Lizzy Berryman is Merlin's Country Health Director in Haiti. This is her second field diary.
Our team arrived in Arnoux, a hillside village of 10,000 people with limited access to health care. In practical terms, this means the nearest government clinic is over one hour's drive away and the nearest hospital involves a car and boat journey. The government nurse who visited weekly stopped coming six months ago. He took a paying position abroad - a common tragedy in countries with weak health systems.
We saw close to 160 patients, many with the usual ailments such as fevers, abscesses, acute respiratory infections and skin infections. But there was one young patient that stood out - Rosena Felix. At 14 years old, she was tiny, extremely weak, and on the cusp of being severely malnourished.
She'd suffered migraines for the last six months, causing her to vomit daily.
After she fainted in the clinic, we decided to transfer her to a hospital in Petit Goave, the main town about an hour and a half away.
Rosena's mother, Roselaine, a widow, had to put her three other children, including a nursing infant, into the hands of a neighbor while she accompanied Rosena to the hospital. As we loaded the car, she voiced financial worries, the costs of transport or doctors' bills. We assured her transportation, meals and medical care would be free of charge.
The hospital was supported by four or five international medical aid organizations. Navigating the admission process is often overwhelming when a number of organizations are trying to coordinate such an extensive emergency medical response. But we got Rosena admitted once we met a doctor on call.
He too was puzzled by her symptoms and ordered an intravenous injection of dextrose. He'd make sure she was rehydrated overnight. Tests would start the next day.
I returned the next night. Rosena was on her own; her mother returned to nurse her child back in Arnoux and would return in the morning. The tests hadn't come up with anything conclusive until the next day, when an x-ray revealed an old skull fracture - most likely the culprit of the migraines.
Prescribed an anti-convulsant and put on a nutritional plan, Rosena was taken home to Arnoux in the days that followed. Now we'll be seeing her on a fortnightly basis through the mobile clinics and monitor her progress.
Rosena represents one of the most important services these mobile clinics provide: preventing simple problems from becoming life-threatening ailments that can develop into severe illness. Rosena's migraines were undermining her health, but now we can get her on the road to recovery. And all it took was a referral and an x-ray.
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