Idalia’s main concern over the last several weeks has been the health of her youngest son. He suffers from shortness of breath, a condition all the more debilitating because they live on the face of a steep slope. She had been especially frustrated by her feeling that her case manager Titon wasn’t taking her problem seriously.

There were, in fact, problems of communication between her and Titon. Planning a visit to the hospital in Mirebalais is complicated. The hospital is over-busy, and though our close partnership with Partners in Health means that we can get our members care, it does not mean that getting them the care is easy. The hospital’s staff have to insist that we do things in very particular ways to get our people through lines that others might not be able to get through, so case managers and our staff nurse give members detailed instructions as to when they must appear and where, and Idalia seemed to always ignore them.

She doesn’t seem to be able to grasp the importance of exact instructions. Doctors want her boy to undergo a series of tests, both blood work and an x-ray. Getting it all done involves waiting in the right lines in the right order at the right time. Nurse Ezianie gives Idalia specific instructions, and Idalia says that she understands, but then she doesn’t follow through. She ends up doing something else. If Ezianie asks her to repeat the instructions, she can’t do it.

We will have to work with her on this, or find another solution. One of her older boys lives in downtown Mirebalais, not far from the hospital, and our first thought is to recruit him to accompany his mother and brother. The younger boy was eventually hospitalized the first time she brought him, and she was told to bring him back after he was released, but she’s not sure when she will do so. Titon will need to work closely with her to make sure she can see the path to the care her son needs all the way through. For the time being, it is at least good to see that she realizes that Titon and Ezianie are on her side.

In the meantime, Idalia is making progress in other areas. Her home is almost complete. It needs mainly some finishing work, and she thinks that she has the materials that she’ll need to get it done. She’s waiting for the builder to become available, but in Gwo Labou builders are also farmers, and at a time when there is a lot of work to do in the fields, it is difficult to get one to spend a day doing anything else.

And though her pig died just as several of the pigs that belonged to CLM members in her area, and though she like others has had trouble collecting the money that’s owed her for its meat, her situation with her goats is starting to improve. She purchased a third goat out of savings, and it appears to be pregnant.