End of our fourth day of clinic. We've now had our 2nd day at St. Paul's facility. We have seen almost 100 women from the communities west of the school/church. It's a mountainous, rugged area...probably some of the women walked 2 hours to arrive at the clinic. Today began a bit more efficiently as we left the exam tables, pharmacy and lab (microscope and urine dip sticks) in place. Only had to set up the fans and start registering patients. All of our morning patients had arrived by 9 am and we had registered, taken histories and blood pressures for 10 of them even before 9!
Yesterday, we had probably 10 women with blood pressures in the hypertensive range (210-120!! Young women, too). Even considering the stress for many of the women for walking so far and anticipating their first pelvic exam...the blood pressures really didn't come down. We referred many to a clinic in Petit Riviere - one that will see our referred patients and provide free care. There is so little here in Petit Trou...if you go to the government clinic, they most often do not have medications to dispense. And I stopped counting how many women told me they had never had their blood pressures taken. WOW!
NOTE to the Mental Health Team: I have made several referrals for these patients to meet with the Women Volunteers to learn the "Relaxation Prayer" (mindfulness meditation technique) that Mike taught in the first day of Trauma training. And we also referred a patient who was clearly depressed...Thank you MIke for that gift.
We are hearing from lots of people that the "appointment card" system is working so well. There have been NO CROWDS pressing to be seen. We have had only a couple of women each day showing up without cards, asking to be seen. And we have been able to see them. Seems to be more efficient for us and has shortened the patient wait time. We are all pleased. The press has begun, though, as we approach the last clinic day...Anita was approached by at least 8 people from the St. Paul's school to see if we would see the teachers. When we asked the manager to triage and prioritize the most extremely needy of the employees, we got a list of about 14. That was to add to our already full days! We compromised, with great angst among our team members, by giving the manager 3 appointment cards for today and 3 for Saturday and letting it go at that.
We haven't done any sort of statistical analysis, but there certainly are plenty of women whose presenting complaint is "lower abdomen pain when my period starts". Guess there may be room for education. We were pleased when the school nurse, Natacha, showed up to observe Pam's practice this afternoon. I had mentioned to Mr. Kesner that she would be welcome, but never thought it would happen. Pam focused on much teaching about NORMAL women's health, hoping that will help with some issues of concern about her practice.
Our day was saddened with 2 pregnant women presenting with "I haven't felt the baby move". One was almost at term and hasn't felt movement for 2 months...and no fetal heart tones...life is really, really hard. The 3 Women Volunteers who had organized the patients for the west side (Wilda, Fanette and Chantale) told me how much they had enjoyed spending these 2 days with us...we hugged and kissed and I managed to not cry. What a gift, how lucky am I to be so richly blessed by working side by side these beautiful, lively, caring Haitian women to bring care to their friends, families and neighbors that they have never receive.
Well, I've taken more blood pressures in the last 4 days than I have in the past 10 years. Probably 50 more tomorrow! I gotta end this as the mosquitoes in the computer room are eating me alive!
-Beverly
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