Wound Care 101

Today brings a much appreciated break. We have a little time off between activities to try to cool down and prepare for the afternoon. Our group split up into two teams this morning with one half going back to the water truck and Cite Soleil and others going back to do a second wound clinic. I was one of the four of us that elected to help at the wound clinic. The line at the wound clinic today was significantly longer than it was on Wednesday. I estimate that there were about 200 people there today. Most were there to get medication but many were there to get treated for wounds. Two people from our group helped out with medicines and two of us aided in wound care. Again, I have no formal medical training. I was told where the supplies were and about 2 minutes of other training and then let loose. My other wound team mate, Tom K., is a doctor so he was given a table where he treated more severe wounds and performed procedures. In theory, you would think the wounds that non-medical personal would be skinned knees, etc. Nope. I saw mostly leg wounds that consisted of deep tissue wounds the size of the palm of my hand. If you are ever put into a 3rd world clinic to perform medicine:
step 1 - remove existing bandages
step 2 - wash would with saline and gauze
step 3 (depending on the wound) - hydrogen peroxide followed by saline rinse and gauze scrubbing
step 4 - antibiotic
step 5 - pack with gauze
step 6 - wrap with bandage
step 7 - send the patient on his/her way
I fairly quickly got numb to cleaning out wounds that I feel would normally make me queasy and/or that I would say looked fake if I saw them on television. Luckily some patients would come in with something a little different here and there to keep me on my toes. Because of the strict HIPAA guidelines Haiti, I will refer to the patient as "this guy". This guy sat down at my station, put his leg up on the examination area and squeezed his wound until puss oozed out. That is when I raised my hand to ask how to treat that. I was told he had an infection/abscess on his leg and that he would have to have the area scrubbed hard and that a portion of his leg would need to be trimmed off. I thought that sounded pretty nasty and was glad that someone else would be stepping in to do that. I was wrong however. With training as complex as "that needs to be cut out", I was left to remove part of this guy's leg. Don't worry, there was no numbing agent, just a slightly dull pair of medical scissors, a tweezers and some betadine. This guy was a real trooper as I removed a part of his leg about an eighth of an inch deep and the size of a half dollar. I was told I did a nice job by the staff, but I know that I did not miss a calling in medicine. This afternoon, I will be back at the home for sick and dying children.

-Jeff Gerst