“Haitians are survivors…they just revive out of any situation”

A Day in the Life of Dr Joey, Telemedicine Clinic Director

The Doctor is in...

 

My interview with Dr Joseph Prosper gave me a taste of what a Telemedicine appointment feels like: we connected over VSee (a Skype-like video-conferencing tool) which the doctor also uses to see his patients in L’Estere, Haiti no matter where he is in the world. Right then he was in New York for a meeting with officials at the University of Rochester about a potential collaboration with the LifePaths Global Alliance Telemedicine clinic for which Dr. Joey is the Medical Director. Dr. Joey had just finished with one of his semi-weekly Telemedicine clinics when he sat down to speak with me and agreed to walk me through a typical day.

Logging into VSee, Dr Joey connects with the LifePaths Global Alliance (LGA) rural clinic that serves as the outpatient clinic for the 38,000 inhabitants of L’Estere. He is greeted by Wagner, one of three Telemedicine Agents, who are local Haitians -who will serve as the “hands of the doctor.” At the back of the room, he can see the group of people patiently queued at the registration desk, holding out the pink cards that they picked up earlier that morning in order to secure an appointment for today. With just one doctor on hand, the clinic can accommodate only 50 appointments a day, 40 for regular patients, and 10 for any emergency cases that may show up.

Angela at the desk registers each patient and measures their vital signs, documenting them for the clinic’s records. Despite their meager means, the clinic vigilantly follows proper medical practice by conducting a basic physical exam.  

As the clinic officially opens and patients are registered, Wagner calls the first patient over to the examination room.   Dr. Joey says, “Bonjour Patient! How are you feeling now?” Most of the patients coming in are known to Dr Joey, who has been conducting mobile clinics in the area for nearly 3 years now.  Dr Joey asks them about their particular ailment while Wagner probes the patient for symptoms according to the doctor’s instructions.  Assorted diagnostic tools such as Otooscopes and Stethoscopes are used to check the patient and possibly allow the doctor to get a direct look at the specific area of the body. The Telemedicine Agent also reads any lab results that the patient may have been sent for previously.  Wagner can share documents with Dr. Joey.  Once satisfied with his examination, Dr Joey types out a prescription, which Wagner gives to the patient who is then sent off to the in-house pharmacy to collect it from Johab.

Wagner now calls forth the second patient. Natalie has been suffering from a high fever for the last couple of days. After questioning her, Dr Joey determines that the symptoms are not specific enough for a clear diagnosis and prescribes antibiotics to get the fever down. Unspecific fevers are a common condition seen at the clinic, and waiting for the patient to get detailed lab tests done in order to determine the cause before any action is taken, can usually result in losing the patient altogether. The Telemedicine clinic in L’Estere serves as a primary health care center, a first port of help, where patients are treated to recovery, or at least have their symptoms controlled while they seek more sophisticated help.

Other patients that follow present a mixture of symptoms: high blood pressure, fevers and diarrhea. When the cholera outbreak happened in 2011, the clinic stepped up and started providing intravenous therapy to alleviate dehydration.  Now IVs in the clinic continue to provide treatment for any cholera cases that show up. Such care is provided by the three Telemedicine Agents who have all been trained as nurses’ aides.  The 3 Telemedicine Agents live in the local community and are familiar with the townsfolk and have the trust of the patient; a system that LGA was deliberate in pursuing for the sake of sustainability. Unlike other medical clinics that sprang up after the 2010 earthquake, the L’Estere clinic is the only one that has remained open since its inception; a feat achieved largely through involving the local Haitian community and through the financial support of LGA.

The day finally begins to wind down in the late afternoon, but the clinic will remain open as long as there are patients to see.  There were no dire emergencies like the ones I see on episodes of ER, which is a good sign. This may not be the happening life of Chicago County General Hospital, but its every bit as exciting. This is real life. 

I ask one last question before I take my leave. Why do you do what you? Dr Joey recalls a story from several years ago. While on a mission in Jacmel, the doctor was single-handedly seeing over a 100 patients a day in his mobile clinic, a task that was overwhelming at best. Beseeched by a little girl at his window who was unable to secure a card for an appointment that day, he agreed to see her younger sister who was suffering from severe malaria and gave her the necessary medication. The next day when the girl reappeared at his window, the doctor feared the worst. Nervously approaching her, he was surprised when the girl smiled and produced a bag filled with canapas that she had spent hours picking from trees in the yard. When she showed up at his window to offer him the delicious Haitian berries in return for saving her younger sister from life-threatening malaria, Prosper knew he had to continue with his mission.

“They’re delicious!” he laughs, joking about his real motive for staying. 

Written by, Sahar - LifePaths Global Alliance