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The weather has been a little more chilly today with intermittent sprinkles — much like the rest of the week. Nevertheless, the planning for tonight’s party at the resort goes on. It is the 33rd Anniversary of the resort which means a lot of activity going on!

The rest of the week has also been full of activity for me. On Tuesday, I returned to Port Maria and saw 35 patients! My hand was cramping from writing prescriptions for clotrimazole cream and paracetamol. Wednesday I returned to Annotto Bay to find that the 25 weeker is still there and doing relatively well. I was very excited to see him. The team and I rounded on the other patients relatively quickly, then I tried to assist the team in carrying out the day’s plan. We obtained a urine culture (unlike at home where we use catheters, they do suprapubic taps here), a lumbar puncture (not successful, but in-process the child developed explosive diarrhea and provided a reason for his fever), and drew blood from several patients.

Thursday was also spent at Annotto Bay; this time in clinic. I took my time (unfortunately for the other doctor who saw 40!). I saw a few interesting cases, including a 3 week old infant who had lost weight since birth. Upon obtaining further history, I discovered his mother had stopped breast-feeding when he was ~10 days old, at which time he developed ‘cold in his chest’. She then tried formula for one day and decided it gave him constipation, and had been giving him nothing but bush tea (a local remedy) for at least a week. She resumed breast-feeding several days before the appointment, but had not been expressing much milk. Apparently cases such as these are not uncommon.

Friday was my first trip to Port Antonio. The drive was gorgeous. I only had 3 patients (this is a relatively new clinic and Dr. Ramos usually sees peds patients here on Tuesdays). All three of them were referrals, two of which I referred on to Bustamente Children’s Hospital. Of the referrals, one child had leukocoria and the other had severe vargus leg deformity. I then rounded on the inpatients where the theme of the day was vomiting/diarrhea.

Other interesting tidbits of the week: The Jamaican workday is approximately 6 hours, although the resort workers seem to double that. “Lasco” is what many children call a powdered milk they drink; however as Lasco is a large company, the term may refer to many other things. June plums are a fruit many Jamaicans eat — with or without salt / pepper. Oh, and apparently housekeeping does not have a key to the bedroom of our villa…so if you want your sheets changed / new towel, either be present or leave the bedroom door unlocked (oops!). 🙂 I think that is enough for now. I shall try to post pictures tonight or tomorrow.

Back to Port Maria today; I saw 26 patients. Lesson of the day: the Ackee fruit is the Jamaican national fruit. When prepared properly, the inner part is has high nutritional value. When not allowed to ripen or not boiled, the fruit can produce vomiting, seizures, hypoglycemia, and death due to alkaloid toxins. Apparently there has been an outbreak of this recently in Jamaica including several deaths. I will know to ask about this possibility of my patients tomorrow! Pictured above: my clinic room today and a cute Jamaican girl who was my first patient of the day. (Picture taken with written permission from her mother.)