The Angel Wings International Blog

Post By:  Lindsay Musser

On Day 4 one of the last patients in the clinic presented our most serious case yet.  His advanced asthma attack was nearly overlooked because his mother was so quiet.  ”Eskize mwen,” she said to Heather (“Excuse me” in Creole) and with a wave of her hand, she motioned toward the little boy in her arms who was having trouble breathing–since last evening!

I’ll never forget how easy it would have been to miss that silent, limp little body in his mother’s arms.  Thank goodness Heather was insistent that Myrlande take a look.  The little boy’s eyes were half-shut and beginning to roll back in his head, and his little belly heaved quickly with breath after helpless breath.

Asthma case on Day 4

“Lele” (the boy’s nickname) needed a nebulizer immediately, and it instantly became VERY clear how important our organizing work in the clinic storeroom had been.

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At this point all the doctors on our team had gone back to the states and Myrlande was the only nurse on duty.  Myrlande called Dr. Robert to confirm the diagnosis-the boy needed the nebulizer to be set up, a shot of Epinephrine, and other care all simultaneously–and since we had just packed up the medicine to prepare the CLC for other use that afternoon, someone had to find the medication–quickly–while Myrlande found and set up the nebulizer.

Andy, Myrlande, and I tore through boxes with an urgency I’ve never used before.  When Myrlande finally found the nebulizer she scrawled “Epinephrine” on a piece of paper and said, “Find this! It’s in a little vial on one of these shelves!”

Despite the careful labeling we had done earlier, there simply wasn’t enough room for all medication to be clearly placed and accessible at all times, especially when we had to pack up and move quickly every time we finished a clinic in the borrowed space.  Myrlande rushed out to the patio to care for Lele, leaving Andy and I to find the vial.  As we scrambled through shelves of bottles, wishing we were medically trained, Andy glanced at me with wide eyes.  “What if we don’t find this?” He asked, first with his eyes and then out loud.

I swallowed and continued scanning the bottles, struck by the significance of a tiny little misplaced bottle.  The fragility of human life, so easily forgotten in the States, was made prominent daily in the Hatian experience.

Andy comforts Lele in Creole

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One of the most urgent decisions was whether to continue to treat the boy in the clinic setting or to take him to the Jacmel hospital.  In the US, this would have been an easy decision: in Jacmel, it was not.  It was hard not to think about Myrlande’s story of the electrician who had died of the wrong injection at the hospital.  The boy was not stabilizing properly: if we took the time to move him to the earthquake-ravaged hospital, would his condition worsen on the way?

Finally Myrlande found the Epinephrine, and, on the phone with Dr. Robert to ensure accurate dosage, administered the medication.  It took about 6 calls and 3 phones to get through to the US, by the way.  Life can so often hinge on the simplest of technologies!

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For a while, the boy seemed to stabilize, and Myrlande talked to his mother about the importance of bringing him in for care immediately next time.  Had he been treated the night before, his case would have been much less serious.  As he gripped the little inhaler we’d given him, I couldn’t help thinking of how many kids in the states use those on a daily basis, and how most of them have had the chance for more education on asthma than was available to this mother of seven!

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After a few minutes, though, Lele was unstable again.  Myrlande put him back on the nebulizer.

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Final decision: take Lele to Jacmel.  Perhaps the hospital would be able to do more for him. Noah carried the boy to the CLC Jeep.

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Our driver and Myrlande pulled away with Lele and Carl in the car, and all the rest of us could do was hope.

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Jacmel needs this new hospital.