the team worked quickly to remove the growth. Neither the heat of the day or the flies in the air could distract the team from the task at hand. They were working to better that child's life.

The minutes passed by like hours, but once again the team had completed another successful procedure. After wrapping the boy's hand in clean gauze, one of the nursing students put the boy in her arms and cradled him until the tears flowing down his cheeks turned into a grin of relief.

The student held onto that child, until his mother eventually showed up to take him home.

I was grateful for the time I spent in the travel clinic. Although it confirmed that I definitely never want to become a nurse, it made me realize how raw healthcare is in third world countries like Haiti.

From common problems to complex cases, patients arrived at the clinic complaining of every symptom they had, no matter if they were related or not. They wanted to make sure they got the most out of seeing a trained nurse, because who knows when they would see a medical professional again?

The PID clinics, including the travel clinics, operate on a no-cost system. While most hospitals in Haiti charge high costs for consultations, procedures, and medicine, PID does not charge for their services. This allows a lot more people to be able to have access to healthcare that otherwise may not be able to afford it.

However the travel clinics also have their disadvantages. First of all, the nurses did not have all the resources they needed. Many times throughout the day, the team realized they had forgotten to pack a specific medicine, or they wished they had different tests to run on patients. PID operates on donated supplies, so if an item had not been previously donated to PID, it could not be administered to patients. Almost everyone who came to the clinic left with at least a bag full of vitamins, but without the proper medicine at their disposal there was nothing more the nurses could do.

Secondly, despite the three days that PID sponsored the clinic, there was no opportunity for follow-ups with patients. Unless the citizens of the trash town made the trek to the PID clinic, we would never know if their symptoms were progressing or getting worse.

"A little goes a long way," Lauren reflected, "A lot is lost in translation but but when you walk up to someone and smile at them, they really appreciate that. The human connection, that is what nursing is all about."

To be continued...