Post provided by Barbara Bergin, MD
I spent the summer between my first and second years of medical school in Mexico City, working with an ophthalmologist who did some volunteer work for the sugar plantations. We saw some incredible stuff. The tolerance for suffering in people of Third World countries is extraordinary. Loss of an eye is common in the sugar plantation work. I guess they get stuck in the eye with part of the plant and it punctures the eyeball. So then they would schedule an appointment to see the doctor much like you or I would schedule an appointment for a routine eye exam. There was no emergency visit to some big eye center in Mexico City. They had a 9:30AM appointment just after the guy who was there to get a pair of second hand glasses. Then they would get scheduled for an enucleation (eye ball removal), which would also get done whenever the doctor had an available time on his surgery schedule! Their eyeball would look like a little raisin sitting in the socket. And the patient wasn’t there, screaming like I would be, “WOULD-YOU-LOOK-AT-THIS-EYEBALL-AND-FIX-IT-NOW!” These plantation workers would walk around with the little raisin eyeballs as if it were an errant hair on their brow.
Their family members could also come to the clinic and many of them had amputations. Once you have an amputation in Mexico as in Haiti, you become a ward of the state (whatever that means in Third World countries). There were no prosthetics, unless you knew someone who could make you something out of wood or you could afford to buy a used or stolen one at some market. Most people had ancient crutches, like the ones you see in old Civil War photos. They look like wooden t-posts. They had huge callous formations on the web space between their thumb and index fingers and I could tell by looking at their hands, many had lost the function of their ulnar nerves from leaning on the crutches for years. Their pinkies were numb and contracted.
We rarely see this kind of thing in the United States. If you lose your leg, whether you have insurance or not, a whole system of doctors, nurses, social workers, prosthetists and physical therapists go into action to get you a prosthetic leg that fits AND functions. And if it doesn’t fit and function, then you have an opportunity to go on disability! It’s amazing and because of this system you see people who can run and compete in sports with a prosthetic limb! The people in Haiti won’t have access to this kind of process. They don’t even know it exists. A young man or woman or a child with wooden t-post crutches could easily become the “poster child” for Haiti rather than a healthy, hard-working Haitian with a functioning prosthetic limb. I’m not sure I know the answer for this. Knowledge and understanding the problem comes first. No, getting the Haitians past their rainy season comes first. Then a whole ship load of crutches…
Barbara Bergin, MD