Tuesday, October 17, 2006

Dear Senator...

Dear Senator Raoul,

We hope that the benefit for GCH was very successful. My brother-in-laws and sister-in-law really enjoyed themselves on Saturday night and were very happy to meet you.

I have to give you a very grim medical report from Haiti. After 25 years of working in Haiti, I have never seen conditions so bad. The people here suffer so much from things that they shouldn’t even have like tuberculosis, malaria, and malnutrition.

Every day I have to force myself to walk to clinic and be part of this desperation. I can barely get in the front door of the pediatric clinic when I arrive because of the crowd that starts accumulating at 5 AM.

During the last year, we have brought a drug called ceftriaxone each trip to Haiti. It is a high powered antibiotic that can be given as a shot and will last for 12-24 hours before the baby needs a second shot. When I see a very sick infant, I give the shot quickly in the clinic. If there is no room at GCH or the baby does not meet the requirements for admission, I have the baby come back in the morning and admit it to GCH if there is a bed, or I take it to another hospital in PAP, and repeat the dose of ceftriaxone. If the baby survives this fiasco of medical care and the baby looks better, I convert the baby over to less expensive antibiotics that can be taken orally.

When I arrived at GCH clinic this morning, there had to be about 250 people crammed into the clinic (includes parents). My first patient was a 3 day old with a temperature of 102 F. I gave it a shot of ceftriaxone and sent the baby home with advice to mother to bring back tomorrow. The baby should have been admitted, but I couldn’t. Three day old babies with fevers are considered pediatric emergencies.

My next patient was a 16 day old baby boy who weighs four and one half pounds. His temperature was 102.5. His mother was very young and she had never given him breast milk, powdered milk, or anything other than water. His picture is attached and he is emblematic of Haiti. I baptized him with stagnant dirty water in a plastic bowl in my office. There was no running water in the clinic today.

I gave this pathetic baby a shot of ceftriaxone immediately and called a missionary who drove to the clinic, picked him up, and took him to another clinic/hospital where we admitted him. Sending him to the General Hospital is not a good option usually. (For one thing, his young mother had no idea where the General Hospital was in PAP!!)

The rest of my clinic day did not go much better. The acuity of disease here is horrible.

Over the years my wife and I have brought thousands of dollars of ceftriaxone specifically for patients at GCH. Since we are about out of this medication at this point, Maria’s parents purchased 300 more dollars worth of ceftriaxone in Peoria last week that I called in to our local pharmacy in Peoria, and sent to us by DHL. We followed the package’s progress via the internet. It arrived in PAP on Friday, but we received no call from DHL until this morning (Monday).

DHL is about one mile from here and they said that we owed them 5,473 gourdes for Haiti customs tax. This comes out to about $144 US. The entire package sent from Peoria has the ceftriaxone for many, many sick babies, and some germ-x soap, and some protein bars which totals about $350 US.

The Haitian government is asking us, to pay almost half of the cost of the package in customs taxes. The delivery by DHL was also very expensive and paid for generously by Maria’s parents. The ceftriaxone was also paid for by Haitian Hearts (Maria’s parents again).

DHL came this morning to deliver the package, but I refused to accept it or pay for it (the customs tax). This is absolutely outrageous. I explained that it contains medication for sick and dying babies, but no one seems to care. I am on my last couple of vials of ceftriaxone that we had from a previous trip and from this trip.

I don’t want to quit working at GCH but I strongly feel like terminating my work there until this problem can be addressed. It is just so difficult to have the medication ordered, purchased, and close by, but not available for the kids that need it most. This of course is not GCH fault or responsibility. Haitian Hearts pays for chest x-rays and medication everyday at GCH for patients who I see in the clinic, and know they have no money to pay for the x-rays and medications at GCH or anwhere else. We also admit them to other hospitals, and Haitian Hearts pays for these admissions also. I don’t want to quit working---I love what I do and who I work with, but if I have no ceftriaxone to take to the clinic, I will be baptizing the first 10 patients I see each morning. This work can feel very futile on a good day. It is just SO difficult as a physician to have my hands tied and not be able to do what is right for people that have no say so in their future.

Senator Raoul, will you get me a meeting with anyone you can think of that has influence at the level of national customs in Haiti. I would be glad to speak with President Preval or the Haitian Senate leader. A very powerful person needs to spend one day in the GCH clinic to see the problems at ground level. Someone needs to step up to the plate in the new Haitian administration. I need this medication now and Haitian Hearts will not pay for it again. We already paid for it in Peoria and sent it down here as fast as we could. The DHL truck drove away with it this morning….a very sad thing to see, especially if you are a sick Haitian baby.

Thank you very much for all you do.



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