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There were vary different experiences at the varied hospitals. Port Antonia was the most spectacular of the three locations. The hospital is situated on a bluff overlooking the bay, with the ocean views overlooking the city. The hospital was a journey from the resort with a travel time around 2 hours each way. Our day was much slower at Port Antonio. We spent the entire day in the A&E (Accident and Emergency). We shared a room there. We only had a pediatric patient (birth to 14 yo) about every hour. They highlight of the day was a darling 11 yo girl who just stopped in to our exam room to chat with us while we were waiting to see another patient. She was a fifth grade student who was watching her 2 yo nephew while her sister was being seen. She was a bright and articulate student who was also remarkably polite. She was the highlight of a good day. Port Maria was a crazy first day to say the least. We were divided in the morning, Becca worked in the A&E and I in the clinic. When I arrived at 8:30 there were patients lined up outside the clinic which did not open for another hour. When the clinic started I was handed a stack of eight chart (dockets as they are referred to here). While I was seeing my first few patients the nurse returned with several more stacks of charts. Between 9:30 and 2 I saw 16 patients from asthma follow up, viral illness, well child check, to septic arthritis. I did have one mother refuse to see me, requesting that she see the “black doctor”, none of which were there that day. When I finished clinic, I joined Becca in the A&E. She had been busy as well seeing more than a dozen patient’s in the time I was in clinic. She was seeing a wider variety of patient’s including children as old as 18. She was finishing up charting when I arrived. Several more patients came in while I was there. We only had the one exam room so we rotated patients. By the end of the day on Monday we saw 35 patients between the 2 of us. It was a great but tiring day.

Hello all, Let me introduce myself (any my co-resident here, the man of few words and my fiancé), my name is Rebecca and Bob is here with me at the lovely Tower Isle Resort in Ocho Rios Jamaica. We arrive here just over 2 days ago after a very uneventful trip down from St. Louis. I have traveled internationally several times in the past and usually the trip down lends itself to some stress and at least a good story or two, but this one was smooth sailing. We were immediately welcomed by the staff and have continued to feel welcome in the 50 some-odd hours that we have been here. The rooms are clean and comfortable and the water is hot so I am a happy camper. I must also mention the food. I am in hog heaven in terms of fresh fruit, seafood, and Jamaican cuisine. Now, more importantly, how did our first day on the job go? All things considered, I think it went well. It was more of a sink or swim situation as orientation was lacking (likely due to our starting mid week) and we had to learn the charting system on the wards on the fly. With that being said, once we figured out what was expected on the inpatient side we dove in as much as we could. I could not say more, however, for the quality of discussion and teaching Dr. Ramos provided on rounds. Bob and I felt right at home as his Socratic style reminded us of some of our favorite mentors back home. The most challenging part of the day was when we ventured down to the Accident and Emergency department to help with Pediatric patients. If we thought getting shown the ropes was limited on the wards, we were sorely mistaken. Placed in a room with two examining spaces and no knowledge of the work flow or charting we got work. Fortunately for us newbies, it was a slower afternoon and the patient load was light, so we were able to figure out how to provided care and not feel like buffoons. When the day was all said and done I must say I again felt very welcomed and appreciated. I was humbled by feeling like a first grader on the first day of school. Most importantly, however, I feel excited about tomorrow. Now off to go eat some BBQ Duck… – Rebecca

    A dedicated team of volunteers, including radiologists, a Neonatologist. a paediatric haemotologist/oncologist and a critical care nurse visited the Island as guests of Couples Resorts and it’s non-profit organization, the Issa Trust Foundation, to provide training to hospital staff at the St. Ann’s Bay Hospital in early April. Another member of the team, Jim Colvin, Lead Coordinator/Volunteerism at WelchAllyn, New York – a leader in the healthcare industry since 1915 – volunteered his vacation time to work with the Issa Trust Foundation in providing over J$5M (US$50,000) worth of WelchAllyn equipment and supplies which were donated to hospitals islandwide, including St. Ann’s Bay, Annotto Bay, Port Antonio and Port Maria Hospitals as well as the Mason Health Centre and the Bustamante Children’s Hospital in Kingston.  Included in this donation were ECG machines, blood pressure machines and vital spot monitors, just to name a few. An xray processor and diagnostic testing equipment valued at J$2M (US$20,000) were also donated to the St. Ann’s Bay Hospital by Radiology Imaging Solutions Inc., a Michigan-based company.  All donations were made through the Issa Trust Foundation and organized by its President & CEO, Diane Pollard, who led the team on this trip.   About Couples Resorts: Couples Resorts, headquartered in Montego Bay, Jamaica, owns and operates four properties in Jamaica – Couples Tower Isle, Couples Sans Souci, Couples Swept Away and Couples Negril.  Pioneered by the legendary Abe Issa, “father of Jamaican tourism,” each Couples Resort is an unsurpassed model of the all-inclusive resorts concept, boldly designed with local inspiration to create a harmonic sense of nature and authentic Caribbean spirit.  For over 33 years, Couples has delighted guests and refined the Caribbean all-inclusive resort experience by providing unparalleled service, exceptional dining experiences and exclusive added value inclusions.  For further information please visit http://couples.com/.   About  Issa Trust Foundation: The Issa Trust Foundation was established in 2005 by Couples Resorts as a registered 501(c)3 nonprofit.  The mission of the Foundation is to provide a system of prevention, health promotion and education, community health improvement and other services to promote well-being and development for the people of Jamaica.  Board Members are Paul Issa (Chairman), Petronia Brooks (Financial Controller), Diane Pollard (President & CEO), Alex Ghisays (PR Director) and Gail Soares (Treasurer).   For more information. please visit www.issatrustfoundation.com

