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22
May

Governor General of Jamaica, Sir Patrick Allen Named Patron of the Issa Trust Foundation

Press Release
 
Miramar, FL, April 09, 2011 — His Excellency The Most Hon. Sir Patrick Allen, ON, GCMG, CD, was appointed Governor-General of Jamaica on February 26, 2009. A noted Christian, Sir Patrick Allen served the Seventh-day Adventist Church in various capacities for 28 years. He has served as Principal, Pastor, Director and President in the Central Jamaica Conference and West Indies Union Conference respectively. Sir Patrick is no stranger to public service in Jamaica, having taught in public schools for ten years, and while working with the church, served on the boards of the Government’s Public Broadcasting Commission, Police Civilian Oversight Authority, and the Strategic Oversight Commission. He was knighted by Her Majesty, Queen Elizabeth II in June, 2009. His Excellency stated, “The wellbeing of people goes beyond the scope of material and physical structures. It includes intangibles such as care, love, service and sympathy towards others, and this, merged with the physical provisions, determines overall wellness. “Since 2005, the Issa Trust Foundation, under the auspices of Couples Resorts, has been helping to provide health care and education for children and young adults in rural Jamaica. The focus on these two areas is important as they are critical to the development and prosperity of our country. “Your selfless service and volunteerism has helped to change the lives of many children and adolescents, who have experienced improved reading and writing skills. The access to much-needed medical services will enable many more persons to enjoy healthy, happier and more productive lives. “The Issa Foundation is a shining example of the positive results which come from acknowledging and effecting corporate responsibility in a practical way. I congratulate you and your local and international partners for the work which you continue to do. Your efforts are a true depiction of selfless love and service to others.” “We are extremely humbled and thankful for His Excellency’s acceptance, and for his enduring support of our work,” states Diane Pollard, President & CEO, Issa Trust Foundation (www.issatrustfoundation.com). “Giving children a healthy start in life, no matter where they are born or the circumstances of their birth, is the moral obligation of every one of us. We have a global responsibility to give of the utmost of ourselves, materially and morally.” “It is with deep gratitude that we salute his Excellency the Governor General, Sir Patrick Allen, for his willingness to serve as Distinguished Patron of the Issa Trust Foundation and his endorsement of the work of the Foundation,” states Paul Issa, Deputy Chairman of Couples Resorts. “Couples Resorts and its parent company, the House of Issa, have a long history of philanthropy in Jamaica, going back to the early 1900s when my grandfather Elias Issa became a successful merchant. He saw the need to ‘give back’ to his adopted home, Jamaica, where he settled with his father in 1893. From his humble beginnings as a pushcart peddler, he built a business empire that is still operating today, well over a hundred years later. Among the many charitable organizations he created were the Issa Scholarship and the Mary Issa Clinic. Today, as a result of the donations of many Couples guests and many other charitable entities, the Issa Trust Foundation continues in that tradition.”
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20
May

Goodbye..what a phenomenal two weeks!

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Hello…well I am back home stateside. Yesterday I said goodbye…for now to Jamaica. All I can say it was a wonderful 2.5 weeks. It was much more than I could have ever expected. As someone said it was well balanced….fulfilling work by day and peace, beauty and serenity by night. I think the best way to chronicle my experience is to do it by section….
1st impression:
 Well I have to say my first day began at Antonio Bay and was I in for a shock. My family is Jamaican and I have visited Jamaica many times since I was an infant and for some reason I do not think of Jamaica as a 3rd world country. However I realized how much it is a 3rd world country when I walked into the pediatric ward at Antonio bay. First all the babies and children are in one section…no separation for preemies (they would be in a controlled environment like a NICU here in the states) and regular sick children. The cribs were not of the best condition and were of different shapes and sizes. I guess you just have to see it to understand. On my way to the pediatric ward, I passed the maternity, women’s and men’s ward, and they were unlike anything I’ve ever seen. All the patients were in these huge room/wards with up to 20 patients in these wards. The 1stdays at Port Maria and Annotto Bay was pretty much the same.
Patients:
Honestly I felt proud to be working with Jamaican children. I felt like I was giving back to a country of my ancestors. Most children came in with complaints of skin infections mostly eczema, scabies and fungal infections. There is A LOT of scabies. Not sure why…maybe it’s environmental…. Jamaica is a very lush, green island. And these kids came with chronic scabies infections. In some cases, due to scratching, they became super infected. I had to treat 2 kids with antibiotics due to super infection. In at least 2 cases, I could not identify the skin condition because I had never seen anything like them before.  In one instance I referred a 10 week old for a severe fungal infection to Bustamante for dermatology. There was nothing more I could offer.
If there is anything that frustrated me was the lack of readily available resources. You really had to work with what you had which wasn’t a lot in many cases. For example I had a child with probable pica. 1stthing I wanted to do was order a CBC to see if this child was anemic. But I knew that would be a waste because I would not get results quick enough and would probably lose the child to follow-up, so I just placed the child on MV with iron. And I guess I was a bit more aggressive with treatment than I would normally be because confirmatory tests were not easily available. I noticed this was done on the ward as well, when on rounds the GP told me he placed a child, who was admitted for bronchiolitis, on antibiotics because he was unsure if the patient would return for follow up i.e. a respiratory check. One child came into clinic with a questionable lung exam with some but really not impressive focal findings but in any case I placed him on antibiotics because I was unsure if he would come back and I couldn’t do any imaging. There was also a great deal of asthma, which for some unknown reason surprised me.
In terms of patient load, it ranged from say 8 kids to 15 or so. On one clinic day at Port Maria, I saw 20 patients during the morning session. In Jamaica, children are normally seen by a general practitioner not a pediatrician. Pediatricians are considered specialists, so if the patient guardian has a complaint, then they are referred to the Pediatrician if one is practicing that day.  In other instances the GP would treat the child.
Resort:
What can I say…the ultimate in luxury. Couples lacked NOTHING. The accommodations were wonderful. The Issa doctors stay in a very roomy villa. We had separate entrances with our own bathroom. The living room and kitchen were shared spaces. Most time I stayed in my room and met up with the other doctor for meals or so. The staff were wonderful, kind and tended to my (and other guests) needs. If you are lying on the beach, there is a waiter there to take your drink order.  The food in each of the 4 restaurants is absolutely delicious.  I felt like I was dining in a 4 star restaurant every night. And since I am of Jamaican heritage, I was able to indulge in some of the islands traditional meals like ackee and saltfish, calloloo, and jerk chicken. Coming home to a place like this after a hard day’s work was perfect. It was just right. There are plenty of activities to partake in such as snorkeling, windsailing, glass bottom boating, shopping trips and trips to Dunns River.
I just have to say, this was one of the most memorable experiences in my medical career. This is the main reason why I switched careers from banking to medicine – to make a real difference in the lives of the underserved whether it’s here in our country or in other parts of the world. I chose Jamaica because it’s the land of my mother and father..and I still have many relatives that lived there.  I felt like a real doctor! In just about all cases I had to use my judgment without the assistance of a readily available preceptor. This is particularly helpful to me since in just about 3 months I will be entering the “real” world as a full fledge pediatrician. It did wonders for my confidence and gave me great experience. I wish more residence knew about this program.  It really offers the best of everything you would want in an overseas rotation.

