Planet Money On Haiti : Planet Money : NPR

Planet Money On Haiti : Planet Money : NPR


I am a big believer in small government.  I think that most of the problems in America come from to much government both state and local.

In Haiti the bribes are explicit, in your face.  Give my this or I will not allow you to leave.  In America the bribes are implicit never mentioned, the hiring of an off spring or spouse.  The better job that is quickly attained working for a large company at many times their previos income.  The laws that are in place to protect against this are easily and readily skirted.  The official now making money at our expense - when pointed out is brushed aside.  'Do you have a problem with people making money, wanting a better life for their family?'

This corruption exists in the non-profit world too.  This story reinforces my belief that for most economic problems food, clothing, shelter, water.  The population being servered would be much better off just being given cash.

Alcoa Eaglecam - Bald Eagle Camera at Davenport Works - #alcoaeaglecam

Alcoa Eaglecam - Bald Eagle Camera at Davenport Works - #alcoaeaglecam

The Bitter End - Radiolab

The Bitter End - Radiolab

Haitian Clinic

March 12, 2013 

I am not a Doctor.  These are my personal non-clinical observations of this third day of clinic in Haiti.  The parasite problem is a much bigger problem than I realized.

A.  PARASITES 101:  The risk of people having them is enormous. The sad truth is that when the earthquake rattled their land, it sent millions of worm eggs/spores into the air which, then, landed on their world.  Larva hatched into the water and the extreme filth that followed the earthquake promoted the ingestion of the worm eggs.  Many patient symptoms point toward the slithering of worms.  Below I have pasted an excerpt from a text discussing the symptoms of intestinal worms by Dr. Annette Bosworth with Meaningful Missions:  

In some people, intestinal worms do not cause any symptoms, or the symptoms may come and go. Common signs and complaints include coughing, cramping abdominal pain, bloating, acid reflux,  flatulence and diarrhea. In more serious infections, diminished sex drive, skin-itching, fever, nausea, vomiting, or bloody stools may occur. Some parasites also cause low red blood count (anemia), and some travel from the lungs to the intestine, or from the intestine to the lungs and other parts of the body.

At first I lacked confidence that worms were such a universal problem.  By the 3rd day, however, I was sure that every single person I had seen hosted a colony of worms.  The adults will not complain of troubles, but, after further reading, I’ve discovered they may not have any symptoms.  Their immune system keeps this problem in check just enough to keep the worms out of the stools.  The best boost to my confidence came when I began asking more questions about the cough.  "It is a dry cough, Docte` that seems to start about an hour after I lie down at night."  The worm migrates to the top of esophagus where it tickles the cough reflex.  Oy! What an image! 

When patients take vitamins or antibiotics, the worms drastically change the absorption of the meds and surely consume much of the nourishment from the vitamins.  I instructed patients to take 400mg of albendazole in front of me, watched them chew the medication, and then handed them a piece of candy to kill the terrible taste.   Chewing increases the surface area of the drug which apparently improves the parasitic kill. This should be repeated in 48 hours.  

 I instructed patients to start the vitamins and any antibiotics I thought were needed for other issues several days after the second worming medication.  Children chewed a 200mg dose in front of me and were instructed to chew another 200 mg in 48 hours.  By the end of the week, I was also giving mothers dosages for any children that were not in the clinic.  Be wary that the medications can be sold on the streets for quite a price, but usually the graphic descriptions of the worms and the need to kill them appeared to motivate people in the right direction.  Albendazole is useful after for patients over two years of age. 

Worms infection will also halt proper peristalsis and, in turn, causes reflux symptoms. Many patients asked for acid pills and the interpreters often jumped to the summary statement that the patients had heart burn.

The chronic skin problems I have been told are a result of the weakened immune system not being able to fight off the simple infections.  The immune systems are weakened from parasites.

The current major cause of parasites is the poor drinking water.  There is NO easy fix for this problem.

Today 92 Haitian Children were treated by Dr. Bosworth for parasite infections.

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Related Blog +prescott haber 

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Realated Blog: +michael st-vilien 

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Mandy Warmka

Last Lunch With My Dad

One month ago about now was my last lunch with my dad.

I will always be thankful that he shared his last meal with me.

About 48 hours after my Dad's funeral I took my 12 year old son Prescott to Haiti.  Bringing Prescott to Haiti is something my Dad helped me decide to do at our last lunch together.

