Mar 10, 2013

Something to think about......

Something to think about......

Friday morning I did an evaluation on a patient I can’t stop thinking about. Her name is Marie and she is 85 years old. She came walking up to our clinic with a large stick as her cane as she shuffled unsteadily along. She had a script from one of our doctors stating she has severe arthritis in multiple joints, difficulty seeing, high blood pressure and impaired balance secondary to dizziness. Unlike most of our patients she came alone without a family member.

I was greeted with a huge smile as I sat down to start to inquire how I can help my new friend. She had no idea what therapy is but was very eager to visit. Each simple question resulted in a story about something from the past and at times I found it difficult to follow as she kept trying to speak in French instead of Creole. I eventually needed to ask for help to translate her stories so I could get more information.

We take BP’s on all patients that come to therapy and her BP that morning was 180/100 which I can’t say is not all that uncommon here but still high enough to be concerned. She stated she had medications at home but had difficulty seeing which med was which. This was when I learned that she has no one to help her at home. This 85 year old who spent her life teaching for a government school and taking care of her family now has no one to look after her. Her husband has passed away and the rest of her family has moved to the states. She tells me her most difficult daily task is fetching water to bathe and wash clothes. She states the well is not too far but she needs to carry the bucket then once full she drags it with a rope back to her house. When I asked how she washes her clothes she stood up leaned forward and made the scrubbing motion. When I asked if she had blocks or a table at home to put the kevet (tub of water for washing clothes) on she said no she only has a small little chair that is difficult to get out of. She mentioned she has fallen a few times but was proud to say she gets her clothes washed.

I was in shock trying to process all that I was hearing. It was hard to not be angry thinking of this ladies family now living in the states, but doing nothing to help care for their grandmother that cared for them for so long. At the same time I was taken back by her resilience to overcome just simple daily tasks at her age. She had found a way to keep on living with peace in her heart. She did not once ask me for anything or show one sign of bitterness over the struggles she faces daily. She just simply was sharing her story with me. Here very often as a  blan (white/foreigner) I am asked for food, money, you name it but not this lady she just simply was sharing her story as I continued to ask questions.

Clearly there is not much I can do to change the severe arthritis in my new friend’s frail joints, but I thought surely there has to be something we can do to help this lady with her daily activities. So I went into the storage closet and found one of our sturdier rolling walkers with a seat and basket in the front where she can port her water. When she saw it her face just lit up and she gave me the biggest kiss on the cheek. She was eager to take it for a spin and then needed a sit break on the seat. She couldn’t stop smiling until it came time to go.  I asked if she came by moto and was surprised to hear she walked. She said she did not have money for a moto so she needed to walk. She was now afraid of walking down the street with her new walker over the rocks. She did not want to fall and she was use to her stick. I told her she just needed to practice and that the walker gives her more support to balance. I then agreed I would walk with her so she could practice. She was all excited for me to visit her home so she agreed to try the walker. Off we went Raymond our rehab tech, Marie and I down the street. Now I say street relatively more like dirt road with potholes, rocks and on this day since it rained the night before large mud puddles. But off she went pushing her walker along occasionally getting stuck on a rock or needing a little guidance and rest break. As the cars, motos, bikes, pigs, goats, and small children whizzed by she just kept on trucking not even phased. In my mind I was thinking how in the world did she manage to do this without getting hit on her own given her vision and poor balance. A mile and a half later we had reached her home.

Just to get in the yard there were multiple large piles of small rocks that are used to make cement. She required help navigating around this with here new set of wheels. Then we reached her house, which had two outside steps making it impossible for her to independently get her walker into her home. (This is something we hope to help fix with a ramp). A young lady greeted us to help open the door upon request and then left to go to the kitchen not to be seen again. I was excited hoping that this lady actually lived there and could provide some help for Marie. I learned this home belongs to a friend that primarily lives in the states but she has allowed Marie to live there. The young lady is the care provider of the home but unfortunately does not help Marie with anything. She will occasionally give her food but Marie never knows when this will be. This young lady does have a nice bed in the same room. When I went to look for Marie’s medicines in a container under her bed I discovered she is literally sleeping on the springs of an old bed frame just covered by a sheet. There was one small child size chair and an old freezer that is used as a table but Marie mentioned she does not use it since it is not hers. She stated she is very thankful for a place to live that she does not use anything that is not hers to risk loosing her ability to live in this home. She asks nothing of others but just graciously receives what food and occasional help that is given. All her daily activities of fetching water, washing clothes, taking a bath she does with difficulty but independently. She takes baths in a large bowel on the floor that she needs to sit in after she ports the water. She did state it is difficult for her to get on/off the ground to sit in the kevet. I was blown away trying to imagine my own grandmother getting on/off the floor.

I left Marie’s house with so many thoughts swirling around in my head. People in our country complain of our health care system, though dysfunctional we have a system. We have nursing homes, though they are not perfect; there are places for people that have no family or places to go.  I don’t know of anyone in our country in their 80’s that would sit in a small floor basin to bath or need to walk 2 miles down a busy street with their walker to get to a doctors appointment. I do know of plenty including myself that have complained about the healthcare system and just the daily struggles of life when in actuality we are complaining more about inconveniences than anything.   Marie does not even know when her next meal is going to come yet she does not complain or ask for a handout. This is not a lady that sat around all her life either and just relied on the government to take care of her. She worked hard for years educating the children of Haiti and providing for her own family that has now left her. Government programs don’t exist in any form in Haiti for the elderly or for those with a disability, yet they somehow find a way.

My heart was broken thinking of the challenges this lady has everyday just to take care of her basic needs and to think her family has just left her. At the same time I was so moved by what she has overcome to just survive. She does this without bitterness or complaining but rather acceptance and faith. She did not once ask me for anything but rather got concerned I was in the sun and kept trying to give me her new walker chair to sit in since she did not have another chair in her home to provide me. Wow this lady has nothing in the sense of things, and she daily has struggles for her basic needs, but she is filled with faith and joy knowing God provides and a better life is to come. I give thanks for Marie and the way she has touched my life. I continue to learn so much in my time here.