Staff Story: A Door for an Ambulance

This is a personal, From The Field story by Andrew McCalla, Direct Relief’s Emergency Response Manager.

We arrived at the small medical clinic in Petit Trou de Nippes about five hours after we left Port-au-Prince that morning. The distance is only 75 miles but the unpaved roads, traffic, and small lakes and rivers we had to drive through to get there made the drive long. Halfway through the trip my Haitian colleague Catherine asked me if I felt like I was in a blender with all the jostling of the Land Cruiser we were driving in. We just pretended we were getting expensive lower-back massages the whole way.

Like the other clinics I’ve visited on this trip, this is the only one serving the 25,000 people who live in the area. Unfortunately, this small government clinic does not have a doctor, because he left for a training course in Port-au-Prince and they fear he’s not coming back due to the poor pay he’s receiving. A young but committed first-year resident who just graduated from medical school last year is now running the clinic. I asked her if she felt ready to be running a medical clinic just one year out of school. Before she answered yes, she hesitated and looked around at the two nurses, social worker, administrator, pharmacist, and lab technician who were sitting on the bench across from her waiting to hear what she’d say. It seemed like she wanted to reassure them that she could do it.

Like the doctor on the island of La Tortue who asked for a better boat to get his patients across the ocean to the larger hospital, the doctor at this clinic also asked for better transport. However, she needed it to get women into her clinic to deliver their babies. The only “ambulance” the clinic has is two broken-down motorcycles, but they wouldn’t want to transport pregnant women on motorcycles even if they were working. They went on to say that pregnant women usually come in on horseback, are carried in a chair, or lying on a door while their neighbors carry them like pallbearers.

Lack is a common theme. For example, nearly 100 doctors and more than a thousand nurses get their degrees every year in Haiti, but low salaries often drive them away from the country. While plenty of doctors and nurses are trained every year, many rural areas are left without the staff to care for their people.

A relatively small amount of money can solve the clinics’ problems, ones they’ve been dealing with for years. The doctor on the island of Ile-a-Vache asked if we could fix the leaky roof in his exam room so when it rained he and his patients wouldn’t get wet anymore. The doctor on the island of La Tortue needed $1,000 to dig a well so he could put running water in his hospital. The doctor in Petite Trou de Nippes said her dream would be to have an actual ambulance, but she’d be happy if they could have gurneys or stretchers so women wouldn’t have to be carried in on doors. The medical director of Beraca Hospital wants a sterilizer so wouldn’t have to disinfect instruments in a pot of boiling water on the stovetop. The nurse on Ile-a-Vache needs a raise from $300 a month to $350 a month because her parents spent all their money to send her to school and now she’s responsible for taking care of her three siblings. And the administrator in Nippes, who was extremely proud to show me the professional patient records and filing system he keeps, said he needed a new desk because the one he’s using is just a piece of plywood sitting on two oil drums. This man was working for almost no pay (and often goes months without even getting a paycheck) yet took pride in his work. He needs a real desk.

The Haitian doctor I was traveling with, who had worked in the U.S. for the last 30 years, promised to personally pay the $1,000 for the well, because of the thought of working in a hospital without running water was unbearable.

I take comfort in the fact that I work for an organization that can respond many of these requests and has a plan to help improve the health of mothers and babies in Haiti. We’re providing pre- and post-natal incentive kits for women who come to the health facility for treatment and delivery, upgrading medical equipment needed for safe deliveries, providing 5,000 rapid HIV tests to test mothers who enroll in the Prevention of Mother to Child Transmission (PMTCT) program, and providing ongoing education for traditional birth attendants. We’re targeting eight health centers strategically located in eight of the ten departments (or states) in Haiti, reaching 563,889 people, including almost 16,000 pregnant women over the course of the next year.

Sometimes it feels like we’re scratching the surface. But it still gives me hope.

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