After a good night sleep, I got up around 7, slept much better having quiet quarters. After breakfast and devotions we headed upstairs to see patients. The room I slept in was converted to an exam room. We saw ill patients, but seemingly conditions were much less advanced then other cases I’d seen. There were many gastrointestinal, genitourinary and various dermatologic issues mixed in with a lot of chronic problems like HTN. Diseases seemed to not be as progressed as they were in say the tented camp or Cite Soleil or other mobile sites. Not having labs, as usual in these environments, treatment is empirical based on presentation. Patients’ often wont follow-up if sent away and asked to return. I’ve found it’s best to just treat what you an while they are available. Mid-day we had lunch made by the Haitian staff who were incredibly good cooks. They worked so hard preparing tasty Haitian meals. Lunch was one of my favorites with Haitian plantains with picklies, I seasoned with hotsauce. After eating we returned to patient care. The most memorable patient I had that day was a malnourished, underweight 4 month old whose mom couldn’t breast feed. It was a welcome change to be able to connect them with community resources like Hope Alive’s mom tot program compared to other cases where I have scarce options. It was nice to send her away with formula and having the baby’s energy increase after feeding him formula even if he did pee on my scrubs. Basic items can go such a long way in patient care in Haiti. Trying to include a little public health education about these not to feed for formula, food and many other topics is always helpful. Training patients to be community health workers and teach their relatives or friends lessons learned helps spread the knowledge and ideally change patterns that cause negative health outcomes. Common issues are cheap ways to treat water, consuming natural products in environment to promote health preventing common issues like anemia, avoiding mud pies that are often eaten and cause worms, managing reflux, high blood pressure and a number of infectious diseases. I’d like to bring more Creole handouts to share in the future with pictures for those who don’t read to help illustrate concepts. The day was filled with a lot of teaching around these topics. We concluded the dinner with a delicious mix of vegetarian food (for me, others had a meat dish) combo of flavorful vegetables and rice and hot sauce. After dinner a group of us walked down the street and hung out with some of the locals for awhile as they played soccer, one of the docs gave them a new soccer ball that they loved. It was impressive to see many of them playing without shoes but sad to think of how basic things like shoes are even hard to come by. We spent the evening hanging out on the guest house roof, joined by a stray cute little kitten that found its new home.