2/21/12 Posted by Amy Westman, MD (a third year pediatric resident from Kaiser Permanente Oakland in…
During the second week of our stay, I enjoyed rounding with Dr. Fisher and the ward team on the inpatient service. There were several interesting cases ranging from rule out kawasaki disease, seizure disorders, and asthma exacerbations. There was one case where a parent believed that bad spirits were causing the medical disorder, and did not believe giving the anti-epileptic medications recommended to treat the disorder would help, asking instead to take her child out of the hospital to see a medicine man that day. One of the doctors and an ambulance worker explained to me that there are people with voodoo beliefs and they can be suspicious of medical treatment, preferring to go instead to those they believe can make the bad spirits go away. This can present as a challenge for medical doctors who are trying to give a child the medical treatment they need and to educate a parent about the condition.
The following day, we had a short clinic day where I saw several well checks, a follow-up for sickle-cell disease, and a girl diagnosed and treated for kawasaki disease whose coronary aneurysm had resolved and was getting ready to graduate the clinic. I was surprised to hear that there was no clinic in the afternoon, and then was informed of a special event that afternoon where the ISSA Trust Foundation was donating incubators and a combination incubator and ventilator to Annotto Bay! Everyone was very excited because this equipment would help improve the care of premature babies in keeping them warm instead of having to improvise by wrapping them in cotton which is not as effective in maintaining their temperature. It was a very exciting day for Annotto Bay!
Here is a link to an article about the event ~ Incubators for Annotto Bay.
The following day, we headed towards Port Antonio, which was a 2 hour drive. We were very thankful for the kind employees who drove us back and forth to this hospital where there are no pediatricians. We helped run rounds where we saw a sick baby with abnormal electrolytes and a boy with sickle-cell pain crisis and acute chest syndrome. We made recommendations to get a CBC, BCx, CXR, and give oxygen and were concerned enough about the progression of one of the children that we called over to Annotto Bay for a possible transfer. I was informed later that the baby’s electrolytes normalized, but the patient with sickle-cell ended up having to be transferred to Bustamante. It is nice to know that we can easily call the ward team or Dr. Ramos with any questions about patients who give us reason to be concerned. One thing that struck me after having rounded on the patient with sickle-cell was that there are no pediatric subspecialists on the island particularly hematologist-oncologists. That is still a fact that I am trying to digest.
Afterwards, we attended to clinic and did not eat lunch in order to see all the patients there. We ended up having to split one room which felt chaotic but were able to see everyone by the time we had to leave. Overall, we agreed that there seems to be a great need for pediatricians at Port Antonio and were thankful for the experience to participate in the care of children there.
Port Antonio Ward
That weekend, we had the pleasure of having dinner with Diane Pollard, Dr. McConkey, her husband, and two Biomed volunteers. It was such an inspiration to hear their ideas and new developments coming in the future for the hospitals and the rotation that will make a positive impact by improving pediatric care. During my experience here, I have had times where I initially felt powerless as a physician when certain resources were not available, but after these weeks, I realize it is empowering to know that one can help out by donating needed resources, spreading awareness, or volunteering.
After a long busy week, we were able to enjoy Jamaica by going bobsledding and ziplining through the Jamaican Rainforest at Magic Mountain in Ocho Rios. Here is a beautiful view from a sky lift showing the coast.