Tuesday, May 10, 2011

The Well-Check Clinic

A small group of St. Vincent's very large deaf population

Watching this group of medical professionals and volunteers running the well-check clinic in March, 2011, was like seeing an extremely flexible, adaptive machine operating to its fullest capacity. The key to the team’s success was their “divide and conquer” methodology: everyone had an assigned role and allocated space. No talent was left untapped, no inch of clinic left underused.

Every student at St. Vincent’s with various special needs, the staff and others were seen over the course of 4 days. Whether they were there for a well checkup, physical therapy, to see the orthopedist, or pick up medication at the pharmacy, everyone’s needs were met.

The crowded hallway at the clinic

A patient’s journey began in the corridor that runs the length of the clinic building that served as a combination waiting room and triage center for all clinics. In the hall, weight, height, blood pressure and other pertinent information was recorded by hand on individual file cards that served as medical records. Recognizing that anemia is a common condition in Haiti especially among children, nearly everyone received a finger prick to test the iron level in his or her blood.

John administering a finger prick

Sheyre (center) working with Dr. Susan (right) and a deaf patient

Working tirelessly in the heart of that narrow hallway was John, a retired paramedic, and Sherye, our only interpreter for the deaf. Also part of the team were high school seniors, Sienna, a seasoned St. Vincent’s volunteer and interpreter, and Hannah who quickly picked up and mastered all assigned tasks.

Sienna and her buddy

Hannah, a St. Vincent's patient and Amy

Following these preliminary actions, patients were diverted to one of 3 areas to see either a physician assistant (PA) or doctor: Wade (our faithful Red Thread PA who spent more than a month in a PAP hospital in 2010), Amy (a PA from Memphis), or Dr. Susan (a St. Vincent’s veteran). Each area was outfitted with a table or chair for the patient, a medical professional wielding a stethoscope and otoscope, as well as an English / Creole interpreter.

Dr. Susan with a St. Vincent's patient

Wade and one of his young patients
(who, by the way, smiled like that throughout the entire exam!)

When groups of exclusively deaf children were brought to the clinic, Sherye was a hot commodity. She bounced from room to room, signing to the kids and interpreting for the doctors. It was challenging to say the least, when deaf children simultaneously filled the hallway and all 3 clinic rooms. There wasn’t enough “Sherye” to around! (Insert gratuitous call to interpreters for the deaf here…)

In each case, eyes, ears, and noses were checked and a physical evaluation completed. Heart murmurs were diagnosed (including a serious heart condition that may result in surgery), a large wart was surgically removed, and bedsores caused by ill-fitted wheelchairs and lack of mobility were treated. Referrals were made for x-rays and additional care by specialists. Medical staff discussed health concerns with pre-pubescent children and their teenage counterparts. You name it, the doctors saw and treated it!

(foreground) Zacharie, a 20 year old student in need of a new wheelchair
(background) Nick and Michelle

Attempts were made to locate specific types of wheelchairs for some of the students, especially Zacharie, who recently spent 2 months in a local hospital due to the severity of his bedsores. Sadly, the wounds were not yet healed and both Dr. Bheki and Nick suspect that he will develop additional sores until he receives the correct style of wheelchair: one with a firm cushioned bottom that is not a “sling” like typical wheelchairs.

A deaf student complaining about her ears not working

When questioned by the medical staff about their health, nearly every blind child stated that he or she couldn’t see. Similar stories came from the deaf kids who complained that they couldn't hear. It was heartbreaking to tell them “I know, I know” and not be able to wave that proverbial magic want to make their little bodies whole. Thankfully, the parts of their bodies that we were able to treat were indeed treated.

Upon completion of the appointment, each patient was sent to the end of the hall to St. Vincent’s pharmacy to see Wes, a pharmacological student from Memphis. It was there that Wes did the majority of his work throughout the week, distributing vitamins and any additional prescriptions. After collecting the medications, Wes worked the interpretation chain: from doctor to English pharmacist to Creole assistant to patient. While it was not a fast process, it worked and for that we are thankful.

The Medicine Man, Wes

Fun fact: the deaf children dubbed Wes the “medicine man”. Even after Sherye spelled out his name— W-E-S —the affectionate nickname stuck.

Some of the biggest challenges of the clinic were:
  • Sharing one interpreter for the deaf—we definitely need more.
  • Minimal work space—on one occasion, we counted 50 people waiting or being treated in the small hallway of the temporary clinic.
  • The Haitian heat in an enclosed area—we won't speculate on the temperature inside the clinic...
  • Lack of a full complement of medical staff.
In some of the team's down time, we comprised this list (in no particular order) that would create our "St. Vincent's Dream Team":
  • family physician
  • podiatrist
  • orthopedist
  • internal medicine
  • physician assistant
  • physical therapist
  • pharmacist
  • x-ray tech and equipment
  • EMT
  • medical assistant
  • optometrist
  • ophthalmologist
  • dentist
  • oral hygienist
We're allowed to dream, right? If you are interested in joining our team during one of our trips to St. Vincent's, please contact kathy@redthreadpromise.org.

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