Monthly Archives: April 2012

Apr 24 2012

Mario Andresol Needs To Act With Boldness

Mario Andresol, the Haitian Police Chief

This nonsense about a component of the Haitian National Police going on strike because some of their peers got shot dead, for the most part in the line of duty, needs to be stopped rigorously.

This is not the way to proceed. As part of their training at the Police Academy, I am certain they were made aware of the guidelines that underscore how complaints and grievances must be properly channeled through up to their commanding officers.

This cancer needs to be radiated at its gestation to prevent it from becoming a gangrenous precedent for the good functioning of the institution.

What these police officers are doing is like déjà vu all over again to me. That is the same nonsense we had to deal with back then –on the last days in the life of the Haitian military –with the foolishness about the “ti sòldas” protesting against their commanding officers. This is plain ridiculousness at its best.

Like the military, the institution of the police is apolitical, meaning it stays away from the political chatters taking place in its surroundings.

In 2006, I could not fathom to witness an installation of the United States Army going on strike demanding the resignation of G. W. Bush, their Commander in chief, for having “wrongly” committed troops in Iraq, having caused the lives of thousands of their comrades. That would have not happened. The day you see such foolishness happens in this country, you must make it your hint that America is definitely going down.

This is not the way the military/police force operates. These folks very well know that, why are they doing what they are doing? Why does it have to be in Haiti for such foolishness to take place?

I am urging the Police Chief, Mario Andresol, to open an investigation immediately to find out who these police officers are; they must be dealt with according to the prescriptions in the institution’s internal code of conduct. This is unacceptable. As far as I am concerned, they need to be kicked out of the force; they need to be made an example out of, so that such misbehavior never has to reproduce itself.

Apr 17 2012

President Martelly Was Flirting With Death

Yesterday afternoon, aboard a commercial airplane, President Martelly was rushed to the Miami hospital he was operated on probably as a result of preliminary signs such as dyspnea (difficulty breathing), tachypnea (shortness of breast), coughing and chest pain on inspiration. After meticulously examining the case, the medical staff came up with pulmonary embolism as the diagnosis.

Briefly, pulmonary embolism is a situation that occurs as a result of a circulating thrombus (blood clot) blocking the circulation of the blood at the level of the lungs. That is the basic definition.

Sequential compression devices (SCDs)

Prolonged bed rest resulting from a major invasive procedure places the patient at risk for post-operative thromboembolism. So to avoid such complication, they usually attach to the patient’s lower extremities sequential compression devices (SCDs) -stockings that wrap around the legs and periodically inflate and deflate with air -to accelerate the venous blood return. Ambulating the patient immediately after surgery also reduces the risk of thrombosis and pulmonary embolism.

From a pathophysiological standpoint, since the exchange of carbon dioxide (CO2) for oxygen (O2) taking place in the lungs is compromised (as a result of the blockage), the patient’s supply in O2 decreases -which eventually, if not rushed to the ER to be treated urgently, will cause cyanosis (a bluish or purplish coloration of the skin as a result of a low circulating oxygen saturation), low blood pressure, tachycardia, tachypnea, collapse and sudden death. So needless to say that pulmonary embolism is a serious condition.

Now, in the case of President Martelly, what could be the cause of such condition? Well, since he just had a right shoulder arthroscopy to treat a damage joint, this will be the main focus in the investigation of the case. But other underlining conditions -hypertension, diabetes, etc… -could cause that as well. So it is imperative to have a clear understanding of the president’s medical history to pinpoint what exactly is the root cause of the condition.

Pulmonary embolism is a treatable condition. Normally, they will proceed with anticoagulant to undo or dissolve the clot. So while the patient is in the hospital, they will probably heparinize him or her with heparin to be tapered down as the patient is being put on warfarin (coumadin) before being sent home still on warfarin (coumadin) therapy.

While on warfarin, the president will have to have his blood studied every month to determine the effects of the therapy and if he must be taken off the drug.

President Martelly was literally flirting with death. So it was a good thing that he was rushed to the hospital to receive the appropriate and most needed medical care. Otherwise, the unexpected, which is death, could have resulted. Per the press release issued by his office, his health is in stable condition. I wish him a speedy recovery.

