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Hi Issa blog family!
Week 1 was a very great learning experience. Port Maria was the busiest of the 3 clinics/hospitals.
There were a lot of sick visits during my 2 days at Port Maris, there seems to be a viral illness going around, causing high fevers, uri, and h/a. One boy who was 13yo had h/a, fever and nucchal rigidity on exam and while my gut feeling was that he probably had a viral meningitis, I couldnt be 100% sure so I walked him and his mother over to the ED dept where I was able to draw labs, send off a blood culture, attempt a spinal tap (which was unsuccessful because there were no spinal needles available, I was using 21g angiocaths); but he was admitted and would receive IV ceftriaxone. He will probably be home by the time I go back next week.

Annotto Bay reminds me most of home; Dr Ramos is an excellent Pediatric clinician and functions as a ward attending; he had 2 pediatric residents and I made a 3rd as I pre-rounded on a few patients as well. Once Dr. Ramos arrives we rounded on the patients with him and he does sit down rounds and PIMPs the residents. One case I took care of was an infant with indirect hyperbilirubinemia, likely 2/2 ABO incompatability; he was on phototherapy however I was not able to discern whether he was getting high intensity; one of his treatments was phenobarb, initially i thought is he withdrawing froms drugs because this is a setting i see phenobarb used, but dr. Ramos explained to me that he was on it because phenobarb aids in liver maturation (this baby was 1wk premature as well). That day I also learned to do a femoral arterial stick! The second day is a well baby clinic; most of the infants born at the hospital get seen at 2wks of age; if there is nothing concerning on exam they are d/c from Anotto Bay clinic and f/u at a private doctor or the various health centers in the parish they live in. I saw an infant with ring worm to the forehead and mother’s lesion was on the R forearm; so I had to treat both with topical meds; there was another infant with an ear skin tag; where I am being trained we routinely do not get RUS as majority are wnl; however I confirmed what was standard of care with one of the residents and they do routine RUS so I gave the mother a lab slip to get it done when she could (she will be paying out of pocket ~10-20,000 Jamaican dollars).
Lastly coming home to couples resort is a real treat; for the real authentic jamaican food definitely the monday night beach party is where it is. Also personal trainer Alfred is really great and will customize a work out plan for you!
Till next week; I am going to read up on tinea infections and meconium aspiration syndrome.
~K. Godfrey, MD
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Day 1: First day was on a Friday- the day you go to Port Antonio hospital/clinic, which is in the parish of Portland. The ride was very scenic, and while the roads were winding they were very pristine; coming from the Bronx, NY it was nice not having to go over any potholes!
I totally forgot to bring my camera, however next friday I will so that I can catch some pics of the livestock hanging on the road sides; the local pple selling their produce (ackee, bananas, guineps) in addition to getting a great shot of the houses espetially the ones that resemble mini-hotels…I even think I saw one that was in the shape of a ship..Ill be sure to post of pic of that to convince myself!

Anyway; the hospital at Port Antonia has 2 stories, with multiple areas. The pediatric ward is humble, 1 large room for all the patients and directly across is the playroom/sitting area for families that come to visit their children. I worked most of the day in the outpatient wing; there I was in an airconditioned room…was very grateful for that, as I completely forgot I am in Jamaica and brought a lot of polyester tops rather than cotton (lol). The room is partitioned by a curtain, beyond the curtain is the examining table.
The room had hand snaitizer, soap, a sink to wash hands; papertowels and tongue depressors.
All I really needed to bring was my doctoring tools; and maybe my Harriet and Lane.

The pharmacy is on the compound, I asked the pharmacist for a formulary; which was very handy as I was able to pick out the meds I would likely prescribe before seeing patients. So when I did prescribe something, I just placed it on provided Rx pads and patients were able to get what I prescribed w/o a hitch!

Overall the staff is helpful and pleasant to work with…shot out to Nurse Burks! she worked closely with me triaging patients and obtaining vitals.

The staff here also wanted me to discuss some topics, I did 2 of 6 so far. It was well received and interactive. We talked about Bronchiolitis and Fever in baby (0-60days old); overall they manage these patients well but do to some limited resources may not be able to do everything recommended i.e. urine culture/blood culture/csf culture or spinal tap may not be performed on an infant in that age ranges 2/2 cultures going all the way to Kingston (4+ hrs away) and not returning in time…so they just treat empirically with amp and gent. Or rather than treating initially with amoxicillin for an AOM, they jump right to Augmentin….
That’s all for now; Will see how the other two clinics are.
Ciao! going to enjoy a glassbottom boat ride.

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Excited about the trip; hope to learn a great deal!
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