March 2009 Medical Clinic

Dear Friends,

This month we are pleased to bring you an update from Dr. Cynthia DeSoi, medical director of Klinik Espwa, on the health care happenings of the village - including developments in the nascent public health program and plans for a new clinic.

Curing a Community
Benito wandered up to me looking extremely uncomfortable - he was feverish and irritable. The 2-year-old's head was wrapped in an arrangement of leaves, the traditional treatment for mumps. After a quick examination at Klinik Espwa, Benito was given medication to help his discomfort and plenty of reassurance that he would be well soon.

A few years ago, Benito would have had to go to the hospital for help. His mother, who makes a meager living as a laundry lady, probably wouldn't have been able to afford the visit or medicine he needed to feel better - so Benito would have continued to suffer. Instead, he received immediate treatment at Klinik Espwa for free.

Benito is one of hundreds of children who have passed through the doors of Klinik Espwa, which opened in 2007 to serve the needs of the children in Village Espwa but quickly grew to accommodate a steady stream of patients from the surrounding community. Residents and staff of Espwa receive free care at the clinic. Members of the community are asked to pay a small fee of 125 gourdes, about the equivalent of $2.50, though patients are never turned away if they cannot pay.

The staff at the Klinik sees 20 to 30 patients daily, and when a visiting medical team comes, they'll see more than 100 patients in a day. They treat expectant mothers from the nearby birthing center; adults with diabetes or arthritis; and children with pneumonia, intestinal worms, and gastrointestinal illnesses. On school days, students will come in with headaches, infections, and anemia. Some of the more serious cases they see are malaria, typhoid fever, and an occasional HIV patient. And there is, of course, a steady stream of resident children with cuts, scrapes, lacerations needing stitches, and several broken bones every month. (Picture 650 boys playing outside everyday!)

Children lining up for their TB tests. Just $125 provides for the medical needs of a child for 1 year.

If one of our resident children has a serious illness that cannot be treated, we take him into town to a specialist or to the hospital, and we pay for his care. Before we had a clinic and the great staff that we have now, daily visits to the hospital, lab, and doctors' offices were common.

Meeting the Needs of Epswa's Children
When new children enter the residential program at Project Espwa, they are sent to the Klinik for a general health assessment, during which they are screened for tuberculosis, HIV, and skin infestations. They also receive a tetanus vaccine and de-worming medication.

The cost of this "medical welcome" is about $125 per child. The children also receive annual assessments of growth, nutrition, and dental needs, along with quarterly treatments for parasitic infections. Another $125 covers the ongoing medical needs of one child for a whole year.

Inside Klinik Espwa
Before it became Klinik Espwa the building was a classroom, a chicken coop, and a carpentry shop. The Klinik consists of one large room divided into two consultation areas. The smaller of the rooms serves as a medical records office and a pharmacy, which has a fairly complete stock of donated and purchased medicines. The other room houses a one-bed infirmary and a lab. The waiting room is four concrete benches outside. Two RNs and two nursing assistants are available seven days a week. A young doctor sees patients three days a week. Medical teams from the U.S. visit the clinic about eight times each year for one to two weeks at a time.

Public Health
Klinik Espwa has several community health programs, including tuberculosis prevention, HIV screening and education.

Plans for New, Fully-Equipped Clinic
My final piece of news: we are working toward raising money to build a new clinic. We've come up with a flexible design that will allow us to greatly expand our services. The new building will have a dental clinic (we already have brand-new equipment but have nowhere to put it), several exam rooms and a treatment area where we can do minor surgery, an infirmary where sick children can stay overnight, and an area devoted to public health education. There would also be an x-ray area, a laboratory, and a pharmacy. Though I love our current little clinic, it is woefully inadequate. We don't have x-ray equipment and can only do a few basic labs. We need this new building to keep up with our daily call to provide care to our own residents, villagers, and pediatric cases from the nearby birthing center. Please pray for the success of this new project.

As with all Project Espwa's work, it is your continued support that makes life-saving programs like these possible. Thank you!

God bless you,

Cynthia A. DeSoi, MD, FAAP
Medical Director
Klinik Espwa