Apr 15 2012

Clostridium Difficile: A Serious Bacterium

Clostridium difficile

There is an array of antibiotics –Erythromycin, Azythromycin, Ampicillin, Penicillin, Amoxicillin, Methicillin, Doxycycline, Tetracycline, etc… -out there to treat bacterial infections. However, extended or prolonged use of them is very dangerous in that the patient could become infected with this bacterium called Clostridium difficile or C difficile or C diff.

In the intestine, as we all know, we do have our “normal flora” –good bacteria necessary for life sustainment. What the extended or prolonged use of antibiotics does, it destroys these bacteria, making the patient very prone or susceptible to being infected with Clostidrium difficle.

The shell of this bacterium is just as hard as the shell of a crab, making it very hard to kill because antibiotics will have difficulty to penetrate it.

A ruptured inflamed colon

As a result of this bacterium, the patient will develop diarrhea, which, if not stopped urgently, could cause inflammation of the colon or enterocolitis or colitis, which could cause the colon to burst open, rupture or break open. So it is imperative that we stop the diarrhea to prevent further complications. To achieve that, we use right away the combination of two very strong antibiotics –Vancomycin and Flagyl (Metronidazole).

When caring for these patients infected with Clostidrium difficile, it is highly recommended that all necessary measures are used to prevent direct contact with them. In the medical profession, these types of measures are called “contact isolation,” implying the use of a protective gown and gloves because of the contagious nature of the bacterium. Some, those who cannot stand the foul smell of the diarrhea, would even use a regular surgical mask.

Like everything in life, you can use things, but not abuse them. Antibiotics are not candies, so you should not be taking them for fun. While they are good to treat bacterial infections, abusing them could have negative drawbacks on your health. When you are prescribed them, follow thoroughly the instructions given to you.

These drugs are so potent that they must not be sold to people without a prescription issued by a licensed medical professional. By the same token, they must not be sold by people without a state-issued licence authorizing them to sell them. That explains the reason as to why I am so against the anarchic way these street vendors in Haiti are allowed to sell these drugs to anybody having money to buy. This is unacceptable, and it becomes a public health hazard, which the authorities MUST stop by any necessary means. I do understand everybody is trying to make a living, but you cannot be doing your hustling at the expense of other people’s lives.  So needless to say that the health of the population is in great danger.

Apr 6 2012

Martelly in Miami: A Surgery Of Controversy

President Martelly of Haiti

According to an official statement issued by the Office of the President in Port-au-Prince, President Martelly left Haiti Wednesday to Miami, Fl where he will undergo a surgical intervention in his right shoulder. No mention of the nature and scope of the surgery is made. He will return a week later, precisely on Thursday, April 12, 2012 to resume his activities.

Apparently, the fact that he is traveling abroad for medical reasons does not please many. Some are arguing that he should not be traveling to the US to be operated on; he should stay home and be treated by Haitian doctors and nurses only for the sake of inspiring confidence in the Haitian health care system. Are these people serious, really?

Of course, that is what every president would hope to see. But such is not the case for Haiti. And who said he will not be operated on by a Haitian orthopedist in Miami -one of our own who had studied in Haiti and left the country for political reasons or because he or she was not valued enough in his or her own country?

This argument, which I consider as a blame on the president’s account, would have made sense had Martelly been president for the past 26 years and nothing been done to structure our health care system and the delivery of care in the country.

Remember, Martelly has been in power for only 11 months; it took years to bring our health care system and the practice of the science of medicine to such a situation of chaos.

His predecessors are done messing up everything, now they want to hold him accountable for the state of affairs in the country. At some point in time, the practice of medicine in Haiti used to be one of the best in the region; it is not so anymore for years.

Aristide and Preval, these two Lavalas guys, for the twenty years they were in power, did not do anything of substance to make sure that their successors would not have to travel abroad should they need care as basic as emergency. They messed it up for all of us. So if blames need to be cast, they need to direct them at these two guys, not Martelly. In fact, did Rene Preval not have to travel abroad, to Cuba precisely, to have his prostate cancer taken care of? I did not hear all these chatters when that happened. Why now I am reading about all these jabbers? I guess Cuba is not foreign to Haiti, America is. Seriously, these healthcare nationalists need to find better ways to show their nationalism.