During my many trips to Haiti since 2006, I always return with the same nagging questions. This time was no different, but at least I had one small answer. The question is this: “Do short-term medical mission trips really make a difference?” I always think I could help more by donating the costs of my trips to a local Haitian hospital that employs Haitian physicians. That is why this trip had a different purpose. For 2 weeks, I was teaching Haitian ob/gyn physicians how to improve their surgical skills, rather than leading an American surgical team. But even 2 weeks is not long enough for a teaching mission and the same question came to my mind. Until I encountered three patients.
During my second day at Hospital Albert Schweitzer a young woman returned to the hospital hoping the American doctor (me) could cure her problem. She had arrived at the hospital in October after an obstructed and prolonged 2 day labor at home. Her baby had died sometime during those 2 days and she required a cesarean to deliver the baby. This was followed by a severe pelvic infection and the need for a hysterectomy a few weeks later. During the healing process after her second surgery, she developed a fistula between her bladder and vagina, causing her to leak urine uncontrollably. Fistulas from childbirth are rare in the US and most ob/gyns have no experience in this repair, including myself. Urologists have experience in fistula repairs related to other causes, but there is no urologist at this hospital. Fortunately, I knew of a Minnesota urologist who would be working at the site of my previous short-term missions, 4 hours away. Phone calls were made and the patient was transported by private vehicle to Hospital Bon Samaritan where she had her fistula repair surgery and then returned home in less than 48 hours. She is only 18 years old and will never be able to have children, but she won’t be saddled with the need to carry a urine bag for the remainder of her life.
Severe pre-eclampsia is a tremendous problem in Haiti, necessitating the premature delivery of infants for the health of the mother. During my first week we delivered 4 infants weighing around 3 lbs. Each day that I visited the special care nursery checking on these babies, I noted other Haitian mothers caring for their growing premature infants. often feeding them formula via dropper or syringe. Formula is very expensive in Haiti, but because these women didn’t have access to a breast pump soon after delivery, their breast milk supply dried up before their infants were mature enough to swallow. Unfortunately, 2 out of the 4 premature infants had died within a few days of birth, but there will soon be 3 breast pumps at the hospital that I was able to order upon my return. Better nutrition and at a less expensive price.
During my second week of clinic, a mother brought in her quite shy 6-year-old daughter who had suffered thru numerous medical appointments in the past, both at this hospital and in Port-au-Prince. She was born healthy but with ambiguous genitalia, neither fully female or male. While being raised as a girl, she is likely genetically male with a enzymatic blockage of full testosterone production. It is important to know her genetics (XX or XY) as she is at great risk of testicular cancer if she is XY. After contacting a pediatric endocrinologist in Minnesota as well as friends who work in Haiti, we were able to determine that there was no possibility of chromosome testing in country but that we will have the chance to get a tube of her blood to a lab in Boston in March that is willing to perform the testing, which is very expensive, for a much reduced rate. We can’t change the girls chromosomes, but we can offer risk reducing surgery in the future and also give her mother some answers to the questions she has been asking.
These patients are a reminder to me that sometimes even short-term medical missions can provide aid. Passing on surgical skills as well as making connections that I have cultivated over the years has a benefit and can make a difference.