Blog

 
Having reached home (brrrr, it’s cold), I thought I would summarize the last week as well as give a few thoughts about the last month. My last few days flew by — the 25 wk preemie was holding his own on CPAP, I admitted a child with failure to thrive (less than the third percentile for weight/height/head circumference), went to Ocho Rios for coffee (yum, Jamaican coffee…) and a movie, and wrote a few more referrals to Bustamente. Saturday I soaked up as much sunshine as I could while saying ‘good-byes’. Despite my best effort, I am still ‘white with spots’ (freckles) as one of the children at Annotto Bay described me :)! My return flight was smooth including customs, and I discovered that it is indeed 20 degrees in Iowa as well as Jamaica…unfortunately, one is Fahrenheit and one is Celcius.

It is incredibly hard to believe that the month is over. At the beginning, I was slightly skeptical about what this experience would be like. I have no more doubts now! For those looking into trying this rotation, I definitely recommend it. It is a great chance to ‘try your wings’ before entering fellowship or taking a real-world job, since you get to function a lot by yourself. Also, the rotation exposes you to a few things that you don’t see often here (at least I haven’t — such as lots of versions of fungal infections, worms, rheumatic fever).

Helpful hints: Take something to read or study with you every day…you never know when your driver will stop at the airport, another clinic, or any number of places on the way. Not to mention that during the majority of my stay, I rode with other hospital employees rather than the drivers as the hospital vehicles were often in the shop. Therefore, you may be waiting for he/she to finish work. On the bright side, you can obtain many different perspectives of Jamaican healthcare by talking to the numerous people who provide rides — I learned a lot from the hospital administrator, parish manager, parish accountant, health officer, and a taxi driver in addition to the regular drivers.
Along the same lines, always take something to eat / drink.
Play volleyball at the resort — apparently, I am the 3rd of 3 of us to do so…it would be fun to continue this tradition :).

Most helpful items I brought with me daily: Otoscope/opthalmoscope & tips…could have used curettes. Harriet Lane, hand sanitizer, stethoscope, toilet paper. Needs I encountered: Port Maria clinic could use some Pap Smear swabs, Annotto Bay would love a Red Book…and I don’t know for sure about Port Antonio.

Enjoy! Feel free to email regarding any questions you have. Thanks for following my journey!
No Comments
 

For those of you who have read previous blogs and remember the triplets…here are two of them who came to clinic last week. As you can see, they are doing very well! If anyone would like to contribute to their care (diapers, etc.), please let Diane know — I have contact information for their mother. I am assured any help would be greatly appreciated!

No Comments
 
Pictures from the last week:
Right: This infant’s umbilical cord was treated traditionally, with a powder concoction. I encouraged his mother to utilize only clean water from then on.

Left: This infant has string on his forehead to prevent hiccups (I learned it does not have to be yellow string…but his mother said this one was working well!)
No Comments
 
My last day at Port Maria is now finished…with a bang. As with most mornings, I sat on the wall of the little circle by the pathway leading to my villa until my driver arrived. As often is the case, I called around 8:10-8:15 to make sure someone is coming. We arrived shortly before 9 AM at Port Maria and I set out my supplies. I asked for more prescription paper and filled out a few in advance as Tuesdays tend to be busy. Patients began to trickle in, mostly referred from the nurse shortly thereafter then came in a flood by 11 AM — 37 of them! The number would have been 40, but 2 turned out to be adults and one disappeared before I got to her.

Once again, most of the dx for the day were tinea or URI. I also saw preauricular ear pits/neck pits in an infant — she is to see ENT in Bustamente, consider renal U/s as well. I also saw a few more such unusual cases. I had brought an apple, but never found time to eat it — I feel so sorry for those waiting. I finished up around 4 PM at which time my driver came to find me (usually I walk around the back to the administrative office to have someone arrange for a ride). Luckily, I had time (while I waited for him to drive to the gas station and return) for a few last photographs of the helpful office staff / nursing assistants and to say my good-byes to Dr. San San Win and a few other administrative staff. While this has definitely been my busiest site, I also felt very productive and helpful here!
No Comments
 
This past weekend was amazing as my fiance flew in and we were able to enjoy many of the resort perks as well as some time together. Amongst many other activities, we climbed the waterfall at Dunn’s River Falls, took a trip on the glass bottom boat, and talked to the man selling shells. We also ate dinner at Eight Rivers/Bayside, both of which were excellent. I even managed to eat my entire meal at Bayside with chopsticks!

My Monday morning had a somewhat rocky start as the driver did not arrive until 9 AM. Then I received a phone call while at work that the resort thought I was leaving today and was looking for me. Oops, apparently my fiance’s departure date had accidentally been recorded as mine as well! That was quickly fixed and the remainder of my day at Port Maria ran smoothly. Themes for the day were tinea, URI, and gastroenteritis although I also consulted on two inpatients; one with seizures and hypotonia in great need of a Pediatric Neurologist and the other with marked lymphadenitis.

Things I learned today or along the way:
Jamaican ambulances are staffed by a driver, a nurse, and a porter. They have nebulizer machines, oxygen, and scissors amongst other things on board. The few available ambulances remain busy transporting patients from home to the hospital in addition to hospital-to-hospital transfers for tests including x-rays!
Few families have paracetamol (tylenol) at home.
When an x-ray is ordered outpatient, it is generally given to the patient. This means a patient sometimes appears in clinic with xray or labwork in hand. Dockets (charts) are kept intra-facility while the patient may go to many facilities, so you may not have the reason behind the testing available.
No Comments