It was mid-morning and
a long way from quiet. One child was screaming
out his frustration while another loudly insisted on her mother’s immediate attention.
Cleaners were swapping jokes in Creole, mopping floors, and moving furniture in
their never-ending effort to wipe out those nasty bacteria bugs that lurk about
in nooks and crannies. Nurses were pushing
clanking carts loaded with equipment, taking temperatures, changing bandages
and coaxing liquid medicine down unwilling throats. Doctors were consulting,
instructions were clarified, and questions were being answered.
And there in the
midst of the noise and chaos that mid-morning, a mother and her son found the
environment a perfect place to give way to their exhaustion. Sleeping soundly,
both of them recovering from their visible and invisible wounds.
Each patient in the
unit has many stories to tell. Their recent burn injuries are only the most
visible of the stories. 50% of our patients are children under the age of
15. Over 70% of those are under the age
of 5. “But why are so many people burned
in Haiti?” friends ask. “Because of poverty,” I answer.
I know that at
first this answer might not make sense. We all have our own understanding of
what poverty looks like and for most of us, burns usually don’t factor into
what we see. But poverty has many faces. And in those worlds where there is a
lack of basic infrastructure, safety standards, and availability of cooking appliances,
burns are a common part of poverty.
In a country of nearly
11 million people, approximately 60% of Haiti’s population live below the
poverty line of $2.41 per day. 24% live below the extreme poverty line of $1.23 per day1. As if making
your way on $2.41 per day isn’t extreme enough. These numbers translate to
people living in less than desirable conditions, often with many people living
together in the small quarters. With no money to buy cooking appliances or fuel
to run them, families cook over open flames. Add to this an average birth rate
of 3 children per mama and the median birth age of mamas at the young age of 22,
it doesn’t take much to imagine the infinite number of ways domestic accidents
can happen in a Haitian home. Nor does it take much of a leap to imagine the
many other stories our patients might have to tell.
Before making my
non-medical rounds, I steel myself for the visit to the wards. There is nothing
pretty about burn injuries. And it is not easy to watch, even from a distance, the
painful and slow recovery process the patient and their family have to go
through. The fear for the future is evident in the eyes of the patients and
their caregivers.
While carefully washing
my hands before entering the wards, I emotionally prepare myself. I don’t want
my eyes to be a reflection of the reality I will see. My eyes need to reflect only
joy for the many small improvements the patients make day by day. My eyes must
show encouragement and hope for the future.
It feels silly to
walk along and ask, “Koman ou ye?” (which is about the only Creole I know) when
I visit. They’re in a hospital. They’re not ok. But what else is there to say?
Without a medical background, the only advice I can give is to “avoir beaucoup
de patience, manger beaucoup, et dormir beaucoup,” because in the end, this is
all a burn patient can do: have a lot of patience, eat a lot, and sleep a lot. The
medical team will take care of the rest.
The doctors have
their way of knowing when a patient is getting better. They have charts,
medical case reviews, and test results. The only way I know a patient is
improving is by the size of their smiles.
For this baby and
mama, if they fall in the range of our hospital statistics, they will stay with
us for about 16 days. The baby’s
bandages will be changed every other day and there will be multiple visits to the
operating room. A psychologist from our staff will spend time with the baby and
mama to help with wounds we cannot see. Physiotherapists will exercise the
baby’s limbs to prevent long-term damage and show the mama how she can continue
the therapy. Throughout the day, she will feed, clean, and comfort the baby.
She will also learn how to prevent future accidents and learn the importance of
hygiene in the house. And during the night, mama will sleep on a plastic
mattress on the floor next to her baby, ready to respond at the slightest call
of her son for comfort.
Recovering from a
burn injury is a full-time job for all involved. It’s no wonder I found these
two sleeping so soundly in the midst of chaos that one mid-morning.
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