Thank you Diane Pollard, the Issa Trust Foundation and Couples Resort for this extraordinary experience.

Randi B. Nelson MD





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24
March

Goodbye Jamaica

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It is with a definite sense of sadness that I find our stay coming to an end. I regard it as having been a wonderful opportunity to have experienced another culture, practice pediatrics and get a taste of a tropical paradise in an all-inclusive resort.
The time was a nice blend of culture, work and enjoyment. I found it mind expanding not to be so dependent on technological medicine we have come to be relie upon, and to free ourselves from are obsession with the clock. Jamaicans are polite, relaxed and respectful, at least all that I have encountered on this trip. What they lack in material possessions is made up for their joy and laid-back life style.
Thanks are due to the Issa Trust and its president Diana Pollard for arranging this opportunity for me and my wife, Martha, to partake of this most beautiful island’s culture.

Richard
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23
March

It’s a Wonderful World

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This is my second week at the Edgehill School for Special Education in Port Maria. I am getting to know these bright eyed students better and learning their names, many are names I’ve never heard before. I taught the song “It’s a Wonderful World” in American Sign Language. One of the teachers found the Louis Armstrong version on the computer and played it along with our singing and signing. That was very effective!  I am leaving my Sign Language book with the school.

Since there are 45 students of various abilities and ages, I modify these lessons accordingly. Paper and pencils are ALWAYS in short supply, and the drawing pads I brought were used up, so I bought more at the local book store.  Dry erase pens are also something which is consumed (dried up) and need replacing. I bought more, but that is also in need as is a copy machine (someday).

Sometimes, I use patterns to trace around. All the art work was displayed in an Art Corner. Most of it I had covered with Saran Wrap, but one day, there was a torrid of rain, some blowing sideways through the windows, and some of the artwork was ruined, but much survived and is still displayed. The students stand in front admiring their artwork and that is a thrill for me!!!

There is an ART CORNER now at the school.

1. tracing their hands with pencils and using watercolors to fill in —taped together to make a big poster

2. used oil pastels (there was a set given but not used, since the teacher didn’t seem to know how to use them—she appreciated learning—I  brought in samples of Hibiscus, fern leaves, Mousetail pods, grape and almond leaves. The students made lovely botanical art which I taped together in a poster.

3. used soft pastels to create still life–I brought in pineapple, papaya, apples, banana, and star fruit for the students to draw and fill in with the pastels. I taught them about how to see and draw the shadows that these fruits cast on paper.  These pictures were mounted and displayed.

4. used old magazines (which the activity director at the resort gave me) and cut out photos of various people doing jobs. These were glued on paper and the students filled in with markers “the rest of the story” This tied in with their Career Day at the school. The speakers who were scheduled didn’t show up, perhaps due to the rain, so I was a speaker. I also taught a game to the whole school which seemed to be a hit. “A…my name is……and I live in ……..and I like……..” It’s a great game to teach thinking skills as well as geography.

5. I will be using watercolors and crayons to teach the concept of symmetry making butterfly pictures.

I think that I’ve enriched the lives of these young students as they have enriched my life, too!!
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22
March

Complications of TInea Capitus

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On Monday and Tuesday this week, I was working in the clinic in Port Maria and saw two complications of tinea capitus . The first child I saw on Monday was referred in from another clinic for an I&D of a scalp swelling that was not getting better on oral antibiotics. I sent the child to the A&E for the procedure. When I returned Tuesday, I spoke to the Dr. Mighty of the A&E and she told me when they opened up the swelling several live maggots came out. This she said happens when tinea goes untreated and the necrotic tissue is a source for the maggots. They were treating the child with a power that is cidal to the maggots, in addition to Griseofulvin and shampoos. This was a new one for me.
The second case I saw on Tuesday. A child brought in by his aunt, who had custody of him for most of his life. She said he had scalp lesions for several weeks. When she removed the bandana covering his head, I saw large bald spots that were boggy and oozing. It was a kerion, an inflammatory reaction to tinea. In thirty five years of practice in America I could only recall only one or two cases. I was advised to admit him for oral Griseofulvin, Prednisone, and to have the social worker access his home life.

Both these cases gave me a new respect for possible complications of untreated tinea capitus.

Richard
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