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Friday I returned to Port Antonio. I alternate Friday’s working between the Hospital (top of the hill) and Health Centre (bottom of the hill). Since its a 2 hour drive from my base in Tower Isle, Fridays involve a lot of commuting. It’s a beautiful hilly winding drive, though, especially in eastern Portland Parish where Port Antonio is. “Lush” is the word that comes to mind. The “bush” as it is called here, is filled with palms, orchids, wild bananas, and huge flowering tropical trees. Portland Parish is called “the Garden Parish” and is decidedly less developed than the western end of the north coast. The bush itself is very dense and wild feeling. I’ve read that Port Antonio was THE tourist center in the 1940s and 50s . The actor Errol Flynn ran his yacht ashore off of Port Antonio and liked it so much he ended up staying. His Hollywood friends followed and Port Antonio became THE destination of the rich and famous. Today its pretty quiet though a yacht harbor here bears his name. The town itself has become somewhat of a backwater despite its natural beauty. There are no pediatricians here that I”m aware of. I function as a consultant while here rotating between the local health centre and the hospital/ED. Sicker kids are referred to Annotto Bay or Bustamante Children’s Hospital in Kingston. Finally, I was asked a question this week by a concerned Mom (Mummy) in Jamaica. I had just finished seeing her daughter who had a very obvious case of impetigo on her face and arms. I had completed her prescription and talked about treatment with Mummy. “But wait, doctor, what about her sugar medicine”. Whoa! did I miss something important? She sure didn’t look like a new diabetic, there had been no history of diabetes, she sure wasn’t ketotic….. As I started to ask Mummy about symptoms and diabetes, she replied “no doctor, every time she eats sugar this comes”. Her favorite food? Sweets of course…..problem solved!! No more medicines needed, Mummy, just stop the sweets!! and Mummy smiled

I can’t believe the time here is passing so rapidly!! My second week started with a challenging Monday at Port Maria. On arrival I became immediately involved with an asthmatic boy. He repsonded to treatment but as I was writing up his chart I heard faint labored stridor from the A&ED. Wandering over, I found it was a small 6 month old girl with significant croup…. croup you that may cause airway obstruction. !!!! Again, working with the local A&E doctors, racemic epinephrine eased the symptoms significantly. But with the baby’s age and presentation she was soon on her way to Annotto Bay for admission and more care than could be done at Port Maria. Off to a busy start! Unfortunately the day ended sadly with the stabbing death of a 15 year old boy. He was in an altercation with a classmate at his local high school and arrived dead…..in the back of a pickup truck trying to get him to care in time. He was still in his school uniform….. My experience so far here has been one of warm, caring, friendly people. Not just at the resort that I’m staying at, but with the staff in the A&ED (ER), the parents in my clinics, all the Jamaicans I’ve met. They’re very proud of their country, they’re very concerned about family, and they have gone out of their way to thank me for volunteering. I saw how shaken many were with this boy’s needless death and their concern for their own children. Violence is sadly present in both of our cultures. Perhaps by volunteering we can help, just a little, better lives both in Jamaica and at home.