Director’s Blog: Finding solutions for continuity of care

“He is so young and brave,” I thought.

A patient was being treated by the mobile clinic set up by Unite de Lutte pour la Sante (ULS) Health Center in Labadie for an infected finger that had been caught in a door. As Dr. Maudelin Mesadieu injected lidocaine into the surrounding areas to numb the swollen finger, I could see the young man’s face in pain. A few minutes later, Dr. Mesadieu applied pressure to drain the finger of pus and infected blood. As the patient continued to sit on the chair after the procedure, I could see a look of relief on his face.

The procedure was a simple one in terms of time and effort. However, the patient had to wait for months for the mobile clinic to come to his village so that his finger could be treated. That is the reality of rural Haiti.

The trip to Labadie from Cap-Haitien is a beautiful one, with nice views of the city and side views of the Caribbean beach. To get to the village of approximately 6,000 residents, one takes a 15-minute bateau-taxi (taxi boat) ride.

ULS Health Center’s mobile clinic goes to Labadie on a Saturday every other month, and the visits are arranged with the help of leaders in the community. During my most recent trip to Haiti, I was able to join Dr. Mesadieu, the executive director of ULS Health Center, and his team, which included another physician, two nurses, and two community health workers.

The patients waiting at the clinic were a mix of adults and children. The adults were mostly women, and the children ranged in age from newborns to teenagers.

The mobile clinic was very well organized. The first team obtained demographic information from patients and checked their vital signs. Next, the doctors observed the patients and wrote prescriptions as needed. The last team ensured that everyone received appropriate medications with instructions.

The healthcare professionals did an excellent job of ensuring that patients were treated well. All patients received consultations, and those who had complex questions were able to engage with the team to discuss next steps. Everyone looked happy and satisfied.

However, one thing remains clear: challenges concerning continuity of care still exist. While the patients are able to come to the mobile clinic in Labadie, it is not easy for them to travel to ULS Health Center in Cap-Haitien on a regular basis. They have to maintain their work commitments during the day, and travel outside the village requires a lot of planning and effort. Some patients who have more complex medical issues need to be examined at the outpatient clinic of Justinien University Hospital, the large public hospital in Cap-Haitien. However, that requires even more planning, as clinicians there are often inundated with patients.

People such as the young man with the infected finger often have to wait months for simple medical treatment. Additionally, they need to wait for follow-up care, as in the case of the young man to ensure that his finger heals well.

Dr. Mesadieu and I often discuss these challenges as we work together to provide healthcare in northern Haiti. Konbit Sante provides support to Dr. Mesadieu and ULS Health Center in terms of funding for staff, medications, supplies, and building infrastructure. We also provide programmatic support to strengthen the capacity of the community health workers, nursing staff, and pharmacists.

What I understand, value, and respect is the ability to work alongside the team at ULS Health Center. By visiting the mobile clinic, I was able to learn much more about the complexities of the clinic’s work and the challenges that lie ahead for all of us, including Konbit Sante.

I am confident that the team at ULS Health Center will continue to care for the people of Labadie and others who lack easy access to professional medical care in their communities. At the same time, there is a lot more work for us to do. We have to continue to think of strategic and reliable ways for patients to obtain continuous care for their medical needs.

“Together, Konbit Sante and ULS Health Center will continue to strengthen the approach to care and find reasonable solutions,” Dr. Mesadieu stated with enthusiasm. I couldn’t agree more.