Klinik

Monday clinic was not crowded; similar to Friday, we managed to test some 15 or so women for HPV. It is likely that the persistent low number of patients is due to the holiday (Carnaval) this week (in fact, we will be closed today and tomorrow). Nonetheless, most are certain it will pick up in the next week or so.

Upon arriving, each woman is required to sign a consent form, which explains the purpose of the test and our research; this form (which is actually written in English) is described entirely in Kreyol by a translator, with multiple opportunities for patients to ask questions. The women are provided a number when they arrive (to ensure that they are seen on a first come, first serve basis) and following the testing, they receive a card with information (their unique ID number, as well as a telephone contact for any lingering concerns) necessary to obtain their results, which are generally available in three week's time. Women who are shown to be negative for the virus, do not need any further follow-up, while those who test positive will return for further analysis and treatment. During our time here, Jackie and I are planning to go out into the community to contact those women (tested over the last year and a half) who have yet to return for the necessary follow-up.

As promised, here are some pictures of the clinic. It is far from complete, but has come quite a long way (trust me)!


Although this progress encouraging, it is still sometimes difficult to adjust to the healthcare setting here. In the US, frequent emphasis on HIPAA and patient privacy (http://www.hhs.gov/ocr/privacy/index.html), has made most US healthcare professionals hypervigilant with regard to protecting patient information. Although attempts are made to do so here, it is sometimes difficult to ensure a private setting in which to take a medical history. Furthermore, the frequent use of translators and nonmedical personnel complicates the picture.

Even more concerning, however, are the stories I have heard about other healthcare institutions (or lack thereof) within the community: patients refused services (including palliative care/comfort measures) secondary to a lack of sufficient money, individuals having to travel to several locations (often over great distances) just to access any care at all... and people dying, from preventable causes, simply because they don't have this access/funds. While it is true that these issues are neither new nor exclusive to Haiti, it is sometimes difficult not to become disheartened!