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I cant believe its already my last week in Jamaica. This weekend was (sadly) the first time I took advantage of resort activities, touring Dunn’s River Falls, and laying by the pool with a nice book. It is times like this I regret that ‘I’ in my personality test profile. Things seem to be winding to a close pretty naturally though, and I even received my first follow up in clinic today. The mother of a girl I treated a couple of weeks ago at Port Maria stopped me in the hall just to report that her daughter’s skin infection had completely resolved. I think that is one of the most satisfying parts about working internationally: there are some diseases that are so easily treated that you feel guilty taking credit for its treatment. Infection? Antibiotics. Done! But of course, that comes with its sad stories as well. People my age would have parents who had died of some readily treatable illness, or a sibling who died from pneumonia. Pneumonia? What healthy child dies from pneumonia? “Well, that’s life,” they would reply to my sad expression. Not any life I’ve lived, I thought.

Yesterday was a particularly exciting day in Annotto Bay. There was a child requiring a CT Head, and due to the lack of resources at that hospital, we traveled to University of the West Indies (UWI: eu-wee) in Kingston via ambulance. After I was done feeling nauseated and dizzy, I had the opportunity to explore this new hospital. Dr Ravi made the journey with me, and was a wonderful tour guide while we were there. The rooms, the emergency department, the wonderful wonderful machines! What a huge difference it was from the clinics I’ve been frequenting up to this point. Being in Kingston really made me feel like Jamaica wasn’t so foreign after all. If you have some Dramamine on hand, and forgot to eat your lunch, I definitely recommend giving the trip a try.

Last week went by very quickly. Out of all the hospitals, I am enjoying Annotto Bay the most, for its resident interaction and learning opportunities. Despite being a level B hospital, it is still very much in need, with minimal supplies. One afternoon, residents were drawing blood via needles to the femoral vein as there was a shortage of butterflies. For IVs, the end of a glove was ripped off to be used as a tourniquet, and the catheters placed and held haphazardly with paper tape. A rolled towel was used as the splint to prevent bending, and again bound by rolls of tape. Children walked around with little bumps of cotton taped to their arm, their scalp, and their inguinal area for lack of band-aids. What I previously thought of as basic necessities were all luxuries here, and was responded by laughter at the mention of things like Tegaderm, adhesive removers, or LMX anesthetic creams. The painstakingly gathered blood samples were then wrapped in lab order sheets, and sent with a driver, who would personally deliver them to a lab 2 hrs away from town. I was informed that this was a necessary process not only for blood cultures, but even for bilirubin levels, as their equipment was not reliable for levels above a certain threshold. Back home, parents wait in clinic while bilirubin levels return within minutes. If nurses or doctors have to walk all the way down the hall and into an elevator to deliver these samples to the in-house lab, it is met with eye rolling and sighs about how the hospital is a mess because the tubing system is malfunctioning. I’ve been here for 2 weeks now, and the more I see, the more amazed I am at how different things are here. In the same way, though, I think the residents look at me amazed when I tell them about bilimeters, 5 minute lab results, and EMRs with electronic films.

Today I was back in Port Maria. I’m growing to like it here a lot as there is the most need, and patients present with very manageable cases, where easy treatment options are available. While seeing one little girl with a viral URI, her older sister insisted on braiding my hair, and asking to see inside her sister’s ear. She was very curious, and many children are eager to learn, which makes clinic that much more fun for me. In the middle of the day, water became unavailable, and none of the sinks were available for hand washing. In any other clinic, this would have been a huge crisis, but here, things went on per usual, as if nothing significant had occurred. I am just happy to have brought all of my sanitation supplies with me today. It’s funny how accustomed I have become to all the limitations of working in Jamaica; I hope that when I return to Iowa, my gratitude for all that we have there is not as quickly fleeting.