Food As Medicine

A busy day in 'clinic' today.

We have moved all operations out of the soccer stadium in downtown because of worsening crowd management and sanitary conditions.

We have taken over the top floor of a church in towntown Port-au-Prince and set up an emergency room.  Slowly this itis taking full shape.  We have 3 examining 'rooms' which are sectioned off by basic curtained dividers, a dispensary for medications, and an oral rehydration station.  We had 3 docs seeing patients today, and the RN's and paramedics covering wound care, dispensing meds, and running rehydration.  Today we received two examing tables.  Our workflow is taking shape and we are providing quick, efficient, quality care.

I am astounded that there is still no food here.  We are treating the entire range of conditions, but I become angry when I see that food still has not arrived to my patients.  Of course they accept this with quiet dignity.  I ask all of my patients:  'how is your family', 'where are you sleeping', 'do you have access to food or water'.  Everyone has a heartbraking story.  Nearly all of them sleep outside on the concrete, some with towels, some with nothing.  Many people present with headaches and body aches.  They have these pains from sleeping on the street- literally- not on grass, not on a bench, on the concrete street.  Only one patient I saw today had any access to food. 

Water is the one that strikes me the hardest.  I have to prescribe diuretics for patients with symptomatic heart failure, who are on the brink of dehydration already.  In the US I would casually tell someone who is extremely constipated to drink more water- impossible.  I saw several babies today that in Wichita we would have admitted for dehydration without hesitation.  Today there is nobody who can take these babies- we have tried to refer them over the past days with no success.  We rehydrate them there above the church.

I have to be specific with my questions on water- not only do you have access to it, but can you drink it?  After pressing a patient today on how she was getting her water, she admitting she was drinking the stagnant, filthy water in the gutter of the street near collapsed buildings, sewage, and decaying bodies- and drinking straight from the curb.

It is distressing that water and food are being released, yet not finding there way to people in need.  We can see multiple ships in the harbor from our vantage point above the church- including the USS Comfort (the Navy's hospital ship).  We are unable to directly release food and water to our patients or we will be swarmed upon by these hungry, frustrated people.  We are set up for medical aid only, yet the most important medicine the earthquake victims are in need of is water, food.  I prescribe a multivitamin for 10 days to anybody without any food at home- a double dose if they are pregnant.

We are thrilled that our clinic has taken shape.  We are setting up referral bases in the area as possible since our situation has changed since the stadium move.  We have a somewhat congenial with a Cuban Clinic up the street, but now a tent hospital in the middle of the city with full OR and delivery suites (with potential Tap Tap ambulance service), direct Medicins Sans Frontiers (Doctors Without Borders) rehydration stations, and other referals are in the works.

We will continue to work, much more to catch you all up on in time.

-Aaron