Follow up care

By popular demand I have decided to write an update about the woman I spoke of in my last blog (sorry for the delay, the power has been less than friendly the past week.) She came to see us at a village clinic last week and I followed up regarding our treatment protocol, we had given her some supplements to help repair the lining of her stomach as well as some probiotics, a mineral blend and some multivitamins as she was eating only once per day.  She was not in any acute distress this time and stated that she was having less severe reactions to food than before but was still having a cramping in her lower abdomen which was better with hard pressure. The latter symptom is a keynote of a particular homeopathic remedy so I gave her one month’s worth of the medicine and made sure she had our phone number to call us if she did not feel better in a few days. In the US we would have referred this patient out to the hospital for some imaging and lab work immediately however here in Haiti most people cannot afford to go have these procedures done. Basic blood testing might be an option if she had money to take a tap tap (think pickup with a canopy and seats bolted to the inside) and then money for the consultation plus whatever medications they might prescribe for her. Though the fees would be considered nominal in our world, for most Haitians this is not something that would happen easily. Most reserve their visits to the hospital for severe illness and traumatic events, otherwise there is simply no justification for spending weeks’ worth of money just because they feel “ill”… a feeling that for most is not a foreign concept.

 As for the patient, I awaited her call and compiled a list of alternative treatment options in my head but I never heard from her. I know for a fact she would have called if she had not been feeling well as she sought us out at a clinic in the middle of another village just to tell us she was doing a little better, compounded by the fact that close to 90% of our patients have cell phones so getting a hold of us is not a difficult task. I have found that patients do quite a bit of follow up here and are not afraid to come back and let us know that our treatment was unsuccessful. It is a great way for us to learn what is and what is not working here and it is also comforting, I imagine, knowing that if you are still ill after treatment all you need to do it go back to the doctor and they can provide you with more care, free of charge. I often tell patients I am immensely worried about that they are welcome to call or come by at any time of day or night if they need anything, and a few even take us up on that offer which really makes me feel like our clinic is becoming a safe place for people to come when they need care and that the community is aware of this.