Last week went by very quickly. Out of all the hospitals, I am enjoying Annotto Bay the most, for its resident interaction and learning opportunities. Despite being a level B hospital, it is still very much in need, with minimal supplies. One afternoon, residents were drawing blood via needles to the femoral vein as there was a shortage of butterflies. For IVs, the end of a glove was ripped off to be used as a tourniquet, and the catheters placed and held haphazardly with paper tape. A rolled towel was used as the splint to prevent bending, and again bound by rolls of tape. Children walked around with little bumps of cotton taped to their arm, their scalp, and their inguinal area for lack of band-aids. What I previously thought of as basic necessities were all luxuries here, and was responded by laughter at the mention of things like Tegaderm, adhesive removers, or LMX anesthetic creams. The painstakingly gathered blood samples were then wrapped in lab order sheets, and sent with a driver, who would personally deliver them to a lab 2 hrs away from town. I was informed that this was a necessary process not only for blood cultures, but even for bilirubin levels, as their equipment was not reliable for levels above a certain threshold. Back home, parents wait in clinic while bilirubin levels return within minutes. If nurses or doctors have to walk all the way down the hall and into an elevator to deliver these samples to the in-house lab, it is met with eye rolling and sighs about how the hospital is a mess because the tubing system is malfunctioning. I’ve been here for 2 weeks now, and the more I see, the more amazed I am at how different things are here. In the same way, though, I think the residents look at me amazed when I tell them about bilimeters, 5 minute lab results, and EMRs with electronic films.

Today I was back in Port Maria. I’m growing to like it here a lot as there is the most need, and patients present with very manageable cases, where easy treatment options are available. While seeing one little girl with a viral URI, her older sister insisted on braiding my hair, and asking to see inside her sister’s ear. She was very curious, and many children are eager to learn, which makes clinic that much more fun for me. In the middle of the day, water became unavailable, and none of the sinks were available for hand washing. In any other clinic, this would have been a huge crisis, but here, things went on per usual, as if nothing significant had occurred. I am just happy to have brought all of my sanitation supplies with me today. It’s funny how accustomed I have become to all the limitations of working in Jamaica; I hope that when I return to Iowa, my gratitude for all that we have there is not as quickly fleeting.