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There has been so much going on this week, I hardly know what to say. All three clinics that we visit are right on the ocean-such a beautiful view. Not what I normally see when I look out the window from clinic. I will say that I will definitely be taking dramamine before my next trip to Port Antonio. I had no idea that Jamaica was so hilly. I saw a lot of typical skin issues this week: eczema, tinea, scabies, etc. I am also becoming familiar with “Deworming”. This is definitely not something I need to do regularly on my usual clinic patients. I had a 3 1/2 year old boy come to see me in clinic on Thursday who has Autism and though mom is sure she has heard that word, I don’t think her son has ever officially had the diagnosis. He has only 5 words and as expected, has many social problems which do not allow him to engage in preschool at all. He receives speech therapy only once every 3 months and has seen a psychologist for behaviors only once. After discussion with Dr. Ramos, I referred him to the child Neurologist in Kingston that usually evaluates in these cases. I actually heard on the radio earlier in the week that the social support for Autism is lacking in Jamaica, but I really hope that the Neurologist is able to provide some more appropriate referrals for this child-at least more that I was able to do. It is difficult to treat some of the children who present,simply because I am not at all familiar with the system of medical care here. I really appreciate all of the help I have been receiving from Dr. Ramos, Dr. San San and all of the other general practice physicians who have been more than willing to answer all of my MANY questions. I did get to enjoy some relaxation time on the beach this weekend as well. There is no better place to read than on a beautiful beach.
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Received my Couples Resorts Calendar that I purchased today! See a picture of one of our medical teams!  Couples -On behalf of all the children touched by the Issa Trust Foundation, we send you heartfelt thanks for your generous purchase of our exclusive Couples Resorts Calendar!The Couples Resorts 2012 Calendar is now available for those who make a charitable contribution to Issa Trust Foundation.
https://issatrustfoundation.com/04-donate.htm
For a $30 donation to the Issa Trust Foundation we will be pleased to send you a beautiful 2012 Couples Resorts Calendar. If you would like two calendars, donate $50.
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Welcoming November Residents, Amanda L. Parsley, DO., Pediatric Residency, Saint Louis University School of Medicine at SSM Cardinal Glennon Children’s Medical Center; and Ndidi Onyejiaka, M.D., who is currently a Tulane third year Triple Board Resident.
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The time has certainly passed swiftly even as I am becoming more familiar with the practice of pediatrics in rural Ja. I have seen some interesting cases: branchial cysts, diabetes inspidus etc. This past tuesday I experienced the ride of a lifetime in transporting a 30wkr in respiratory distress from Port Maria to St. Anns Bay hospital which had better capabilities. It was a harrowing 20 minutes (normally 40-45min ride) driving at an average of 95km/hr on the curvy narrow roads in a…taxi! The baby was in the backseat receiving O2 via mask. I was so scared!! But baby and us made it safely and it was a familiar scene of incubators and cpap devices once we arrived.
But still these and otheres are reminders that I am in a developing nation. There was the cutest little 2mth old boy who was hospitalized in respiratory distress, known to have transposition of the great vessels, thriving but still in need of surgical intervention. Unfortunately, there is not a dedicated cardiac team in Jamaica so I was told that he would be sent home to die eventually UNLESS the visiting cardiac teams (from US or Great Britain) gets to him in time. Ughhh..Stark reality of life in Jamaica.
Or how about no new born screening in JA (but to be fair this was only been in vogue for the last 20-30yrs in the US). Waiting a day or two or three for CBC, inflammatory markers, urine analysis. No abgs available in certain rural hospitals of Ja…arrgghhh.
The parents and patients are so much more appreciative and respectful than what I am used to in NYC. I cannot forget counseling this young man re asthma and his humble “Yes miss, no miss, yes miss” responses. The general population honor the doctors AND nurses. It is a tremendous, tremendous opportunity to educate and they WILL listen and improve. Knowledge is indeed power.
Case in point: A pair of premature twins were foremost in my mind because they were 4 pds, barely, and not gaining weight. They also had very bad diaper dermatitis, formula was mixed incorrectly etc. So I educated the parents, gave them some A&D along with Rx and advised a return. The parents were extremely grateful and thanked me profusely. Today they returned for weight check and while the rash was much improved, formula and breasfeeding was appropriate, Twin A was gaining weight beautifully, Twin B was actually losing weight so I had to admit her. I know she will be well taken care of. But I was so glad that I was able to help as a doctor and educator. I love, love, love to help them.
I promised to talk more about Couples in my last blog. It is simply paradise! The food is divine, the ambiance is the best of island life, and the staff is EXCEPTIONAL. They have, without a doubt, made my stay so very comfortable, and I will miss them so much!!!
Water sports, pools, blue and bluer beaches, trips to Dunn’s river falls (a must), Mystic Mountain, horseback riding, plus daily in house entertainment are just some of the activities available. But my personal favorite is tennis! I absolutely love tennis, and the pro instructor, Colin, is the best! I played tennis almost everyday after work and on weekends ( I prefer this to the gym).
Is there a more genuine set of people than Jamaicans (no bias here.lol).Shout-out to all the medical staff at the various hospitals/clinics who held my hand and instructed me on the proper medications and procedures; Dr. Ramos, Ravi, Cleary, Dr. Fisher, Dr. San San, the nurses and Mina (previous volunteer). Love you all.
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Hello to all!! I am a Jamaican living in NYC now back in JA as a volunteer pediatrician. Just finished up my first week. I specifically wanted to volunteer in Jamaica so I could forego any potential culture shock and focus on the nitty gritty from the get go.
Well I have visited all the clinics so far, and Port Maria has been the biggest learning experience so far. I had to see 18 pts in 4 hrs (no more complaints about the clinic in NYC) while learning the protocol for labs, imaging and admitting to inpt service. It is all about doing what you can with what you have, a common theme among Jamaicans on a daily basis.
The problems are quite similar, with a fair amt of semi-acute care. When a pt comes in respiratory distress there was no pulse oximeter to take O2 sats, or nebulized solution…this calls for quick clinical judgement and a referral to the ED. A 3mth old boy with fevers for one wk and a large axillary mass. Unable to do CRP, CBC, and bld cx then and there because the lab was closed so I was entrusted with the unenviable task of doubling as a phlebotomist while the charts are being brought in 3 at a time. Nevertheless, another quick referral to the ED for an admission.
What we deem as necessary medical amenities (ear curretes, tongue depressors, otoscope specula, alcohol pads, covering for the bed etc) are not readily available and I stuffed as much as possible in my little black bag. But even in the rural parts of Ja appropriate medication is pretty much available and many a times, free at cost to the pt. That is reassuring.
But after a hard, day in the heat and rush, going back to Couples is a definite treat. I promise to talk more about that in my next blog so stay tuned. Ciao!
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