Monday, Tuesday, and Wednesday I worked with Kay. I wanted to overlap a few days with her because it has been so long since I have been here and things have changed- medications that are available, protocols, etc... Monday I pretty much observed and asked questions. Tuesday I saw a few patients and Wednesday I saw over half of the patients that came through our room. There are 2 Haitian nurses working at the clinic too. I didn't hear the numbers for all of the days but Mondays are usually busy days and 105 numbers were given out so we probably saw a few more patients than that. The patients get a number according to what time they arrive at the clinic and will be seen in that order unless there is an emergency. Jay's took Kay down to Port today- also Jay's folks and two of his nieces who were here visiting. Kay leaves today, the rest leave tomorrow so Jay's will come back tomorrow evening sometime. Today and tomorrow I will be working together with Roseline- one of the other nurses who works here. She knows English well so that makes it easier to communicate but I am trying my best to speak Creole because I will not have an interpreter working with me next week.

     We saw a pretty sick boy yesterday who was about 12 years old. He had a high fever and it seemed like pyelonephritis or some kind of kidney problem. He had a lot of pain in his lower back and abdomen and his urine looked horrible, 4 + protein, blood, etc... We gave him a shot of Rocephin and some Tylenol and observed him for a few hours. When his fever broke he did look better. He looked to me like one of those kids that are so sick they don't make a peep when they get a shot but he sure did holler and carry on when we gave him an IV, he was quite dramatic actually! Sent him home with instructions to return to the clinic on Friday. Yesterday there were several malnutrition cases that looked pretty pitiful. One was 2 months old, the other was 11 months old. The baby was supposed to go down to Port-au-Prince. The other child was already enrolled in the nutrition program in Foret. We did give him some antibiotics though for a gut infection and tried to stress how important it is that they follow-up  with the nutrition program. I don't have a good feeling about him though- 1 1/2 months ago he was seen at our clinic and weighed 6 kg, yesterday his weight was 5.2 kg. Today a lady came in who had 3-4 + pitting edema from her abdomen on down. Her abdomen was so swollen she looked like she could be pregnant. Her vital signs were pretty good, respiratory rate was definitely elevated and she had shortness of breath but her heart rate and blood pressure were good. We started out by getting an IV in her and a catheter to measure urine output. After two doses of IV Lasix she had put out 3900 ml of urine, and that was just in the first couple of hours. We sent her home also with medication to take and a follow-up appointment for Monday. She wasn't out the clinic door yet when a lady came who was in labor. She delivered after probably 45 minutes. She needed some encouragement to really push, she was getting tired it seemed, but she rallied and delivered a baby boy. The cord was around his neck but it didn't take him long to come around. After a while they walked home, the proud daddy carrying the baby.