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Dr. Nomil reflects on her time in Haiti

Yesterday was Dr. Nomil’s last day at the HIV clinic. Early this morning, as Edner drives her to the border in a hand off to Jobanny, she writes a few parting reflections:

This is the end of my journey in Haiti. I spent nearly 2 weeks delivering medical care. I can’t say everything went as it was supposed to, but given the circumstances, our team worked together and tried to make the best of the situation.

I have a lot of mixed emotions leaving Port-au-Prince. There is still so much to do, not only medically but in every way we can imagine. I hope in time, each and every one affected by this disaster in Haiti will free of this misery…That at least their basic needs are being met.

I have seen some small improvement since my first week in here. At least, just outside the family health center I’ve witnessed daily rice distribution. What I’m afraid of is that these events are very much localized. I still meet many who have reported to me they’ve yet to receive any food. The sight of so many with little or inadequate shelter is still too widespread. One common question among the patients is “How can I get a tent for my family?”+

I’m embarrassed to admit I have no answer for this question even after two weeks of staying in Port-au-Prince. I’ve even asked a couple of UN relief workers whenever I’ve made trips to the UN compound. Despite my inquiries, I have not really gotten a good clear answer on tent distribution. I’ve only seen one open area not far from the airport with some nice white tents erected with an apparent sense of order.

Each time I passed to drop off our patients to the field hospital of the University of Miami, I feel the urge to get out of the car, venture over that tent city to inquire. I imagine folks have no clue as to their good fortune. They are the lucky few in a sea of thousands.

I hope this journey will be one of many on my part as I feel my work here is very much incomplete. I can say I’ve met so many people with great hearts, I’ve been inspired by them. I speak of those who were my patients for the past two weeks. I will forever remember their sorrow, their gratitude, and their will to live. This journey reminded me of why I choose to practice medicine.

In exchange for Dr. Nomil, we have two HIV-trained nurse practitioners, John Roberts and Eleftheria Tsavoussis, coming in. Their plane was delayed by winter storms on the East Coast. Meanwhile, two brothers, Ron and Ralph Supplice, find their own relief trip cancelled after they bought non-refundable tickets. They want to know if they can join us. Ron is in the insurance business. Ralph is a school teacher.

I tell Ralph that if he can rent a car, we will lead him in and put him and his car to work. I know a week of logistical support with be a big relief to Edner. It might even allow us to get a team up to St. Marc so we can get that clinic open. I hope Ralph will prove a Godsend. Just yesterday, Carine Joselyn e-mailed me that she had received a report from Dumas, the Centre Medico Social administrator. His big concern is the hundreds of children in the vicinity of the clinic with nothing to do but sit in the rubble.

He reports that the principal of the collapsed school stopped by. But he had nothing to offer in terms of plans to rebuild. Dumas wants to use a portion of the school ground that has been bulldozed clear to create a safe children’s zone. I am hoping Ralph can help him figure that out. Meanwhile, I put out the word: we could definitely use some sports equipment. Soccer is big in Haiti. And some jump ropes….other athletic equipment…and basic school supplies…Maybe some stuffed animals, though it is terribly dusty._

In my e-mail, I ask make it clear, if people want to donate these things, we should only accept stuff in top quality condition, preferably new. We don’t need to send ratty toys to children who have just lost everything.

Dr. Jennifer Kasper, who went down with Marcelo Venegas to open the HIV clinic several weeks ago, forwards me an e-mail by Dr. Chris Behrens, the Clinical Assistant Professor of Medicine, at the University of Washington and the Medical Director of the International Training & Education Center on Health, raising concerns about the number of people on firstline HIV anti-retroviral medication who still haven’t be able to get back on therapy, titled 
Risk of NNRTI resistance following abrupt cessation of NNRTI-based HAART: implications for Haiti started by Chris Behrens..

Haitians with HIV have never had access to second line drugs. They have always been deemed too costly in a country where a third of people in need of ARV’s still don’t have access to first line treatment. I wonder if this situation will change. Or will treatment failure on first line drugs mean a death sentence, something we no longer find acceptable here in the United States?

• Categorized as: AIDS Issues Update, Charles King Blogs
• Posted by Diana Scholl, February 07, 2010 at 3:33pm

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