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So… this is something I never thought of and something you may never see in the USA… Myiasis… Maggot of the head!! We were stationed in Accident & Emergency when the patient was referred from a community clinic to the hospital for treatment and admission. Upon arrival the patient was having head pain and very hesitant to be examined.  While at the community clinic the area was dressed with gauze. Although hesitant the scalp was examined and we were shocked to see a tiny maggot poke its head out of the 1×1 cm wound and then retract back in. After examination labs were drawn, IV placed and patient was then admitted. This is obviously a condition that happens in tropical regions due the screw worm. Just thought I would share Until next time…. Wanda and Shanna
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While in Port Antonio, we saw a baby for the concern of enlarged breasts.  Grandmother had recently started taking care of her so she didn’t know the specifics as to how long they had been enlarged and so forth.  We didn’t think much of her examination because in infants, breast hypertrophy can be related to stimulation from maternal hormones, and can persist for several months in girls. Prior to her leaving, grandmother mentioned that the older sister (who was also present during the visit) also had enlarged breasts.  Her question was, “Can this run in the family?”  On examination of the older sister we noticed a striking difference in the size of her breasts- Unilateral Gynecomastia. A common normal variant in breast development is the unilateral onset of enlargement, which can be misdiagnosed as a tumor.  Unilateral breast development can exist as long as 2 years before the other breast even becomes palpable.  Although pathologic breast conditions are rare in children, we sent our patient for further evaluation of the breast with ultrasound.  Our hope– to identify normal breast tissue and a normal variation of breast development, while ruling out a tumor, cyst or abscess.

– Your friendly neighborhood pediatricians, Shanna and Wanda

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Your support saves lives! The story of little Grace sums up the sustainable programs created by the foundation. If it had not been for the training, the donations we provided to St. Ann’s Bay Hospital and the dedication of Dr. Woodham-Auden, her outstanding team of doctors and nurses along Fabia Lamm, Regional Director, the outcome would not have been so joyous. Taken from the Jamaica Gleaner: https://jamaica-gleaner.com/article/news/20170106/gods-blesses-couple-miracle-baby
Mandeville, Manchester: There is no pain greater than that of a mother who thinks she may lose the precious life she was entrusted to bring into this world. Shelly-Gaye Cuff endured much: having to fight for her own life and reserve strength enough to pray and fight for her baby’s survival. But God showed up and granted the Cuffs a blessing in the form of doctors and nurses at the St Ann’s Bay Hospital. “I was 26 weeks pregnant on Friday August 26 of this year (2016). I had just run a few errands and came home to prepare some light dinner. While there I felt a gush – I thought it was urine at first,” she explained. She ‘Googled’ the normality or abnormality of what had just taken place and even sought the help of a friend who was a medical practitioner. Soon after, Cuff went to her doctor’s office and yet again experienced another gush of fluid down her thighs. After an examination it was confirmed that she needed to go to the hospital because she was about to have the baby. With shock and fear of the unknown in less than unfavourable conditions, the soon-to-be mom, with a ruptured membrane and a vulnerable baby, sought to push pass the worst. “In the early morning of Wednesday, August 31, I started feeling contractions: I wasn’t dilating. I then developed a fever; I was hot then cold, shaking uncontrollably and I couldn’t breathe, my complexion had changed and at that point my body was becoming septic – my body was literally shutting down and I thought I was going to die – my family thought I was going to die.” By then a doctor advised Cuff that an emergency C-section had to be done, but priority would be given to saving her life, as her baby could very well be dead as a result of an infection. “When the baby came out she wasn’t breathing, they kept resuscitating her but it wasn’t until after 20 minutes that she gasped. A doctor told my husband that the baby was slowly deteriorating and it was highly unlikely that she would make it to morning.” She continued, “My baby was there – just panting and the hospital had no ventilator to help her breathe. On September 2, she flat lined three times.” When it felt it as though hope was diminishing, God reminded the Cuffs who He was and what He can do. A call came in from the St Ann’s Bay Hospital enquiring if the baby they were told about in Mandeville still needed the ventilator, as a baby had just been discharged. “JDF (Jamaica Defense Force) came and took the baby to St Ann’s Bay Hospital and the baby not only received the ventilator, but top-class care, I felt as though my baby was the only patient there.” She continued, “Initially the doctors and nurses said the baby didn’t look promising: they said they were only instruments, it was all God’s doing. Every doctor on call came to the assistance of my baby; it was just a different experience, state-of-the-art care… I want to say thanks to St Ann’s Bay because they didn’t have to take her and to have spent such a great deal of time on her – 59 days – was awesome. I must thank Elaine Johnson-Kelly from NERHA (North Eastern Regional Health Authority) who pretty much opened her home to accommodate me for the period.” Cuff said upon leaving the hospital, after being granted the go-ahead to take her baby home, she watched all the members of the medical team who knew and worked with her baby, cry. “They called my baby ‘Miracle’ and ‘Grace’. I’m happy to know that in Jamaica there are still health practitioners who don’t deal with humans as statistics but as persons, amid the negativity around there is a beacon up there in St Ann.s Bay. I’m forever indebted to them for the care they gave to me and my baby.” With a new found joy; 17-week-old Aaryn-Grace, the Cuffs have, for now, completed their happy home.
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Week 2 brought more patients to see and a new location. Since we began in the middle of the week, we finally got to visit Port Maria Hospital and we absolutely loved it.  There was always a great steady flow of patients…with many of the common pediatric conditions… cough, viral illness and asthma. We are getting into the routine… wake up, work out, breakfast, to the hospital, back to the hotel, beef patty, cappuccino, dinner, sleep and repeat. The hotel is very welcoming and feels like home now… On Friday of last week we visited Port Antonio hospital for the first time. Although we were located at the hospital we only saw patients in the clinic and accident/emergency. The hospital advertised our presence so as soon as we arrived we were handed 10-11 charts of waiting patients.  We worked hard and was able to help a lot…. saw a child with unilateral breast mass, posterior auricular abscess that spontaneously began to drain during examination!! and a baby with bilateral polydactylyl. Can’t wait for week 3!! Until next time, Wanda Out!!
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Direct relief is a humanitarian aid organization, active in all 50 states and 70 countries, with a mission to improve the health and lives of people affected by poverty or emergencies. Direct relief’s work earns wide recognition from independent charity evaluators, including a 100% fundraising efficiency rating from Forbes, the no. 1 spot on charity navigator’s list of the “10 best charities everyone’s heard of,” and inclusion in fast company’s list of “the world’s most innovative nonprofits.”

Jamaica Information Service Article: Ministry of Health Receives Donation of US$2 Million Worth of Pharmaceuticals

Photo:Minister of Health, Hon Horace Dalley (2nd right) discusses some of the items donated by Issa Trust Foundation and Direct Relief with Permanent Secretary, Dr. Kevin Harvey (right), Chief Medical Officer, Dr. Marion Bullock DuCasse (centre), Chairman of the Issa Trust Foundation, Paul Issa (left) and CEO of the Issa Trust Foundation, Dianne Pollard (2nd left) during the handing over of US$2 million worth of pharmaceuticals held at the Kingston Public Hospital on Friday, January 15, 2016.
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