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2020 MISSION TRIP - Report

Jamaica Missions USA

Medical Report – Carla J. Howard, MS, CRRN, ACNP-BC, FNP

St. Elizabeth Parish, February 28 to March 7, 2020

Jamaica Missions, USA, had another successful project in the parish of St. Elizabeth from February 28, 2020 to March 7, 2020. This project was carried out in collaboration with St. Elizabeth Public Health Department and the Ministry of Health. Jamaican leaders for this project included Sean Brissett (Parish Manager), Dr. Tonia Dawkins (Medical Officer of Health), and Eugenie Anderson (Head Dental Nurse). Leaders from Jamaica Missions, USA, included Vinus Alscott (Founder/CEO), Edward Smith & Melissa Watson (Project Directors), Dr. Kent Willett (Dental Director) and Dr. John Kopchick (off-site) & Carla Howard (on-site) (Medical Directors). The project included medical care, dental care, and integrated health care. Medical care was provided at clinic sites at Springfield, Ginger Hill (2 separate days), Elderslie, and Burnt Savannah. Dental care was provided at clinic sites at Ginger Hill, Springfield, Aberdeen, Malvern, and Newell.

There were a total of 15 participants involved in providing care from the medical team. These participants included one Nurse Practitioner, two Jamaican Medical Doctors (one from Kingston, Jamaica and one from Ft. Lauderdale, Florida), four Nurse Practitioner students, one Pharmacist and one Pharmacy assistant, two helpers on the Integrated Health team, and two runners. This team was lead by two Project Directors, Melissa and Edward. The dental team was led by Dr. Kent Willett and Project Director Vinus Alscott with five other team members providing assistance. This included two Dental Hygienists, one Dental Assistant, one Registration/Administration helper, and one Integrated Health helper. The Medical team and Dental Team traveled from various places in the United States to Jamaica to provide this care during the project.

Our team started each day with Bible study and breakfast followed by departure to various sites by 7:15 am. We returned each evening to Junction Guest House in St. Elizabeth Parish in time to prepare for the next day, eat our evening meal, and then relax in groups or in private to reflect, rest, or socialize.

During this week, 177 adult patients were seen and 52 children were seen by the medical team. Numbers of adults for the week included 35 Monday, 50 Tuesday, 22 Wednesday, 38 Thursday, and 32 Friday. Numbers of children seen for the week included 8 Monday, 16 Tuesday, 8 Wednesday, 6 Thursday, and 14 Friday. Nineteen adult patients received knee or shoulder injections for arthritic conditions. Parasite treatment was provided to all children who were seen. A total of 753 prescriptions were filled and provided to Jamaican patients in the clinics. Numbers of prescriptions for the week included 112 Monday, 257 Tuesday, 85 Wednesday, 144 Thursday, and 155 Friday. Medication was purchased or donated in the USA and carried to Jamaica, along with other medication purchased or supplied from Jamaica. There were also medications that were supplied from the 2019 project that had been stored in Jamaica for use in the 2020 project. Medical referrals were made for patients as needed for further evaluation and treatment in Black River, Mandeville, or other private medical facilities in Jamaica.

Our Integrated Health team and Pharmacy team provided private and group health counseling on topics such as disease management, medication management diet, nutrition, exercise, proper stretching and body mechanics, oral hygiene, testicular and breast cancer self-screening. All patients receiving medication received personal one-to-one counseling on their medications for all 753 prescriptions that were filled. Our Integrated Health team provided education on topics included in this report as well as individual and group prayers and fellowship to 225 patients. Numbers of patients seen in Integrated Health for the week included 43 Monday, 64 Tuesday, 30 Wednesday, 44 Thursday, and 44 Friday.

The Dental team saw 147 adult patients and 11 children during the week. Numbers of adult dental patients included 46 Monday, 45 Tuesday, 19 Wednesday, 30 Thursday, and 7 Friday. Numbers of children seen by the dental team included 7 Monday, none Tuesday, 1 Wednesday, 1 Thursday, and 2 Friday. Dental tooth extractions for the week included 96 Monday, 97 Tuesday, 29 Wednesday, 60 Thursday, and 14 Friday for a total of 296 extractions for the project week. Dental prescriptions for analgesic medications included 53 Monday, 45 Tuesday, 20 Wednesday, 31 Thursday, and 9 Friday for a total of dental prescriptions for the week of 158.

Total prescriptions for the project week for medical and dental teams was 911; this included 165 Monday, 302 Tuesday, 105 Wednesday, 175 Thursday, and 164 Friday. The total patients seen for the project week for medical and dental teams was 387; this included 96 Monday, 111 Tuesday, 50 Wednesday, 75 Thursday, and 55 Friday. This was a great week!

During this project week, the medical team encountered and treated a variety of medical diseases and conditions. Two of the primary conditions treated at most sites were Diabetes Mellitus and Hypertension. Other conditions that were seen and treated included respiratory diseases of COPD, Asthma, tobacco addiction, allergies, and upper respiratory infections of bacterial and viral nature. Cardiac diseases included coronary artery disease, atrial fibrillation, peripheral vascular disease, hypercholesterolemia, bradycardia and tachycardia. There were musculoskeletal conditions such as low back pain, osteoarthritis, rheumatoid arthritis, sprains, strains, and plantar fasciitis. There were a few patients with neurological conditions such as seizures, headaches, tremors, dementia, and Parkinson disease. Gastrointestinal disorders such as GERD, possible ulcers, and generalized abdominal pain were also seen. Several patients had suspected thyroid disease or other endocrine disorders besides Diabetes. There were the usual conditions of sexually transmitted diseases, bacterial and fungal infections, and skin diseases seen at most of the clinics as well.

One interesting thing to note is that even though we continue to see patients with Diabetes and Hypertension, the blood glucose and blood pressure readings taken during the clinics have definitely decreased in value recorded. In other words, there are more patients with blood pressure and blood glucose readings that are not as high as they were a few years ago. The diseases are still present but I see a difference in the values in a positive way. This is antidotal and not scientifically recorded but I believe based on what I see now compared to six years ago, there are some changes being made in a positive light. Perhaps it is the medication that is provided along with the education but also the annual visit and the people we see who are now more familiar with our team and feel a partnership in this project with Jamaica Missions, USA.

I believe the benefit in returning to areas we have previously visited is evidenced by changes we have observed in population health and in clinic improvements. This is especially true of Ginger Hill and Springfield. We did have a low turnout at Elderslie this year secondary to another clinic that occurred the day before we arrived. This should be something to consider for the future so we can make the most of our time in Jamaica and help the most in communities who need us.

This was a successful project and the team were all touched by the beauty of the Jamaican people, our hosts at Junction Guest House, and the love we all shared in helping people in need. These annual projects feed our souls and allow us to see Jesus Christ in everyone we encounter and in each other. Our lives and world are better because of this work we do for our Jamaican brothers and sisters. Thank you for this opportunity.

Respectfully submitted,

Carla J. Howard, MS, CRRN, ACNP-BC, FNP/Medical Provider

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