Volunteers Busy in Jamaica

A Tale of One City; Two Sites

I learned as a graduate student in public health that there is a “time price” and a “money price” attached to everything in health care. From this civilian’s perspective, it appears a boatload of both have gone into the preparation for our arrival in Kingston, Jamaica.  Months of planning took place between Continuing Promise 2011 officials, the Jamaican Minister of Health and other host country public health experts to determine how we could best help them meet their objectives. There were scores of decisions to be made, but the chant of realtors was echoed in one of the most basic: location, location, location. After assessing the pros and cons of many potential sites, two were selected:  Windward Public Health Center and the National Sports Arena.

The two sites could not be more different. The Windward Public Health Center site was chosen for its proximity to people in need of services, proximity to the ship, and the fact that it is already set up to deliver health care services. But it is a small site, one that normally serves 200 patients a day. It took precise planning by our Jamaican hosts and our mission providers to keep nearly 1,000 people a day moving from Point A to Point B…to point Z throughout the day. Despite high temperatures and tight quarters, each doctor, nurse, dentist or other provider listened respectfully as patients described their concerns in the soft, lilting cadence that characterizes Jamaican speech. While many problems were beyond our scope, hundreds of patients left Windward with the relief of having been heard and reassured; much needed medicine, or a referral to a local health provider.

Listening to the needs of patients is somewhat more challenging at the National Health Arena. Oceans of space are available to us and “offices” are created with privacy screens. But there is nothing to absorb the grinding sound of the large generators that serve the power needs of the large dental operation. At tables with paper signs identifying “Pediatrics,” “Women’s Health,” Adult Medicine,” etc., the one constant is that doctors are leaning in to hear what their patients have to say.

Regardless of the site differences, great health care – sometimes lifesaving – was provided. Our pediatrician, Dr. Barry Finette, ran out of little patients towards the end of one long day and began seeing adults.  A janitor came in saying he just didn’t feel right. He couldn’t remember the last time he saw a doctor. Turns out that his blood pressure was sky high and he was at risk for an stroke. Dr. Finette was able to get him on immediate medication, provide a referral to a local blood pressure clinic, and give advice about what ongoing care was needed to avoid devastating consequences.

We all marvel at the patience of our patients. Enormous tents cover hundreds of chairs, and some of the people in snaking lines have waited since the night before. No one reads a newspaper or book while waiting.  You will see an occasional cell phone, but no one is tapping away at a Blackberry. The Jamaicans talk quietly among themselves or stare into the middle distance, perhaps daydreaming about the cup of hot tea they will enjoy at home once this long day is over. The children, some wearing school uniforms, are equally serene, despite the interminable tedium of waiting.

Among the hundreds of children I’ve seen at the two sites, I’ve seen exactly one toy: a small rubber ball that rolled and bounced around the expanses of the stadium floor yesterday. Nonetheless, the children sit next to their parents with implacable composure. They respond to any attention with broad smiles and soft answers to our questions. Just like many of our children, they have dreams of becoming doctors, fashion designers, soldiers or teachers.