L is a 29 year old woman who came to clinic in Cazale for the first time last week. She was extremely weak, her father in law half carried her into the exam room. She was emaciated, so thin it seemed her legs would break if she tried to stand. Her blood pressure was low, 60/40 and she had a fever. An IV was placed and she was given some IV fluids which improved her blood pressure. Lab tests revealed that she was HIV+, and given her clinical condition, she probably had advanced HIV, otherwise known as AIDS. She was septic, possibly secondary to an opportunistic infection. HIV treatment is available in Haiti and is typically free for the patient thanks to international funding. L. needed to get to a hospital fast and to one that has a reputation for providing quality care to patients with HIV. This patient’s best option was the Partners In Health Hospital (PIH) which is over 2 hours away from us. Her family did not have the means for transportation (money for motorcycles and tap taps) and I did not feel the patient would survive public transportation to the hospital. It would take many hours. So I called an ambulance system, they were unable to come. However, they gave me contact info for a helicopter ambulance, Haiti Air Ambulance. Transfer to PIH was accepted by a physician there and then Henoch, my brother in law, drove the patient to the helicopter landing site and she was taken to the hospital. Henoch did have to arrange for the police to accompany him to the landing site to keep crowds back, as a rather large group of onlookers gather to watch what was happening.

L. made it to the hospital and, as far as I am aware, is still receiving treatment and will hopefully recover and live a relatively healthy life, though will always need treatment for HIV. It was pretty remarkable, and encouraging, to see this modern and life-saving service in Haiti.