We are 3 days into a 2-week medical mission trip in Haiti, near Jacmel, where a 2-week clinic is held 6 times per year. I saw a very sick 6-month-old baby today. The mother had no idea how sick this child was. Most likely this small Haitian patient probably had bronchiolitis – resp rate of 80-120 (I counted myself in addition to seeing the vitals on the chart), tachycardic, subcostal retractions, nasal flaring, grunting. I knew this child needed more care than what we could offer at the “House of Life,” as the Haitians call the clinic. We gave him Tylenol for his fever of 101.2 (axillary, likely was much higher in reality), orapred (oral steroids), and an albuterol and duoneb breathing treatment. The child showed no improvement. He was still breathing about 110 times per minute about an hour later.
There were no ambulances to call. Only a “tap-tap,” the Haitian version of a taxi, to take the young boy to the hospital, which would likely take at least 15-20 minutes. The child’s mother was provided with money to pay for the tap-tap and for care at the hospital, which would not be provided without payment in advance. She promised to take him there and it was impressed upon her that he was, indeed, very sick and that they really had no choice but to go if she wanted him to live.
I felt helpless. I will likely never know if this child made it to the hospital alive. But I also can’t help but think that had we not been here today at the clinic, this mother may have never taken this child to get medical care, as she didn’t realize there was anything wrong with him. Without medical care, this child would have certainly died at home.
My husband (a paramedic also on this trip) and I prayed for him and his mother that they did make it safely to the hospital and that the hospital (also with limited resources compared to our American hospitals) would be able to provide him with the respiratory support he so desperately needed. Prayer was the only other thing we could do.
I would not trade this trip for the world. I will never forget this baby’s face. Or that of his mother’s. I will remember many of the other patients and their stories. I am reminded with every patient encounter how fortunate I am to practice medicine in a developed country, where my patients come to the emergency department waiting room, get seen, and Peds Intermediate unit is just upstairs waiting with Heated High Flow to support a child such as this one, in addition to the other meds and testing he would need. I am also blessed to have been born in a country with easy access to medical care for myself — and for our own baby girl.