Is it really almost over???

I can’t believe that this experience is almost over.  Stevie and I have been so grateful for this month and are so sad when we realize its coming to an end. 

Wednesday and Thursday were our last days at Annotto Bay Hospital.  On Wednesday, we helped with patients on the pediatric ward.  Per usual, the morning was filled with interesting cases and great discussions led by Dr Ramos.  In the peds ward, there was a 1 day old 26 weeker who was doing surprisingly well.  At 900g the child was doing fabulous, maintaining good oxygen saturation without being intubated and maintaining his temp with an incubator that was duct taped closed!  We had an interesting talk on rounds about fluid management in neonates and the ways that things are done both at home and here.  Although we knew we were returning to Annotto Bay on Thursday, Stevie and I were both a little sad saying goodbye to the doctors we had worked with on the wards.  Dr Blake, Dr Yandav, Dr Fisher and Dr Ramos have all been fabulous to work with here in Jamaica and we hope that our paths cross again at some point!!


Wednesday afternoon Stevie and I had our first exposure to cricket as we watched a high school match.   Jamaicans take their cricket games very seriously!!  I was amazed at the number of people watching and the loud cheers when the home bowler hit the wicket!!

Thursday was a busy day at Annotto Bay!  Every other Thursday is well baby clinic where any infants born recently return for one follow up with hospital physicians.   After that visit, if they are doing well then they are just followed at the community health centers for immunizations.  When Stevie and I arrived there was a huge line of mothers holding their infants waiting to be seen.  We quickly got to work seeing the adorable newborns.  Fortunately, we did see many healthy newborns who were breast feeding and gaining weight wonderfully.  I also saw 2 patients with supernumerary digits.  Interestingly, when I mentioned removal one of the mothers told me she wanted the extra digits to grow— she had also had supernumerary digits and was angry that her mother had hers removed.  Unfortunately, the extra fingers were already starting to turn purplish so I spent a great deal of time educating the mom about why they would need to be removed and referred her to surgery clinic.   I contemplated tying them off myself but due to lack of equipment and mom’s reluctance I decided the surgery clinic would be a better idea!! 

I didn’t want to forget to mention about some of the Jamaican culture we have learned about here.  Many of the babies seen here have “ascifnata” placed in their hair.  Stevie and I had no clue what we were looking at the first time we saw it!!  Finally one of the mom’s explained that it’s to keep colds away from the babies.  Apparently it doesn’t work for older people though so don’t go searching for ascifnata at the drug store next year during cold season!!  Also many of the babies have red bracelets on that look like hair bands.  The nurses told us that many of the mom’s will get angry if you take these off the infants because they are placed there for protection and to ward off evil spirits also called dunny’s.  No matter where you are in the world, culture will play a role in your medical care!! 

I also wanted to make sure that Stevie and I mentioned our gratitude for Dr Ramos.  Dr Ramos is one of a very small number of pediatric trained physicians here in Jamaica.  After clinic he spent a long time explaining the Jamaican medical training system to us, as well as how the hospitals function on a day to day basis.  He was also curious about the US system and details involving the residency program.  Dr Ramos is an excellent physician who constantly challenges you to push your knowledge base.  He is a great teaching physician who is wonderful for any learning physician to get to work with. 

Our afternoon at Annotto Bay actually brought us back to the peds wards where we helped Dr Yandav with procedures.  We were able to start IVs and perform femoral sticks for necessary labs.  In Jamaica, the physicians, not the nurses, start all IVs and perform all necessary labs.  Stevie and I both love procedures and wish we had more opportunities to perform basic procedures such as starting IVs at home.   This rotation has been a wonderful opportunity to help patients in need while also learning procedural skills from physicians who do these basic procedures day in and day out.  Although Dr Yandav disagrees, he is a wonderful teacher of procedures and Stevie and I both were successful at the procedures because of his advice!!  These hints are things I will continue to use while practicing in the US.  Another advantage to performing procedures in the afternoon was that Stevie and I were able to say goodbye to many of the fabulous nurses we have worked with on the wards!!  These people have huge hearts and we will miss them!

There is a soccer field right by the hospital.  Well a soccer field, cricket field, whatever you want to call it.  I love soccer and some Jamaican kids are amazing.  It’s clear that they’ve grown up with a ball on their foot!!

Unfortunately, the ride situation home from Annotto Bay can be much more frustrating than at the other hospitals we work at so we are getting back to our resort way later than usual.  Stevie hasn’t felt great today but we’re hoping a relaxing ride home will help her feel better.  Keeping our fingers crossed that later on we’ll be enjoying the great food and live music that we’ve become accustomed too.

Still feeling so blessed,

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