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enjoying the time here. lots of work, averaging 20 patients a day in each of the different settings. Port Maria is the most consistent, seeing a mixture of typical office based issues from URI’s to constipation, last week however there was an outbreak of impetigo and saw multiple kids with identical histories. Doled out a lot of Augmentin and Mupirocin as Cephalexin is unavailable. Annotto Bay has been the hardest to get to, transportation issues a constant so one needs to learn to relax and get there when you get there. You can enjoy breakfast and ask front desk to call you when driver arrives. makes the wait better. Port Antonio has been great fun, stay mostly in A and E, see lots of kids and staff very grateful for the help. this week had a child with pneumonia and another with both bone forearm fracture that was 3 days old. Tough kid, parents just happy to have child evaluated. Did see a Mom with elephantiasis, had had illness for thirteen years. otherwise mostly typical illnesses seen in US with emphasis on derm here. Would recommend a few things on your visits to hospitals. would suggest hand sanitizer and if you want to wash your hands, bring your own soap and paper towels. should probably carry tissues as well. I happened to bring stickers for the kids, a big hit. They are definitely big sponge Bob fans, girls have liked the princesses. People do not complain about waiting and are thrilled to have Pediatric input. You do need to feel comfortable working independently, but people will try to help if you have questions. Looking forward to next week and some new experiences. AT

Interview with Ms. Opal.  She shares her insights during the 2013 medical initiative in Oracabessa.  Oracabessa is a small town in St. Mary, Jamaica 10 miles east of Ocho Rios with a population of approximately 12,000. Click here to view video.  

Great week so far. first day at each site a bit rough. Have to get in the swing of things, but then things roll. In Anotto Bay, hospital moderately larger than in Port Maria. Busy ward, interesting too. Multiple kids in ward like setting. Babies in with bigger kids, Dr. Ramos is very sharp as consulting attending, pushes general docs to consider all variables in diagnosis and management. Obviously very invested in the welfare of the children. today, second day seeing many newborns and up to 1-2 month old well babies, general pediatric care and beautiful children (and Mom’s). Very kind and gentle souls. Get to see them quickly though as there are many newborns. then on to the A and E (accidents and emergencies)area. today none to see so left a touch early. Gets pretty toasty in room with no AC and only open windows. But families happy to get care. Looking forward to seeing last site tomorrow. I am enjoying hanging out in the pool after work. Also even found time to work out before our ride arrives in AM.

Great start to our trip. Enjoyed the first few days relaxing at Couples Resort, truly vacation like. First day at Port Maria quite the contrasting experience. Beautiful children, a true joy to see in the clinic. Very sweet and caring parents, obviously devoted, seeking out care for their kids. Not much in the way of supplies, pharmacy closed, radiology closed, but certainly able to evaluate kids clinically. Parents very appreciative of our efforts. 2 asthmatic children, one dog bite and one fussy little infant were the highlight patients of the day. All the kids wore big smiles.

Today I realized that I only have one of each day of the week left to spend here. It has certainly gone by quickly. Each site has its own rhythm and I have learnt to have a different set of expectations based on the day of the week.  From the relatively steady pace of Mondays, one moves immediately to the barely controlled chaos of Tuesday vaccination day at Port Maria. Then Wednesday mornings come with their share of “thinking time” where we are afforded the luxury of engaging in academic speak and differential diagnoses.  Alternating Thursdays could be a seemingly unending line of newborns or a steady pace of old timers – ex premies, patients with asthma, sickle cell, epilepsy, the works. Depending on whether or not the charts are available for those chronic patients, you may have an easy time figuring out why they are there or be dependent on a mother (or random accompanying adult) who may very well give you a blank stare when asked why the child is there. Friday is never a bad day, because it means familiar places and faces, and only then am I truly home in every sense of the word. I have become quite accustomed to the undulating rhythm of my weeks here. But this week will be different.  It will be a week of good byes. A week of saying thanks to the many wonderful people at each site that I have met and come to know.  My first goodbye will be to the blog as I look forward to savoring my last few days in my sweet island home. I must begin to pick up the ends of my New York life that have been flapping merrily in the Caribbean sea breeze for the last 3 weeks. I must slowly begin to return to reality. Its been real, Jamaica. You never, ever, ever disappoint. Bless up. Much love. RH