Preparing for Haiti: Travel Clinic

I've been waiting a couple of days to post anything about Haiti, because I wanted to tell my mother in person. A blog entry is no way to find out your daughter is going to spend a week in Haiti.  Mom knows now, so now I can write about it to my heart's content.


As you may have read in yesterday's entry I am going (in part) through work. This is great news because I know most of the people I am traveling with, and one of the nurses going is a close friend of mine.

Yesterday I went to the Boston Medical Center Travel Clinic to start my medical preparations for the trip.

I can not recommend this place enough if you are planning a trip to a country with any health warnings. The Travel Clinic was clean and pleasant. The waiting room was very spacious. And every single person I interacted with from the moment I stepped through the door was friendly and helpful.

The nurse who took my vital signs was actually from Haiti. She asked where I was traveling and she thanked me, shyly, for going. I didn't know quite how to respond to that. I (shyly) told her I was scared but looking forward to being there. Which is the truth. 

Then I met Dr. Thea. He greeted me with a smile, asked where I was going and then asked some other questions about my life. He then asked if I wanted to ask questions first, or hear his "spiel." I opted for the spiel. He was well prepared with a small lecture on the diseases to watch out for in Haiti, including symptoms, pathology and treatments. 

Basically he reassured me that there is almost nothing medically that can go wrong on my trip.*

Meeting with Dr. Thea was great. He took a lot time to explain all his recommendations to me, and let me ask as many questions as I wanted. 

Next I headed to the lab, where I met a student doing a research project, a phlebotomist, and the nurse who gave me my vaccinations. We all chatted about our connections, strangely enough to BHCHP. 

For those of you who are curious, I'm going to write a bit about the precautions I've taken, and by proxy some of the dangers. So Mom... consider this one fair warning!

Here is what the Travel Clinic helped me with:

-  Hepatitis A vaccine. 

   Got this one yesterday. Pretty sure I already got this, in order to go to nursing school. It's 90% effective with the

   first dose.  So I'm considering this one a booster.

- Typhoid Vaccine

   Started this one yesterday. It's actually a series of four pills. The capsules contain live attenuated bacteria, so I

   have to keep them in the refrigerator. I am fascinated by the little pills and the orange brochure with a smiling capsule on the front which explains how to administer the doses effectively.

- Anti Malaria Pills

 I am taking a four week course of chloroquine. I feel confident in this choice of antimalarial agent because according to my own research into the subject this is the best tested and safest of them all. And the least expensive!

- Antibiotics

  I got a prescription filled today for some antibiotics to take with me in the event of traveler's diarrhea. Dr. Thea   explained the different types of diarrhea and what I can expect to do if it's not a bacterial case.

Additionally, I have already completed not one but two Hep B vaccination series in my lifetime and all my routine vaccinations are up to date, including tetanus.  The only other recommendation Dr. Thea had was to purchase an insecticide treated mosquito net for my sleeping quarters. I'm agreeable to the idea, but for now  I'm waiting to hear back from the first group about where they're sleeping before I decide on which net to order online.

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* This sentence has been censored and edited to protect my mother from going crazy when she reads this entry.

H1N1 Update

The media may have backed off the story a bit, but H1N1 continues to be a problem in the U.S. Please, please get vaccinated, especially if you come in contact with people who are likely to have complications as a result of infection from this strain of flu. Remember, per the CDC, most of the deaths have been children and non elderly adults.

BHCHP is offering another public flu clinic on Wednesday, January 27th from 10am-1pm.

Jean Yawkee Place, 780 Albany St.

Please pass it on to anyone you know who may be at risk for spreading H1N1.

Scary Wagers

The recent Hib break out has everyone all up in arms. Mainly because out of the five cases there was one death. And the death was not a child too young to be vaccinated, but a child whose parents deliberately did not vaccinate. It's a kind of Holy War, these vaccine arguments because those who believe in the shots firmly believe they are saving their kids. But those who have reasons against it believe just as firmly that they are doing the same thing.

Parents chose to not vaccinate their children for many reasons. Religion is obviously on the list. Especially religions like Christian Scientists*. But religion aside, there are still a ton of parents who are opposed. Many parents fear the toxins used as preservatives in the vaccines, some of which have been loosely linked to the development of diseases such as autism, Multiple Sclerosis and other genetic, autoimmune or neurological conditions which have increased in prevalence since the introduction of so many new vaccines.

Or else they fear that the manner in which vaccines are prepared (generally in a blood broth from an animal like a pig or a horse or a monkey) is not safe. People have even questioned if this is the cause of some cancers. Not far fetched at all. In fact, the polio vaccine in the 1950s was largely contaminated with the cancer virus SV40. The FDA does not regulate the purity of the bio-materials vaccines are grown in. That is something left up to the drug manufacturers. That blood might not be clean. But it might be! But maybe not!

The reasons to vaccinate your children are largely to protect them from horrible and untimely deaths from preventable illnesses. In addition, vaccinating your own child helps to build up herd immunity. The concept of herd immunity is simple: if almost everyone in a community is immune to a disease, the disease will not infiltrate and harm those who are not immune (let's say, the 1% religious folks, and fetuses and infants too young to get the vaccines). Therefore some children of anti-vaccine parents enjoy protection just by living as a minority among those who have received a vaccine.
It is also true however that in the case of vaccines which involve the injection of a live attenuated virus - MMR and also the TB vaccine), that newly vaccinated members of the "herd," can actually pass the disease along to the unprotected in the days before the virus is killed off. The unprotected will either A) get very sick and possibly die or B) develop a passive immunity that is undetected because their immune system took care of the job on its own.

The benefits of having most of the population vaccinated are clear, however the risks seem great. Although I chided my friend Ayla for days about not vaccinating my godson, just one look at the site Think Twice shut me up for a while. Although no nationally recognized studies link Autism to the MMR vaccine, story after story of families turned upside down after a child receives one of these shots become hard to ignore. One of the greatest and most published case for a link between MMR and autism to this day is of course Hannah Poling.

The official stance of the Center for Disease Control, the FDA, and the American Academy of Pediatrics is that the MMR vaccine does not cause autism. They have studies that you can download and read online. The Institute of Medicine published this safety review. The CDC is quite sure that the Hep B vac doesn't cause MS, and would like you to be sure as well.

I feel like the number of immunizations children receive today is too high. I do not think babies in developed countries need Hep B vaccines, for example, unless the mother has Hep.
However, I also think that vaccination technology has come a long way, and several vaccines are absolutely necessary. But why stop where we are? I demand more regulation instated for vaccine preparation. Why isn't anyone testing the carcinogenic potential of sheep agar? Why isn't anyone searching for an alternative to thimerosal??
I'm irrationally angered by the lack of consensus surrounding this issue. I like my medical issues to be resolved by hard facts. But the hard facts don't appease me here because the data is as fuzzy as an ethical dilemma, not scientific at all. It says, yes some children developed autism after this shot, but they were outliers and so we are not even entertaining the link. It says, although mercury poisoning is rare you are a bad mother if you vaccinate your child because you know you're doing him harm. It's better to count on herd immunity to protect him from a meningitis that may take his life than to knowingly give him what may become cancer.

It says you're damned if you do and damned if you don't.

My heart goes out to the families effected by the Hib outbreak. Your choice to not immunize cost the life of a child. But I see how a choice the other way could have done the same.
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* and Jehovah's Witnesses but only until the late 1940s when someone (I forget his name) made the decision that possibly receiving a bit of pig blood in a shot is not the same as drinking blood, and therefore not against Scripture. Just in time for Polio. Phew!