Today I had the opportunity to examine four young Haitian adults with severe heart valve abnormalities. There were three men and one woman.
Regarding the three men, they most likely have rheumatic heart disease secondary to rheumatic fever they had at a young age that was asymptomatic or went undiagnosed and untreated. One of the men, due to his severe mitral valve dysfunction, has been in congestive heart failure for 13 years! He had to quit his job as a teacher and bought his heart medication only when he could afford it. He is very thin now due to his advanced heart failure and the amount of calories his heart problem consumes in a sustained catabolic state.
The young lady became ill after the delivery of her baby 2 years ago. Her mitral valve is very leaky and she is also in heart failure.
The youngest of the four patients is an 18-year-old boy who grew up in an orphanage. During the last two years, he had to flee that orphanage to live in a different part of the country due to a gang having taken over the city where the orphanage is located. He has no parents or biological family members. He is in heart failure, too.
Three of the four patients came from Port-au-Prince and travelled in a van with thirty other people in the packed vehicle.
They told me that armed gang members did get on their van three times during their journey but that the gang members did not hurt anyone or steal anything from anyone. The van they used is one of many vans traveling on this main highway out of Port-au-Prince and they mentioned that their van pays the gangs a monthly fee in order to pass unharmed. They also told me that the main route that they used from the capital is now closed due to gangs. If they would have tried to travel this week, they would not have been able to do so.
All four patients have dangerous sounding murmurs due to the damage that has been done to their valves over the years. And with the men and their rheumatic heart disease, I thought this is what doctors decades ago must have heard with their stethoscopes as they examined emaciated young people with end stage heart disease and “dropsy” that could not be prevented or treated effectively. What would these doctors have thought about diagnostics and therapeutics that exist today including incredible echocardiograms and bypass heart surgery….but only used in a small minority of people around the world who can afford the medical care?
Today’s headlines state that Temporary Protected Status (TPS) is over today for 350,000 Haitians. And they have been instructed that they can no longer work and must leave the United States voluntarily or they will be deported. Just as it is cruel and inhumane to allow people to become this sick with heart trouble, it is equally cruel and inhumane to deport people to a country that is experiencing widespread violence and a humanitarian crisis.
These four Haitian adults that I examined are typical resilient Haitians. And they are very appreciative of the opportunity for their upcoming heart surgery that is being arranged by Haiti Cardiac Alliance. They want to stay alive and will risk much—even Haitian gangs—in order to do so. And as I think about the TPS being stopped, I am sad how we are attempting to purge the United States of tens of thousands of very good and deserving people who have the same characteristics as the Haitians in front of me today.
Pope Leo XIV raised a question in June during his visit to Spain, “What kind of world have we built, if so many brothers and sisters must risk death to seek life?”
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John A. Carroll, MD
www.haitianhearts.org
johnacarroll.substack.com
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