Med student grows up fast in Haiti

By Elizabeth Gibson
THE COLUMBUS DISPATCH

Dr. Howie Werman of Ohio State University cleans Calixte Afantila's stomach at a clinic in Fort Liberte, Haiti, before medical student Maggie Rosen drains the fluid built up inside.

FORT LIBERTE, HAITI -- Calixte Afantila's swollen stomach looked as though she had swallowed a water balloon the size of a beach ball. It jiggled with each breath as she lay on a table.

"Whoa," Maggie Rosen of Columbus said as she opened the door to the exam room and saw the 90-year-old Haitian woman.

Afantila had about a quart of fluid in her belly, probably caused by cancer, the doctors on the medical mission to Fort Liberte said. Rosen, an Ohio State University medical student, couldn't do much more than drain the fluid to make Afantila more comfortable.

Dr. Howie Werman, a professor of emergency medicine at Ohio State University, wiped down the bulge, and then Rosen slowly pushed in a needle, snapped it to an IV tube and drained the fluid into a trash can.

"That's good, that's good," Werman said, leaning over her shoulder with a smile. The belly began deflating as Rosen pressed down on it.

"You'll already know everything now by the time you become a medical resident," Kristina Carr, a nurse from North Carolina, told her.

Before Rosen came to Haiti, she knew there was a clinic and she knew there were a lot of people in need after the Jan. 12 earthquake. But she didn't know what her role would be. To meet demand, the team basically promoted her to doctor.

"The hardest part is getting used to making decisions about diagnoses and treatments on my own without an attending physician," she said.

But she does have help when needed. Werman was working back to back with her yesterday in the cramped clinic quarters.

At one point, she pulled back the gauze covering a gash caused by the earthquake, instructed a nurse on what to do and then turned over her shoulder to double-check with Werman.

Practicing medicine in a chaotic environment without all of the modern equipment that she is being trained on at school has been a bit weird, Rosen said. Even her stethoscope was mostly useless because she couldn't hear anything over the chatter of the people crowding her on all sides.

Watching doctors out of their usual environment has been interesting, though, she said. People's personalities start to emerge in a clinic overflowing with patients, more so than in a formal university setting.

"Instant friends, that's what you get," said John Schreiber of Columbus, another first-timer on the mission.

The Ohioans also are making Haitian friends, such as the entourage of children who follow them around. But the newcomers said a lot of guilt comes with getting to know the people of Haiti.

No matter how many times Haitian pastor Andre Jean told them to make donations through the church -- so they wouldn't promote begging and so food could be distributed fairly -- the missionaries found it hard to resist the children pleading for food in Creole while rubbing their stomachs and looking up with sad eyes.

Lisa Alianiello, a nurse at Nationwide Children's Hospital, looked crushed when Jean asked her which of two girls she wanted to sponsor. She corralled both children in her arms and decided to sponsor them both -- $30 a month each for food and school.

Within minutes of crossing into Haiti from the Dominican Republic on Saturday, Alianiello was lowering a set of shoes out of the bus window to a barefoot girl.

The missionaries also have to abandon the line of patients who haven't been seen at the end of each day.

"Part of me feels really bad that there are people still there, but part of me knows that it has been a long day and I have done all I can," Rosen said.

The team members saw 314 people yesterday, and they needed a little time to relax before the roosters started to crow at 4 a.m.

Rosen said she misses warm showers. Peanut butter has been her main staple at meals, and the bathroom smells like a latrine, she noted. "But at least there's a toilet. It's not that bad."

Helping the Haitians is fundamentally not that different to her from what she deals with at home, she said. "I don't like seeing people sick at home. And I don't like seeing people sick here."