Abstract
A 30-year-old unresponsive woman was cared for by a volunteer team of US medical professionals at the Partners in Development Clinic in Port-au-Prince, Haiti, during the December riots. Previously, she had been evaluated at the clinic for vomiting and had been given granisetron after lab results showed a normal urinalysis and blood glucose level and a negative pregnancy test. The day she re-presented, her family called the clinic because the patient lost consciousness and had a possible seizure after arguing with her husband. A medical team dispatched to the patient's tent village found that she had stable vital signs, reactive pupils, no signs of trauma, and a blood glucose level of 120 mg/dL; however, she was unresponsive to painful stimuli. Once at the clinic, she underwent a more complete evaluation, including a negative malaria test. At this point, the clinic's limited resources were exhausted but, due to armed rioters, the patient could not be transported to a local hospital. After the patient remained unchanged during the night, her husband visited a voodoo priest who cast a spell to aid the patient. One hour later, the patient awoke, interacted normally with her family, and left the clinic ambulatory.
A combination of factors impacted patient care. First, the clinic had limited resources and intermittent electricity. Secondly, rioting restricted transportation and supplies, and it increased stress in this already traumatized population. Furthermore, illnesses were compounded by underlying malnutrition, anemia, and poor living conditions. Finally, team members were providing care in an unaccustomed medical and cultural environment.
Medical care is not provided in isolation; rather, multiple factors impact the patient and should be taken into account during treatment. Skill sets developed in more ideal settings can be translated into a valuable foundation for providing care in suboptimal circumstances; however, maintaining a cultural awareness and openness is critical.