This is a very
poor country and we're
right here in the middle
of the richest country in all of Africa.
2.2 million people,
a third of all the adults are living with HIV
and the mountains
are where a lot of people live.
This is the most
challenging situation I've ever been in.
First of all you can only get there by airplane.
Secondly
the nature of the disease patterns
we've just never dealt
with a country before that has 30% of its adults living with HIV
that just complicates everything.
tuberculosis, now we know drug-resistant tuberculosis is a major
major problem.
We just started doing what we've always done which is to try to bring
good people who've had experience in delivering health care very
for settings,
"ok, next Monday"
hiring lot of local people
and then working with them to try to
dramatically upgrade the quality
of services
thirty years old
newly diagnosed HIV today comes in chronic diarrhea
and also acute hearing loss.
So on Wednesday she lost her ability to hear.
You know we were very lucky because one of our most experienced doctors to Jennifer Furin
volunteered to come and lead the team
So I think at this point
that lady needs to move out,
when she's ready to go she needs to be admitted and the usual.
So I left a note in the bucana.
It really takes a person like Jen
with her extraordinary background
but also the fact that she received such great training at Harvard medical school
to Brigham Women's Hospital,
she's bringing all those things here with her.
she should get some
Ceftriaxone, 2 grams
She should get started on TB treatment,
and high dose Fluconazole, and with the hearing loss, I can't think of anything other than meningitis
that this could be. And we should start her on Prednisone.
so let me just put a note in for
the medical officer.
The fact that things have developed and grown so quickly here is a
fantastic testament to Jennifer, to Jonas Rigodon one of our physicians who came
from Haiti
" It is ok mam, almost finished"
Jonas was trained
in the Partners in Health method
in the clinics in Haiti. He is another extremely accomplished individual,
he studied for two years in Belgium, speaks French fluidly, he speaks English fluently,
speaks Haitian Creole,
and he's now here
working with Jen to develop these critical services that
you know I think
is as good as any in Africa.
"Exactly, there is no real confidentiality
but the patient is excited also to come to see doctor because they are sick
and they need help, they come to get help.
but we are improving everything, as you can the new clinic right here,
and fiscal control and everything, everything is getting better after a few months.
these are places that have never had a primary health care system
so
a lot of the kids have never have vaccinations,
and there's no such thing as such thing as a regular doctor in fact until we came in
there was no such thing as a medical record. In other words
if you're really sick and about to drop dead you come to the clinic
and they try to do something or other and they ask you pay
and if you can't pay and you can't do anything, you die.
And so a lot of these places are known as places where you go to die
as opposed to places and that reach out to you to keep you healthy
Now, that's what we're trying to do here. "you know I think the painful feet are probably
nutritional and HIV neuropathy
I mean that's how I would put
this story together
although it could be wrong
and the reason that we're going to have her stay is so that you guys can watch her
when I go to the Brigham,
there's a hundred doctors on the floor I'm on, and if I forget to do something properly, somebody else picks it up
so in some ways this job is very stressful because
if I forget to do something for her it could mean the difference between her life and death as well.
They don't suppose one can expect to know the
joy of saving a life plan if one isn't expected to also know the pain of losing one.
So that's what we do here.
we're not giving in to the poverty
and inequality
and the terrible conditions here.
Our goal has always been
that all the fruits of the extraordinary labors of people
in hospitals in the laboratories making new tools that have just transformed medicine
our conviction always has been
that everyone on the face of the earth
deserves to have access to those things
and of we want to train
the next clowder of Jennifer Furins
"he's too skinny"
who will be able to go to all corners of the Earth
to deliver these kinds of tools
"you should come and see us"