Diabetes, diabetes, diabetes

Yesterday I spent a few hours with Dr. Manno as he saw patients. I just sat there, listening, observing, thinking. Manno would explain things to me as we went along. I asked a few questions, but mainly I just observed. We had about 15 diabetic patients (or maybe even more). They come on a regular basis to have their blood pressure checked, get more medication, talk about complications or pains they are having. Manno said that depending on their case, they might only come once a month for insulin. Once a month!? A country of starving people and diabetes is so common here. Seems ridiculous.

Last summer we picked up a patient in the jungle and she lived with us for 1 month and then returned a couple weeks later for a week or two. She was malnourished and diabetic. So tiny, yet I remember her hands and feet being huge (likely not that big, but she was very tall and about 18 years old, so likely they were normal size just ginormous because she was just bones). She passed away after leaving our house and it was mainly because she just didn't want to live. No fight left. Life here is hard. Not just hard. Sometimes it's impossible. With a condition like hers, and lack of food, it was almost impossible to stay alive. Where would she get insulin from? And if she could get it, how would she pay for it. And if she could get it, where would she keep it? And how would she monitor her food intake if she has no food, or only has access to the wrong kinds of food. And that's what SO many people here deal with.

Manno told the patients again, what to eat and what not to eat. One man asked if he could eat mangoes. You see, mangoes are in season and are everywhere right now, those are free these days. I was glad to hear Manno tell him he could continue eating them. How do you stay away from certain foods when you just hope to eat something that day?

One patient had sores. One was very skinny (but Manno says he's gaining weight). One had a backache, others had other problems. Sigh. Diabetes.

Manno mentioned that if you have Aids here you can receive medication for free in Cap Haitien. But diabetes. Pffff. Good luck. We are waiting for a box of medications (including insulin) from someone in the States. Patients were told it would be here on Monday, and so they waited. The boxes came, this box was not included. I hope they can make it until we find more medication for them. Life here is different. Being in the doctors office reminded me of that.

A little girl fell at school and walked in with a small gash in her forehead. Blood on her yellow school uniform. No tears. No expression. She got up on the examination table, laid down, and Manno gave her 1 stitch. No point in freezing it as that would hurt just as much as the stitch. She didn't flinch. Didn't even clench her fists. She was maybe 8 or 10. She makes us look weak. They all do. Gulp.