The patients who arrive in the outpatient clinic often wait for hours to be seen but without any good reason. The child is there. The physicians are there. But the clinic nurse does not give the chart to a physician. I keep asking the interpreter to ask for a chart but I cannot seem to make this process speed up. There is an inherent slowness to the system. No one seems to be concerned. The patients wait in silence. I do not understand this.
Today I saw a three month-old baby brought in by a mother whose breast milk stopped 8 days ago. She has been giving the baby soda pop for food. I wrote a prescription for formula and she will be able to get this for free.
I did not see a child who was brought to the clinic by a friend of the mother. The child was in hospital a few weeks ago and asked to return for follow up. The requested follow up was for yesterday but the family could not come. Instead they sent the child today. The hospital number on the follow-up note was wrong by one digit so they could not find the chart. I sent the interpreter to help but he said nothing could be done. I took the note to the paediatric ward and asked the clerk to look up the child and we found the correct number. The child went back to administration for the chart but they refused to allow the child to be seen because the child was not with the mother. I do not understand this.
A man who spoke good English asked me to sign a note so his child could be assessed in the clinic today. I signed the note. Later I saw the child with the mother. The mother looked very well turned out. This is not your usual poor Haitian family. The story was fever every night since November 30th. The mother was very specific. The fever started exactly 23 days ago and has continued every night. The child is otherwise well. The boy is happy and he eats, plays, and sleeps fine. He has no other symptoms except fever. The six year-old boy had a completely normal physical exam. I could find nothing wrong. I think the parents wanted a check up by the Canadian doctor.
Mothers are obliged to take their child to the lab or x-ray to have these procedures. They are also obliged to go to the pharmacy to pick up oral medications. My job is to fill out a requisition or prescription and give this to the nurse who explains the process to the mother. The mother is supposed stop by at hospital administration for the requisition or prescription to be officially stamped. About a quarter of the time the mother returns to say they were not allowed to have the test or to be dispensed the medication because there was no official stamp. This is a daily frustration. I cannot fathom how the communication breaks down so often. I do not understand why these forms are not stamped on the ward.
There are no bathrooms on the ward for the children or parents. The older children sit on pails to poop or pee. There is a very public bathroom by the entrance. Mothers take naked sponge baths in this open bathroom. Modesty is a luxury that these poor people cannot afford.