First off, Happy Thanksgiving. I have an incredibly blessed life and am thankful for many things—but most relevant to this post is the fact that I’m thankful for the Frist Global Health Leaders Program. Because of it, I have been given this amazing opportunity to come to Cayes and work at HIC. It has been—and I’m sure will continue to be—an incredible experience, and I am so grateful for the Program and for having been selected for it.
HIC as a hospital is trying to improve its HIV testing rates (a goal that I think is true in most hospitals in Haiti). As such, testing rates are now closely scrutinized, and it has become clear recently that the maternity has pretty low rates of testing women while they’re here to give birth (last month was about 25%). That low rate is in large part due to the fact that most women who come to the maternity have already been tested once during their pregnancy—sometimes multiple times—and so don’t need to be tested when they come to give birth. (The women who have had prenatal consultations typically bring their prenatal card when in labor, and that shows if/when they were tested and the results.) There is still however, a portion of the pregnant women who haven’t been tested—typically those who haven’t had any prenatal consultations—who do need to be screened when they arrive to give birth.
Between the hours of 9am to around 4pm those women who haven’t been tested can easily get tested, as there’s a woman who tests pregnant women—typically it’s those women who are at the hospital for their prenatal consultations, but she happily tests ones here to give birth too (and I’ve sat in and watched her counsel women and she does a great job). The problem however, is that when this woman isn’t at the hospital the pregnant women who haven’t been tested, can’t get tested. So for most of the afternoon, and all of the night shift, we aren’t able to test women who haven’t been tested during their pregnancy. This is particularly difficult given the short amount of time that the women stay in the hospital after they give birth (an average of 6 hours). I had a woman on Tuesday come in, give birth around midnight, and then want to leave at 7am. I tried to convince her to stay until 9am to get tested—she sadly stayed until around 8am (I checked on her before I had a delivery and she was there, but when I finished with the delivery and went to see her again she was gone).
We’re trying to work on ways to address this problem—but as far as I can tell it comes down to the lack of money to pay someone to offer testing during “off hours” and the lack of motivation on the part of the nurses/doctors/midwives. Until a real solution is found I’m just going to try to beg women to stay until they can get tested in the morning (which I was successfully able to do on Wednesday).