16 Nov 08
We're delivering all of Port-au-Prince these days.
I exaggerate only slightly. The Hopital Generale is still on strike--we're at about five weeks now – and so is Hopital de la Paix. The remaining major hospital has closed since Friday afternoon for decontamination. Apparently they have been having problems of wound infections there. They plan to re-open Monday morning.*
So, besides us, there are two small hospitals at opposite ends of the city, each with small maternity wards, that remain functional. But they usually don't have anaesthesia available after hours. And sometimes they don't have an obstetrician present. There is supposed to be a midwife there 24hrs a day.
When I arrived at Jude Anne Hospital, two months ago, it was a 65-bed hospital. Despite already being cramped and always full, we have managed to become a 79-bed hospital. This doesn't count the triage and delivery beds, which we have also increased to nine and six, respectively.
It also doesn't count the pediatric ward, which is really a neonatal unit. We have a lot of premature babies because of the medical complications that women are admitted with. One day last week, we had 21 babies admitted, so many that they were sleeping on the desk and on the scales. Fortunately they're small.
We should be medically triaging patients and keeping only the most urgent and serious cases. But with no other maternity to transfer patients to, we're keeping everyone.
And people come not only from Port-au-Prince, but from further afield also, to deliver here. From a town 120km away, for instance. Our staff tell me that there is no reliable health care in that area.
Since March, there has been a national program for free obstetrical care (Soins Obstetricaux Gratuits). It's funded by CIDA through the WHO. I won't comment on it.
*as of 22 nov, they are still closed.