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Making the Effort to Live in Cité Soleil

Port-au-Prince.

We won’t be able to go to Soleil tomorrow.  Too much shooting. Gangs against gangs and then the police come and shoot too. My driver Djongo does not play. He grew up in Soleil.

But this morning I creep into Drouillard on the outskirts of Soleil to check a patient named Daniel. A cement maze of corridors. Up a stairway to where? A cell phone light shows me Daniel’s face. We hug. Daniel’s mitral valve is squeaky and he is thin. He can’t breathe in this dark room. His bioprosthetic valve has calcified and he needs help from St. Jude. He is scorned on both sides of the water but says he will make the effort (m’ap fe efo) and slowly elevates his cachectic frame onto a tap-tap for an echocardiogram in dusty terrible downtown.

We continue on into Soleil. No gunshots this fine morning. But the general pediatric clinic in the back of Soleil is only one-quarter full and the starving-baby clinic is only one-half full. The mothers are afraid to come today. Who likes ducking bullets?

And since January 1, three weeks ago, the Haitian Hospital next to the pediatric clinic is now charging 100 Haitian dollars for a bed and 250 Haitian dollars for oxygen if you need it. And 50 Haitian dollars will buy you an IV and rehydration fluid that will save your miserable life. And a treatment of a first degree burn is cheaper than treatment of a third degree burn. These obscene charges keep many moms and babies away because they can’t pay. Only eight babies in the almost empty shabby rooms of the pediatric department. There should be hundreds of babies filling these rooms getting treatment for the ubiquitous stupid slum illnesses.

However a sad sixteen year old brought her baby boy in after paying eight Haitian dollars for his dossier. Baby Boy is nine hours old. He has no real name quite yet. She delivered him in Sarthe at 3 AM this morning and carried him into the slum today at 11 AM because he wasn’t moving or crying. His cord was tied with a dirty piece of cloth. Baby boy stared and took shallow breaths. But he would blink if I blew in his eyes.

My guess is hypoxic encephalopathy while he was trying to enter this hell. Who knows? Mother was staring too with no emotion at all. Oxygen per nostrils and an IV and NG tube didn’t do much for Baby Boy but he was making the effort to live.

John A. Carroll, M.D. is a physician working in Port-au-Prince.