First (real) day at Port Maria

 
Hello everyone! I am one of the pediatric residents from University of Iowa, and I just arrived to Jamaica 2 days ago. This is my first time in Jamaica, and hopefully I can share the experiences I have here with you.

I was scheduled to start today at Port Maria, a small rural hospital up a hill with unpaved roads; however, due to some mix ups with the driver, I was unexpectedly taken there yesterday morning. I saw maybe 7-8 patients within a short 2 hr period in the middle of the day, and then none for the rest of the day. Apparently, patients here are seen by their number in line, so even though I was free most of the morning, since it was not yet their turn, I waited in my room, until 1pm, when they all came through at once. During my waiting time, though, I did learn a few things: there are no alcohol wipes, no hand sanitizers, no gloves, let alone any otoscope attachments. It was stressful working in conditions you knew were far from acceptable, and as I desperately rubbed my stethoscope with my personal pink rose scented hand sanitizer, I understood how different everything would be here.

Today, I came prepared. After some rummaging in my room at the resort (which did stock a few of these supplies), I was able to bring my own mini travelling sanitation center. Life was so much better when I was able to properly clean everything between patients! The morning started out with 3 siblings, and from there, charts were brought in by the handful every 30 minutes. By 12pm, I had seen about 10 patients, but still had a stack of charts on my desk. With all these patients with their mothers, siblings, cousins, and friends waiting outside, all I could think about was how low our “patient satisfaction scores” would be if we were in the States…

I started getting stressed at 2pm, when it seemed like there would be no end to the day, and I lost track as to whether I was sweating (glistening) from the heat or from the pressure. I went out at 2:30 to call the next patient in, but saw that somehow, the herds of people had disappeared, and there were now only a few people left in the clinic. Although relieved, I knew most of them were probably sent home as it came near the end of the day. It was a sad thing, because most of these children didnt require long visits, and with a quick prescription, could have become better much faster. There was one boy with severe eczema all over his arms, and a history of secondary cellulitis due to skin breakdown during his last flare. One look, and I started searching through the formularly for steroids available at the clinic while his father told me the history. They had been waiting there for 6 hrs but only needed 10 minutes for a triamcinalone script and some quick reprimanding for a habit of hot showers and aggressive drying techniques. I felt bad there was nothing more to offer for their wait, so I unsatisfyingly handed the boy 3 packets of neosporin to use in case there is again any skin breakdown. It’s weird how giving people something (a script, medicine, food) is so gratifying…I’ll be running out of supplies fast at this rate.

On the drive back to the resort, I learned about soft Jamaican apples, the “akee fruit poisoning conspiracy”, and the behaviors of the local popo. I was glad to be back in Ocho Rios, but felt a little guilty getting off at a resort. Rural life and Resort life couldnt be more closely juxtaposed. I can already tell this is going to be a very eye-opening trip..!

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