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I’ve seen the advertisements with Jamaica’s inviting cyan waters and the lure of a tropical climate, but what to expect in the clinics and hospitals was still a mystery as I arrived in Montego Bay. After all, I didn’t have much international clinical experience before coming to Jamaica. My only previous exposure was an educational opportunity teaching cardiology in Kathmandu. There was, however, no direct patient contact and we were working with students with fluency in English. This time around, I was traveling with a seasoned expert who had spent time in South Africa and Botswana – a very helpful accessory to the adventures ahead! Looking back on the 100 or so cases from the past 4 weeks, there was a whole lot of fever and viral illness floating around. The rainy season has arrived and school is back in session – the perfect recipe for spread of these kinds of infection. I encountered many cases of wheezing and tried to establish children on controller therapy for the first time. I was forced to learn a lot of dermatology with almost half of the cases coming in with some form of chronic or new skin lesions. In our last two weeks, we saw emerging cases of hand, foot, and mouth disease with more limb involvement and larger, angrier lesions than we’re used to seeing at home. With heavy rains and mosquitos on the loose, we came to recognize longstanding, difficult-to-treat cases of pustular urticaria. And the most impressive of all were the cases of tinea capitis with kerion formation. As I’m preparing to write our board exams in the spring, I won’t forget what a kerion looks or feels like and how to manage these fungal infections. And if you asked me for my favourite encounters, I loved seeing adorable newborns for their 6-week wellness check as they were thriving in the first weeks in the world. Besides the adorable babies and interesting cases, my main highlight was how we felt valued by parents. One of the things that we can offer as pediatric doctors is time. While there were many patients to be seen, parents valued having someone spend time hearing about their child and concerns, doing a full head-to-toe physical examination, and explaining what was going on. Parents – sometimes waiting up to 8 hours to be seen – were always thankful for the time that we dedicated to helping their children. I think that reflects how we saw Jamaicans. Whether we were in clinics, hospitals, wandering in cities, or back at our hotel, the staff, parents, and locals were almost universally warm, welcoming, friendly, and laid-back. The other highlight is the collegiality within the Issa team. I was very fortunate to have Alison with me. We traveled to the same sites together. Whenever there was a puzzling rash or an unclear diagnosis, it was helpful to have her weigh in on what was going. When I was unsure about how to navigate the system, she worked with me to find the best way forward. We were also fortunate to meet the Issa team with Diane and her colleagues coming down to Jamaica for other medical missions. Compared to others’ experiences, this elective was easy to “walk into”. Diane organized the details around accommodation, transportation, food, and clinics. And we can’t complain about sleeping in a beautiful location with delicious food, leisure activities, and access to fitness. We will miss Willis’ fruit smoothies and the fresh food that couldn’t possible survive through a Canadian winter. So, here we are on the last day of 4 weeks in Jamaica. While there are always bumps in the road, there lots of highlights that I will remember. The staff and patients keep asking when we are coming back. We haven’t decided just yet, but we will be back for more adventures!
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