Hospital Habitat and Inhabitants
Thought you all might be interested in a little tour of the hospital here. The inpatient side has about 48 beds in 4 wards — there are no complete walls between sections, just a half wall dividing each side in 2, with a central nurses station.
Outside of the ward is a waiting area that also has the lab and Xray departments — the capabilities of these departments is quite limited. Note the way Xrays are kept (though actually, the patients are supposed to keep their own Xrays and bring them with them for any visits). You’ll also find the improvised snack bar out in this area as well as the hospital dog (when he’s not in the wards themselves!)
Physical Therapy is downstairs and is the site for Advantage Haiti, a project to help those with disabilities integrate into society and to help make Haiti more accessible. There is a shop for making prosthesis and orthotics as well as the usual mats and some equipment. Dr. June Hanks runs this program and has a couple from Nicaragua who are prosthetists and a PTaide. Physical Therapists from the US are recruited to come help with the project which not only provides services at the site at the hospital but also to people in the “rehab center” who are staying there while learning the skills and getting the equipment needed for mobility and while going to the Bernice Johnson Center where they learn useful crafts and handwork that can be sold. Advantage Haiti also hires Haitians with disabilities — the scheduler/secretary is a paraplegic woman and a helper and general aide is a man who is deaf and mute.
The outpatient clinic is on the same level as the inpatient, with the waiting area, lab, and xray between. There is also a waiting area inside the outpatient area where patients wait till they’re seen. Basically it seems that people come first thing in the morning to be seen, then wait till it’s their turn — though they often push into the exam room while someone else is still being seen. Although they wait for long times, it’s not the same type of waiting as in Mexico, with people here jockeying for position and telling each other off if they’ve mistakenly thought it should be their turn, etc.. In the outpatient area, they also use one room to do pelvic ultrasounds — someone donated the machine, and now it seems as if nearly every pregnant woman has an ultrasound! Meanwhile, other basic lab and imaging tests are lacking — this is more than a bit frustrating to me! I don’t have many photos of the outpatient side, but am including some photos of my patients here.
So a bit different from my experiences in both US and Mexico health facilities (though more similar to Mexico than to the US in some ways). While this is owned by Lumiere Ministries, a Christian organization that is part of the Baptist Church of South Haiti, this is not a free facility. Patients pay for consults and procedures, and while there is a “poor fund” to help with some costs, I did see doctors asking whether someone could pay for a procedure before going ahead with it. In my humble opinion, there has been some rather negative impact of the US expat doctors in Haiti in that they not only do medicine, but they let the Haitian docs know what the life of a rich US doctor <G> is like, and no matter how much fear there might be of the impact on income of health reform, this looks very good to the Haitian doctors. This is further complicated by the fact that being a doctor in Haiti gives elite status (although the medical education there is rather lacking), so telling those who already feels they are special and above the others that other doctors are charging lots for consults and procedures and making a lot of money has had a rather negative impact in some situations.
Thanks for touring the facilities here with me. This post has been delayed because of technical problems while I was still in Haiti (ie, no access to internet). The next post will be photos of various things in Haiti, and then I will post a summary post on Haiti, titled Degagé (a word in both French and Creole that pretty much sums up how one has to work in Haiti).
