Today as I entered "L'hopital general" I was reminded that miracles continue to happen and prayers continue to be answered here all the time in Les Cayes. Not only did Baby Joseph look better despite not receiving any medicines overnight, but one of Dr. Robin's staff was waiting for me with the medicines for Baby Joseph as soon as I arrived at HIC! Living in Haiti for a little while, I think, has given me more local instincts. Even though the guy waiting for me looked like any other Haitian in their vehicles near the entrance, I somehow knew it must be Henry. Sure enough! He made eye contact, said "Are you Kristen?" And then after we confirmed who the other person was he handed me the bag of meds and we were each on our respective ways. I have also found in my short stay that making connections here isn't just necessary for business ventures, it is necessary for survival. Maybe that's why so many Haitians I have met so far are really good at what happened this morning. The idea of - you're my friend, or a friend of a friend, so you help me out and then later you can track me down and I will help you out or give you the name of a friend who can help you. The power of information travel merely by word of mouth here is unbelievable, and something I hope is tapped into for future public health education projects.
Fast forward to later in the day - and the reason why I truly think that Baby Joseph being alive is a result of miracles and prayers. The doctors had yet to give him any medicine for, what a doctor I spoke with in Port Salut believes to be, pertussis (there have been huge pertussis outbreaks lately in the Southern department due to a lack of vaccination programs for infants and children). They also hadn't examined him enough to notice his incessant coughing or the Candida (oral thrush) fungal infection in his mouth. When I spoke with the infectious disease doctors about his diagnosis, they agreed with me. BUT they wouldn't let me tell my suspicions to the pediatrician! Why you may ask? Well because they knew she would get mad and it's not allowed here for one departmental doctor to suggest to another departmental doctor how they should do their job. They were worried it would insult the pediatrician or hurt her pride.
So I was forced to choose - do I work really hard and push them to let me give Baby Joseph the medicine I have for him and tell them about the referral I received yesterday? Or do I sit by and wait and hope he's okay, in order to maintain good relationships with the staff here. I have been, after all, working hard all summer long to prove to the Haitians I am in it for the long run. I am here to work and learn as a medical student so I can come back in the future to continue to improve the system. My stepping on toes would put me straight back into that category of tempory blan who comes here fleetingly and bosses locals around on how to live their lives/ do their jobs. But at the same time Baby Joseph is not just another patient. He's the team's miracle baby. And somedays he even feels like mine.
Pride is not unique to the Haitian healthcare system. It is a universal problem. I have witnessed many times already in the US, medical students or junior staff not wanting to speak up and give their opinion because they knew the higher up physicians, or the nurses who had been working their for a long time, would get angry and upset. They didn't want to hurt the pride that tends to come with seniority. And while I think it's okay for people to be proud of big accomplishments - for HIC staff here to be proud of some of the impressive outcomes they can have with minimal resources - I think we need to set a boundary line. Pride becomes harmful when it gets in the way of effectively caring for our patients and practicing good medicine. Whether here in Haiti, in the US, or in whatever country or region people are practicing medicine, I think we need to realize that our patients, and not our pride, comes first.
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