Tuesday's Le Petit Savanne clinic day

Today was tuesday and that means clinic day. One group went to the La Plaine clinic while my group went to Le Petit Savanne's clinic. The last time we went to this clinic it was closed but today the district doctor and pharmacist were there so there was a huge turnout. I think we counted about 35 patients waiting there at one time. One of our preceptors said it was the largest turnout she's seen in 3 years. Upon arrival, the nurse made an announcement of our presence and that the patients could ask us anything. She was extremely hospitable and the patients were incredibly warm and more than happy to share with us; welcoming the extra help.  My first impression was that the clinic was very small; about the size of someone's kitchen and dining area in north America. The patients came in the morning and the nurse and doctor started triaging people based on the severity of their illness. I asked one of the patients how long they usually have to wait for and she said if she wants to go to the clinic, she plans on staying the whole day ... and yet none of them got impatient or complained.  After talking to the patients, it seemed like the most prevalent disease states were diabetes and hypertension. Although the medications are free, the supply is extremely sparse which limits not only which medication is prescribed, but also the amount. The pharmacy was the size of a small walk in closet but no one seemed to complain about that either. The pharmacist gave the patients their medication and kept track of the remaining inventory after every patient manually in a huge book. If a medication was not available, the patient could go to the city which is an hour drive away and purchase it at a pharmacy there which really hinders compliance. At the end of the day, the pharmacist would pack up what little medication she had and take it with her. It was shocking to see such little inventory. One of the patients I talked to was asking for GERD therapy and although we donated some PPIs, we didn't have anymore and so I had to recommend H2RAs or over the counter and non pharmacological therapies. Thus, although the island is very lavish and the people have plenty of food and water, medicine is what seems to be lacking as their health issues increase from the influence of North American culture. Hopefully we can teach them and help them in any way we can that is sustainable once we leave, but in the meantime, I've realized how important it is to keep sending even the simplest medical supplies such as bandages for which they are almost too happy to receive. 

~ Sincerelly Maria