The steady whirring of the overhead AC unit at Port Maria is almost hypnotic after the steadily rising cacophony of the morning breakfast buffet at the resort.  Several wedding parties arrived over the weekend, injecting both youthfulness and a certain amount of noise to the system.  While this is good for resort business, I can’t help but be slightly wistful for a beach lined with friendly open lounge chairs, their white cushions warmed by the sunlight, and devoid of the oppressive smoke from a cigarette, or the spicy smoke from other inhaled ignitions.

The pre-crowd beach life

Laughing at my own sense of entitlement, as well as the knowledge that the bustle will slow again in a few days, makes it all right. Flashback:  The ebb and flow of patients continued throughout the week.  Dr. Ravi, who is the more or less the equivalent of a chief resident, was very patient and helpful navigating the system.  We had some excellent discussions regarding differences in admission criteria in and among hospitals in the US, Jamaica, and around the globe, as well as the finer points of “whose patient is this?”

Starting the week at Port Maria A&E (accident and emergency).

In Jamaica, Good Friday and Easter Monday are both public holidays.  The energetic pomp of the marching band was a welcome addition to lunch on Monday.

Yay band!

As such, it was a welcome slow vacation weekend, despite my need to relearn the skill of relaxation, which I hadn’t necessarily lost, but had partially buried under a few layers of dirty scrubs, floor tiling equipment, and board study DVDs.

“Oh, THERE you are, Peter!” (Peter : relaxation)

In rediscovering relaxation, I took advantage of the free scuba lesion here to take my first ever dive.  While the bulk of my attention was focused on diving techniques of “breathing”, “kicking”, and perhaps most importantly, practicing “not touching anything,”  there was enough of my sensorium available to marvel at the towering coral wall to one side and the majesty of the vast blueness to the other.  We explored the shallow shelf of the wall at 40 feet deep.  For those that are absent diving experience, it felt like being hit with a shrink ray and thrown into a tropical aquarium in the role of the plastic diver figurine.  Had we been at the site of the sunken ship (an old WWII ship that the Jamaican government elected to sink off of the north coast for scuba diving tourist purposes), the sensation would have been complete.   The coral caves were marvelous and filled with bright oranges, blues, and purples.  The neon yellow shock of a trumpet fish, the ponderous waggle of the horned, cow-like trunk fish, and the sneaky, sandy camouflage of a puffer fish all made appearances before our steady ascent back into the light world of air. Otherwise, the weekend passed with fine food, good friends, plenty of sun, exercise, and only a little bit of time reserved to read and study.

 

Sunset from the deck of the Bayside Restaurant.

I had a small visitor to the villa (below).  I was suspicious that he was merely freeloading and not volunteering medical services for the foundation, but as I haven’t seen him since, I haven’t been able to confront him.

The freeloader.

Yesterday, I had the unique experience of diagnosing sickle cell disease (correctly!) for the first time since medical school.  The rate in Utah is low owing to a relatively homogenous population to the point that most sickle cell patients become case presentations for our residents. Unwarranted self-congratulatory pride aside, the experience of obtaining the diagnostic test and subsequently establishing appropriate follow up was simple and efficient.  It is this aspect of Jamaican care that I hope others can see.  While the resources are limited, they are largely put to good and effective use by those who see to their management. Present time:  Sticky humidity hangs in the air this morning across the island in the pediatric unit of Annotto Bay as I type and wait for morning rounds to commence.  One of the pediatric surgical patients who last week had his legs tied up above his head has since been cut loose and sits patiently in his crib.  Until rounds start, it seems like good fun to make faces at each other.  And it is.