Feedback Finale: Thank You Jamaica

Week in Review

• If you recall the 2 yr old who had a blade of grass stuck I his throat last week, you’ll be surprised to know that he was admitted several days after our meeting for allegedly ingestion Clopidogril ( an anti-platelet medication that can cause bleeding). But you”ll be happy to know that he finally swallowed the grass without needing the ENT referral.
• The x-ray machine was malfunctioning for several days in Annotto Bay, so we really had to put our clinical skills to the test.
• The team at Annotto Bay were able to facilitate a transfer for a newborn term infant to Bustamante Children’s Hospital in Kingston within hours of birth because of impending respiratory failure. The new intern had a look of fear on her face as they left. Our words of advice: you can use bag mask ventilation till the cows come home. Unfortunately the baby passed soon after arrival.
• The interesting cases for the week go to a 7 month of female at Annotto Bay hospital  who was admitted for failure to thrive and dehydration. She has multiple abnormal electrolytes along with pneumonia. At this time the working differentials were Cystic Fibrosis and Bartter’s Syndrome. With hydration she improves clinically but continues have abnormal labs. A nephrologist in Kingston has been consulted to evaluate her. The second case is a 14 yr ol female at Port Maria hospital who had significant right arm pain, limited range of motion at the elbow and severe point tenderness at the joint. Our concern at the time was fracture, septic joint, or osteomyelitis yet there was no history of recent trauma, fever, or joint swelling. An xray of the right elbow had what appears to be an intraossessous bone cyst/abscess. Orthopedics were consulted from the next parish in St. Ann but the patient will have to wait until next week to be seen.
• We have noticed over the course of the month that many newborn infants whether in the A&E or Clinic have a red ribbon or band on their wrist. When asked “what is this for” to the mothers, the common response is “Me nah kno, fi him/her grandmada did put ti pon deh”. After a quick google search we found that this is a Jamaican custom to place the red tie/band on the hand or foot to ward off evil spirits.
• 

  Dr Ravi working on patient transfer to Bustamante Children’s Hospital

  

  Dr. Nicole Davidson taking a brief and much needed break at Port maria A&E

  

  Dr. Roxanne Samuels,
  reviewing arm film of our 14yr old female.

  

  Dr. Hayden-Peart

  
  

  children in infant class at Free Hill Primary school

  

  Mr. Rory Suarez, great driver

  

  Dr. Wilson on our last day at annotto bay

Global Health Rotation in review: Nicole and I are very glad that we decided to do this rotation. We are both of Jamaican heritage , we have a special connection to the island and feed a personal responsibility to keep giving back. We recommend that other residents try to do the rotation in pairs. Working in pairs can be great when trying to manage patient loads and maneuver through the Jamaican health system. We both had the pleasure of meeting with a couple hospital administrator by happenstance but this that these introductions should be standard to provide an introduction to the healthcare system. While to orientation was helpful is seems to be out of date with what labs, ,medications, imaging, and consultations are available at each facility. Having these resources prior to the start would have helped with a smoother start. We recommend that any residents and volunteers visit the Free Hill Primary and Infant School excursion provided by Couples Resort. This gave us the opportunity to see the children you serve in a more natural state, the communities they live and learn about the structure of the education system in Jamaica. Special Thank You to…

• thank you Diane Pollard of the Issa Trust Foundation for assisting use prior to and during our ration. The hotel staff have treated use like family and we truly appreciate all the accommodations made on our behalf.
• Thank you to all the medical and hospital staff at Port Maria Hospital, Annotto Bay Hospital and Port Antonio Hospital.
• Thank you to the hospital administrators, Dr Sloley, Dr. Hayden-Peart and Ms Nunez of Port Maria, Drs. Ramos , Ravi, and Wilson of Annotto Bay, and Mr. Campbell and Dr. Levwok of Port Antonio. All these people have helped us and taught us many lessons for which we are grateful. These service that these people provide to the country of Jamaica s greatly appreciated. Keep trying to change to world.
• Thank you to all our drivers who got us to and from work safely. Special shout out to Mr. Munsie, Mr. Forbes, and Mr Steve.