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Week 2: Work Hard, Play Harder…

Posted by Thao Nguyen, MD (a third year pediatric resident from Kaiser Permanente Oakland serving a global health elective at Issa Trust Foundation in Ocho Rios, Jamaica).

9/18/10

his past week started out rough with a big storm (at least in my opinion), but the native Jamaicans here called it “heavy rain”….not enough wind to call it a storm….but it was pretty scary nonetheless…heavy pouring rain, lighting, and thunder that literally made you jump out of your seat….I have not seen weather like this in a while. Driving to the clinic was of course more challenging with flooding roads and potholes. The drive to the remote River Rock health clinic (located high up in the mountainous areas of inland Jamaica) was so nauseating from dodging potholes and the width of the road barely enough for two cars to pass. My patient load was somewhat affected on these rainy days, but of course it picked up as soon as the sun came out again. Sometime midweek, I was relieved to learn that Hurricane Igor had diverted away from the Caribbean.

The clinical experience themes for this week are newborn exams and school physicals. Actually, it was somewhat refreshing to see well children after so many acute care visits. I learned that over here all children receive BCG at birth or shortly after birth. Varicella vaccine is not readily available so unfortunately it is still not part of the standard vaccination schedule yet.

I have diagnosed quite a few tinea capitis (a very common fungal infection here in Jamaica). What I found interesting was typically in the States, we would initiate oral Griseofulvin for treatment, but here in Jamaica, often the clinicians will prescribe antifungal shampoo and cream as a first line of treatment before considering Griseofulvin. Often cost and unavailability in the pharmacy are the factors. Also monitoring of hepatic function can be difficult as patients often are lost to follow up.

Despite my vigilance about mosquitoes and constant use of repellant, I still managed to get bitten by these crazy bugs….man and talk about pruritic rash….it drives me crazy! There is currently a dengue fever outbreak in Jamaica. I actually saw a patient in the clinic this week that I suspected of having dengue (fever, headache, eye pain, arthalgia, weakness). Dengue fever is caused by Aedes mosquitoes. It is sometimes also known as “breakbone fever” because of the joint pain. Complications include dengue hemorrhagic fever or dengue shock syndrome. Treatment is supportive care. Luckily, most cases of dengue are either asymptomatic or mild. So far I’m good….crossing my fingers.

I finally met the medical mission team from Children’s Hospital Iowa this past week! What an amazing group of people, so incredibly friendly, caring, and fun. The team went to several of the hospitals that I work at, however it was on different days, so I never actually worked with the team. Every night, after a long day of hard work, we would dine together, share stories, and dance the night away, but of course within a reasonable curfew, so we that we were all ready for the next day of work. Today marked the end of their one-week trip. We were all treated to a wonderfully hosted and delicious dinner as a token for our hard work. I will definitely miss them! We will keep in touch most definitely!

As for me, the weekends have turned out quite well since it is the only time I have off. The excursion to Dunn’s River Fall was incredible. My adventurous side took me sailing, kayaking, beach volleyball, hydraulic biking, and a feeble attempt at water skiing (it turned out my feet were too small to fit into the skiing shoes and I was consider high risk since I cannot swim…still working on that). I also got a chance to eat authentic jerk chicken and pork at one of the best jerk restaurants in Jamaica (Scotchies!).

 

I cannot believe that I only have about 10 days left here in Jamaica. Where did the time go? This upcoming week I will meet the medical mission team from Children’s Hospital Philadelphia.

Until next time….

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