Monday, May 15, 2006

Machetes & Medicine in the Developing World

Written By Britt:

Machetes are real bummers, I'm telling ya. Okay, so I know that it is a very useful and obviously necessary tool since everyone and their brother has one. Kids walking down the road with machetes, ahh...that's another story.

So today, about 3 this afternoon, a little boy came who was said to have a very bad cut. Since he was outside the gate, I figured it was pretty bad if he couldn't even walk up here. I stepped outside the gate to a crowd of about 15 standing around our injured friend, Wellson.

Wellson is 11 years old and a third grader at the Lifeline school and like most kids here, he had gone to work in the family garden after school was finished for the day. As the story goes, he was up in a coconut tree and his dad had been cutting branches down and dropped the machete on the ground. Wellson, the poor young chap, didn't know it and jumped down from the tree on the machete. Now I still don't quite get how a machete lands with the blade up but it must be possible.

I stepped through the crowd to begin to apply pressure to his foot. When I looked up, they were having him sip from what looks like a beer bottle?! I was concerned a bit. I asked Robenson (Lifeline interpreter) if it was beer? Robenson says, "No, it's not beer. It's Guinness." And I'm thinking .... hmmmm ... since when is Guinness not beer? He said oh no, it's just very strong, not beer though. Oooookay!

After the bleeding had stopped and I was able to get a better look, it was very clear that this little man needed stitches and in a big way. It was too late to take him to any clinic since the major one or two that are around here are at least an hour drive, maybe more. Robenson thought he knew of a place where we could take Wellson for help.

My Mom went to get the big truck and we (Robenson, Pastor Rony, Mom, Me, Wellson, his mom and his aunt) pile in the truck. The Guinness came too. I just sat in the back and kept pressure on his foot and kept it elevated to keep it from bleeding.

The first place we tried looked nothing like any sort of official Dr. office. It looked that way because it was not. We walked in and some lady dumped Hydrogen peroxide on him and took the pressure off long enough for it to start bleeding again. Thanks, I could have done that. She did not want to or could not (I never figured out which) give stitches. She seemed offended that we wanted him to have stitches. A few people who were hanging out at her house showed us scars from wounds that she had apparently helped them with. It felt sort of hostile for a minute and my mom said "we need to get out of here." So, we told her thanks for the cleaning and we left fast.

Robenson convinced us to give him one more try so we went to the next non-descript house, in the middle of a banana field to see the next "medical professional." We were starting to worry that we should have tried to do something for him ourselves.

Thankfully, this non medical place had a better prepared lady living there. She had a bunch of medical supplies and seemed to possess the knowledge to use them. But, before she could work she had to take a few notes. She asked our little guy his name, age and his mom's name. She also asked where he lived. After that she looked under the towel at his foot and took a few notes on his condition.

We informed her that the cut was plenty clean by now, after all that hydrogen peroxide used by the other lady (oh & apparently we "owe her" for the hydrogen peroxide. I'm thinking about just throwing a bottle of it over her gate the next time we drive by, since I'd rather not visit that place again). She went into her house and got a pair of gloves, some medical sponges, a needle (packaged!) and what appeared to be a local anesthetic. Things were looking up.

She numbed up the foot, which was so sad since that is the worst part of getting stitches; it's so painful the way they have to move the needle around. (I know because I've had them twice) After that she began sewing him up. It was really interesting to watch. I was empathetic and fascinated all at once.

She finished the job by putting iodine on the wound (with the same piece of nasty gauze she used for everything else!) and then wrapped it up. After that she gave him two shots, one for "infection" and a tetanus shot. At the end of it all, she wrote up a bill and gave the mom medicine for Wellson. The total was 450 haitian dollars, which is $56 US.

What an afternoon! Stitches would be a very useful thing to know how to do here, and hopefully I can learn sometime this summer if I get the chance to go stay with a NP up north. God is good, I'm so happy we found a place that could help him out. It was interesting, because when we were talking with the family ... saying that he needed stitches, they weren't going to take him. We just sort of did the American thing and said "well, he needs stitches lets go!" and they just looked at us like we were dumb. They said "we can't pay for it." It is so odd to think about the reality of this situation. Can you imagine having a hurt kid but not being able to go get him help? It is just beyond my understanding. We are certainly blessed.

The outside of what turned out to be the place where we took Wellson for stitches.

This is the medical records department. Seriously, all patient information is written in this notebook.

Me and Wellson prior to the work. If you are squeamish you should not scroll down.


His mom helped him by covering his face so he could not see what was happening. He was SO brave. The last photo is when the toe was stitched but the foot was not. The foot part hurt him the most during the stitching.

After all of this, I wonder if this lady did similar work to what a U.S. medical provider would have done. It is hard to know. Something is always better than nothing but I just hope that it heals properly and that Wellson is back on his toes again soon.