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Back home now. It’s Thanksgiving. What an ideal time to consider our experience in Jamaica. We were fortunate to spend 3 weeks on this beautiful island. Truly thankful for the opportunity. The work was difficult at times, limited resources, limited medication, less than ideal facilities. These were the difficulties. The beautiful children, charming parents, supportive and helpful health care providers easily offset these difficulties. We are proud to be associated with Issa Trust. This trust is striving to provide quality care for the children of Jamaica. On reflection of medical trips, I compare projects like Operation Smile to our role with Issa. Very different goals but both are exceptional projects. While we as Pediatricians are unable to fix cleft lip and palate, a spectacular accomplishment, we provide longitudinal care and take “baby steps” in optimizing the well being of many more children where we work. While Issa Trust also does big things, donating radiology equipment, ventilators etc. our contribution must be viewed in a longitudinal perspective. Each Pediatrician during their one month stay helps a small but significant number of children, the cumulative effect of all the Pediatricians who come to Jamaica substantially enhance the well being of all the children in the service area. This is one of the laudable achievements of Issa Trust and in our experience a unique aspect of medical care projects. We want to thank Issa Trust and the people at Port Maria, Annotto Bay and Port Antonio for the opportunity to help the children of Jamaica. We loved our time there and hope we can return soon. A special thanks to Diane Pollard and all the hard work she does to make this project so successful. AT and CT