I asked Prescott to read the Eulogy.

 Me)  Do you know why I asked you to read that?
P) No
Me) I asked him to read
            - The day with the people he loved
            - The Obituary I wrote
            - The Obituary that was published

Then I explained to him that by slowing down and pouring into the people he loved.  I realized that people had strong thoughts, feelings, opinions and memories about Grandpa.  Most of the things they wanted to talk about Grandpa happened over ten years ago.  Prescott do you want me to only talk about things you did ten years ago?

P) When I was 2?
Me) Right?
P) That doesn't seem fair!

Me) I realized the stories they wanted to tell about Grandpa is not how I wanted him to be remembered.

I said the Eulogy is a Love letter to my Dad - the funeral would be the last time most of the people in the church thought about my Dad.  I wanted them to know he loved them and I and loved him.

P) That sort - of -  helps - does make it easier to understand.
Me) What do you remember?
P) From the funeral or just now?
Me) Doesn't matter what do you remember?
P) Focus on the person in front of you not the one who will be in front of you.

If you have had read more than one of my Blog posts you know that we have no money!  Friends of ours are accusing us of taking a vow of poverty.  We might have taken that vow but it was not intentional. 

 Lunch with Prescott

I gave him $10.00 and asked him to negotiate lunch for the two of us.

P) OK? What do you want?
Me) Lobster, we will need two, one for each of us
P) Yesterday they wanted $20 each
Me) Go

About an hour Later.
Me) I gave you $10 to buy us lunch today.  Why do you think I did that?
P) Actually dad you gave me $20.  Because you are thinking about Grandpa a lot today and you want me to be able to negotiate.
Me) I gave you a $20.  Laughing that's a lot more than I had budgeted for this exercise.
P) Actually dad you have to give him $5 before he gives us the food.
Me) Laughing, What?

Just then a Haitian man selling sea shells walks up and offers to sell us beautiful sea shells for $20.
This is the point that once again I am amazed by Prescott.  Prescott so very patiently looks at everything the man has to offer and so confidently and gently tells the man thank you for sharing.  I am not capturing this moment well.

Prescott is able to pause show this stranger that does not speak English that he has nice stuff and with every once in Prescott's body honestly thanked the man for sharing the shells.  Thanked the man for showing us the shells in a way that both the Haitian and the Dad realized Prescott was genuinely thankful and felt that his life was richer for the experience.  The most amazing part of this little encounter was the man realized that Prescott had gotten as much enjoyment as he would ever care to get out of his sea shells and was not going to be spending any money on them.  Very odd encounter the whole exchange happened in less time than I spend repeatedly saying no to the same encounters.

I hope I can give him the space he needs to let this skill flourish.

Me) What were your instructions?
P) Buy two lobsters with the money you gave me.
Me) Laughing.. So what happened?
P) I came down to the beach.  I couldn't find anybody that had lobsters for sale.
They helped me find somebody that had lobsters for sale.
Me) who?
P) Pointing to some Haitians in a hand made boat about a hundred meters from shore.
Me) I decide not to ask how, what, why etc... the illusion of security needs to be safe guarded at all times and no joy can be found on that line of questioning.
P) They didn't speak English but they understood the word lobster.
C) The man that sold us the lobster doesn't speak English either but I know he needs another $5 before we get any food.

Prescott goes and gets our lobster.  The lobster is great see the above pictures.

Me) Prescott does the man selling lobster have anything else to sell?
P) No
Me) How much do you think these lobster cost him?
P) Nothing, I saw him take them out of the trap.
Me) You did a good job.
P) Laughing at me... but not good enough, right Dad!  Yesterday they wanted close to $50 for the exact same thing we just spent $25 on. How could I have done better?
Me) Yesterday how many people were on this beach?
P) I don't know we couldn't find a chair.
Me) Lots, right?  Everybody wanted lobster and he didn't have enough for everybody did he?
P) I don't think it was the same guy dad.
Me) Ok, tell me in your words what you think I'm saying?
P) I think  you are trying to get me to say that the rules are always changing and just because something was good enough yesterday that doesn't mean it is today.  I am the only person on the beach he should have been willing to take whatever it was that I was willing to give him for his lobster.

I had the power and I gave it away.

I hope I make it longer than 64 I want to have more lunches like this one.