Poverty, Lack of Health Care and Indifference Affect Medical Team
When she came in the next morning, the child was dead. The night staff hadn’t given him the solution. Someone had left the hospital with the medication.
Medical student Brian Rogers was overwhelmed by the poverty and lack of health care for the residents of Dérac. Other students were equally dismayed by conditions they saw. View more photos >>
FORT-LIBERTÉ, Haiti (June 29) – As the students and staff at Howard University of Medicine undergo their medical mission here, there is invariably something, some medical case that tugs at their heartstrings. For Howard medical student Aminatu Lawal, it was the tiny 7-year-old rape victim.
Earl Brewely Jr., a fourth-year student in the College of Medicine, was shaken after delivering stillbirths on consecutive days.
Third-year medical student Brian Rogers said he will be forever haunted by the grinding poverty and seemingly hopelessness of the nearby community of Dérac, where medical students and physicians worked for two days.
Even seasoned professionals, like Howard pediatrician and assistant professor Dr. Oninye Onyekwere, can be thrown.
Last year, after three painful cases, she broke down in tears.
First, she said, there was the 11-year-old boy, so constipated that the bowel had backed up into his stomach. After successful surgery, he was to spend the night in the hospital and probably be released soon. Onyekwere left strict instructions that overnight that he was to receive intravenous solutions and prednisone.
A day or so later, another case showed, a boy about two or three. He was severely dehydrated and had some other medical conditions that were serious but could be handled. Again, strict orders were given to keep him hydrated overnight. The next morning he was dead, again because of lack of attention the night before.
Finally, another child, about two, arrived with persistent fever and dehydration. Onyekwere prescribed IV fluids and antibiotics. When she came in, the next morning, she asked about the child.
“They said he had a high fever and died in the night,” she recalled. “I broke down and cried. I left the hospital and walked back to the hotel. I couldn’t take it. These were deaths that could have been prevented, but the nurses wouldn’t listen to us and neither would the pediatrician.”
It is cases and situations like hers that test the mettle of all the physicians, especially young medical students.
Lawal, 26, a third-year medical student who hopes to specialize in obstetrics and gynecology, said she knows that children are raped, but the age and size of her patient shocked her.
“That is one where I really had to hold myself together,” she said. “She said she was seven, but she looked five. What really bothered me is that when we examined her, it appeared that this wasn’t the first occurrence. But her family didn’t have the money to pay to come to the hospital.”
Dérac, a small, isolated community of about 2,000 people not far from Fort Liberté, was an eye-opener for Brian Rogers, 30, a fourth-year medical student from Durham, N.C.
He spent a day working in the dusty, desolate neighborhood taking care of children and the elderly. The community has no electricity, no water except for a nearby inlet and no visible means of support. Many homes are built of tree branches held together by mud. The situation appears hopeless.
“It had a real effect on me,” Rogers said. “You’re there and you realized no matter how much you did, it wasn’t going to make a dent in that community’s health care or all the things they need medically. Yes, we helped some people, but it was like putting a Koolaid package in the ocean. It’s not going to make it sweeter or change it at all.
“I was so overwhelmed.”
Brewley said his first still-born delivery “wasn’t too bad.” The second was different.
“We were working with a Cuban obstetrician, who had told us the baby was dead before we started,” he said. “Then, I saw the feet and I started to get a little sick, and the baby looked a lot older than what the mother had said.
“When the fetus came out, I don’t know, I treated it like it was a live birth. I was massaging it and rubbing it, and then my mind said, ‘Earl, this baby is not going to cry. This baby is not going cough. This baby is dead.’”
Nearly every Howard student had a hard luck medical story to tell. They said they also have learned so much diagnosing disease and delivering care. But cases like these, they said, have been the hardest lessons of all.