Day 2- Sunday

Frustrated by finding a different opportunity than we imagined. Chaos, somewhat. Inefficiency somewhat. No lack of patients, that's for sure but we don't feel like we are doing disaster medicine per say. There are lots of fractures that need fixing, on top of the usual chronic human diseases complicated by scarcity of resources, trained personnel, and wellness knowledge. What these people have in plenty, though, is family, quality relationships and a faith in god. They have more prayer than anything. I am not sure it's helping. Everyone is dressed in their Sunday best- frills and ribbons, tucks and pleats. Another of many ironies here- little girls in fluffy dresses picking their way across filthy, cracked streets, through trash and poisoned water, motorcycle exhaust and skinny dogs to school or church. Chaos, yes they have in plenty.
Maggots. Maggots keep the wound clean, at least. This is a 92 year old gentleman with peripheral vascular disease. His poor circulation has caused what I am sure was a scratch at one point to brew into a large hole in his shin with tunnels that host little friends. They squirm away from the light when we remove his filthy yellow bandage. I am not as squicked out as I would be normally. I am not sure why. The little worms keep the wound a little cleaner, at least. Giving the pseudomonas and staph and whatever else less dead material to grow in and infect the rest of him.
How do they get there? Do flies lay their eggs there? Do all maggots look the same? I wonder about the fly's lifecycle. I wonder about my lifecycle.
Too many doctors, not enough nurses. Doctors fight over cases, try to organize themselves into an effective OR, but without anyone to structure things, they flail a little.
We all do.
Haitians are stoic in the face of pain and laugh, joke and tease their way through daily life. They shout, sing and stomp their prayers, but intense pain is met with a quiet "Oh-oh-oh..." I wonder if we subject them to more pain than is necessary because they do not complain about it. There is no 5th vital sign, here. I saw morphine on one man's chart but haven't seen any evidence of it being used. "Beaucoup doule?" I have learned to ask, despite having nothing but a smile and a pat to help when sometimes the answer is "Oui, oui."