Helping in Haiti: Dr. Khare Checks In

Northwestern Medicine
Emergency Medicine and Trauma February 13, 2012
Dr. Khare in HaitiAs a follow up to the February 2 post “Northwestern Medicine Doctor Heads to Haiti to Teach Emergency Medicine,” below is an update from Rahul Khare, MD, emergency medicine physician at Northwestern Memorial Hospital, regarding his journey.

It’s been a phenomenal week so far. We are in Cap Haitien, Haiti, a city in the north of Haiti on the water. We are working at the Justinian University, which is the 2nd largest hospital in Haiti. Justinian University has a nursing school, residency (one year for primary care), and over 250 hospital beds (including surgery, medicine, OB/GYN, pediatrics, urology, and orthopaedics). Like many hospitals, the ER is not a big part of the hospital…yet.

First let me describe the hospital. It has no cardiac monitoring, very little oxygen, few lab tests, and 3-5 hours of no power a day. It costs about $3 to see a doctor, but if you need sutures or IV saline or any medications or x-rays, the doctors will write an order, and you or a family member will go to the pharmacy or radiology area, and purchase what was ordered. Obviously, in a 3rd world country, this is prohibitive, as I had a patient who was involved in a motorcycle accident who had severe tenderness and pain, yet would not get his x-rays because he had no money. The ER is crowded, and there is no real triage. In fact, patients are normally seen on a “first come, first serve” basis. The only exception of this is when people are extremely ill, where those in front have no objections to the sicker patients cutting in front of them.

Here’s what Dr. Khare had to say about his first day of work… 

Woke up at 6am, grabbed coffee and walked a mile to the Justinian Hospital. I gave the 1st lecture on Acute Myocardial Infarction (heart attacks). The night before, I had to make major revisions because the hospital does not have any cardiac biomarkers (lab work like Troponin). It was interesting to give a lecture on heart attacks without the main way we diagnose it. There were a total of 40 students at the lectures, all extremely attentive and smiling, many taking notes. It was great to see. We had a lot of interaction, which is not the case for most Haitian students.  I asked a lot of questions too.  They don’t offer a lot of the procedures or use the drugs we do.  In theory, they have aspirin, Beta-blockers, statin, Ace Inhibitors, and Plavix, however I have not seen anyone on these medications while I have worked. There is no dietician to discuss eating a low-fat diet, which is almost impossible here, as most food is fried, large amounts of rice, and a desert of fruits and vegetables.

We worked until 6pm. I was pretty exhausted, but extremely amazed at the students’ gratefulness. I did 2 hours of lectures, 1 hour of small group, and saw five patients with the resident while doing some bedside teaching. Pretty awesome day.

We hope to share more updates and photos, so stay tuned.  Thank you Dr. Khare for sharing your journey.  The people of Haiti are fortunate to have you.