Doctoring in HAITI Twice a Year

Timothy Foeller, MD, and Megan Foeller, MD.

As measured by per capita income, Haiti is the poorest country in the western hemisphere. It has a lot of things working against it: crumbling infrastructure, political instability, an undernourished population, and a location that makes it prone to hurricanes and earthquakes. Its medical resources are few.

In La Croix, population approximately 600, 12 to 14 medical missionaries arrive twice yearly, paying their own expenses, to attend to whatever medical needs they encounter. Word travels fast, because Timothy Foeller, MD, a clinical instructor of hospital medicine, and the other three physicians each treat about 100 patients a day for two weeks. There are also four nurses, a maintenance person, a pharmacist, and a police officer who organizes the 600-plus patients who show up every morning. “Our catchment area is much bigger than La Croix,” says Foeller.

"We see everything...from pediatrics to geriatrics.

“Once an 85-year-old woman showed up. She seemed a little demented, which is rare because people there usually don’t live long enough to develop dementia. She looked confused and wasn’t responding appropriately. It turned out she was from a town 30 miles away over a mountain, and she had walked most of the way.”

What leads a doctor to a medical mission to Haiti? For Foeller it’s a family trait: “I got involved with Haiti about six years ago through my wife, Megan [Foeller, MD, a clinical instructor in obstetrics and gynecology]. Her uncle, a semi-retired emergency medicine doctor in Rockford, Illinois, and his wife, a cardiac nurse, got involved with missions to Haiti 20 years ago through their church. Megan got involved when she started medical school, and I started going when I met her. The 501(c)3 organization we are affiliated with is Friends of the Children Haiti .”

The illnesses they treat run the gamut. “We see everything,” says Foeller: “high blood pressure, acid reflux, badly infected machete wounds, burns, TB, HIV, malnutrition, birth defects. Everything from pediatrics to geriatrics.”

The group has developed several initiatives aimed at controlling some of the population’s greatest needs in the six months between their visits.

The first initiative concerns high blood pressure, which is the source of many strokes and heart events in Haiti. Addressing it requires both medications and education. “We explain that patients must take one pill a day, and that’s a foreign concept to them,” says Foeller. “We give them a six-month supply and tell them to bring back the bag with any pills they missed taking. If they don’t bring it back they don’t get more pills; they always bring it back.”

The second initiative selects several local individuals and teaches them to be emergency medicine technicians. “We give them gauze pads and teach them basic wound care,” says Foeller. “We have them take blood pressures in hypertensive patients. We give them glucometers so they can check on the diabetics. They do a good job.”

“The third initiative is Megan’s. Nine years ago she learned that midwives deliver most babies. She asked all the midwives to come to the clinic so she could meet them, and 20 showed up, mostly 60-year-olds with no formal training. She spends one day each visit re-educating them and giving them sterile materials like razors and latex gloves. It takes a long time to teach someone to put gloves on who has never seen gloves.”

In summary, says Foeller, “lots of things are very rewarding about our time there. We provide a good service and we help a lot of people.”