Monday, July 28, 2014

Roads, remote clinics and lymphs systems

The plan was to visit each of the four chosen mobile clinic sites in that one week.  We would be able to help with the set up, assess potential obstacles and see what additional supplies and support were

The sites were remote and far up into the mountains.  We piled into vans and made our way.  The roads were often more of a foot path;  intended only for animals and people walking and not for vehicles.  There were no tap-taps and rarely even a moto.   With each foot spent climbing upwards, I was aware of how it would be nearly impossible to get a woman down in an emergency.   It was far but there were also no vehicles and the going was very slow, even with one.  The idea of the mobile clinics was to prevent complications, treat what could be treated and help women to know if they should wait for their  birth in a place closer to emergency care.  

The roads in Haiti make transport for emergency medical care in childbirth almost impossible.

Meanwhile the lymph system within me, was also trying to assess the damage being wracked inside it. The tiny viruses ( 1/100 th the size of a bacteria ) were trying to reproduce inside my cells.  They cannot reproduce without invading a host cell and in this case I was the host; bouncing along rocky, dirt  roads.   My body was fighting hard to eliminate them through my own internal paths of immune system.   It was trying to understand who the new virus was and make antibodies to stop it.

We climbed higher and higher,finally coming to a flat, fertile area; isolated but lovely.  The clinic was held in a church and with the help of the community health worker and midwife was quickly set up and seeing the women who had gathered there. They were told the midwife and doctor would come every month.  It was a moment of hope and possibility.

After about an hour, I forced myself to fall  down in the grass rather than faint.   My blood pressure, always low was even lower.  I laid looking up into a tree  with my world spinning about me.  The nurse continued to say I could not possibly have Chikungunya so I lay there wondering what I could possibly have.  

In time, I would see that just as the roads to the village were critical in saving lives, our own internal highways of lymph would be critical in saving my own.  Was it working well?  was it free of rocks and potholes and able to quickly eliminate the dead cells that carried the virus?   Just as I had never thought of roads as a critical component of good midwifery care, I had taken my lymph highway for granted.

When the women were all care for and we packed to go back to town, I began to ached from head to toe.  I limped to the truck, up the steps and fell into a delirium of cold and hot.  Later, much later the CDC in the United States would confirm it was indeed Chikungunya.   By Wednesday night, after our second mobile clinic visit, a nurse had developed some symptoms too and it was decided to go home.

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