2019 Mission Report - Week 1
Project Medical Director Report
Jamaica Missions USA
St. Elizabeth Parish, Jamaica
February 22 - March 2, 2019
The Jamaica Missions USA medical, dental, and educational missionary project in St. Elizabeth's Parish from February 22 - March 2, 2019 was extremely successful. This part of the project constitutes the first week of a two-week project. All participants on the teams acted to help each other.
This health fair was held in conjunction with St. Elizabeth Public Health Department and the Ministry of Health. The reports from the dental portion of the project and the second week of the medical and educational project are to be submitted separately.
Those health centers visited included Springfield, Ginger Hill, Elderslie, Myersville, and Newell Maternity Center.
Those participants in the medical and educational portions of the fair included twelve people. Of these, four are physicians, with two from the U. S. and two from Jamaica (one married to a Jamaican and from The Bahamas). Two people are emergency medical technicians from Canada, one is a pharmacist from the U. S., and his assistant also comes from the U.S. There were four general helpers who came from the U.S. though two of those people were originally from South Africa. One of these people was born in Jamaica. There were three project directors, one from Jamaica and two from the U.S. though one of those people was born in Jamaica. Thus, people in the project represented five different countries and five of these people were born in Jamaica.
The weekly schedule included 6:00 am Bible study (voluntary), 6:30 am breakfast with devotions during the last half of breakfast as well as announcements. Departure for health centers occurred at 7:15 am with arrival about one to one and a half hours later. After setting up the clinic a short service with singing, a short sermon, and introduction of the volunteers was held with the waiting Jamaicans. Evaluation and treatment of the Jamaicans followed, going from about 9:00 am to 4:00 pm. Return to our base camp at Ocean View Hotel was followed by dinner which was served at about 6:30 pm and followed by sharing, packing medication, and free time. Quiet time began at 10:00 pm.
There were multiple diagnoses made including sinusitis, cough, sore throat, hypertension, diabetes mellitus, urinary tract infections, enlarged prostrate, prostrate nodule, dysuria, vaginitis, hydro nephrosis, blood in urine, urinary retention, many dermatologic disorders, heart disease, asthma, heart failure, reversed internal organs, and over forty more diagnoses. No cases of Dengue fever, Zika, Chikungunya, malaria, or other mosquito borne viruses were found. No HIV/Aids patients were seen. All patients were prayed for.
Many patients were either given free medication from the JMUSA pharmacy, prescriptions were written so that treatment could be continued, and prescriptions from local Jamaican physicians were filled if that medication was present in the JMUSA pharmacy.
Many referrals were made to both Black River and Mandeville Hospitals for cardiac, eye, other medical or surgical evaluation or laboratory tests, local health care facilities for ultrasounds, x-rays or blood work and to local physicians for follow up care.
There were no injuries or untoward events among the Jamaicans patients or volunteers.
Statistics partially show how busy the medical and educational teams were. The medical team evaluated and treated a total of 334 Jamaicans of whom 222 were adults and 112 were children (under age 18). A total of 557 laboratory procedures were performed and 443 were for adults and 114 for children. The pharmacy team filled 1,204 prescriptions. Integrated health counseled 261 Jamaicans.
Many suggestions for improvements in the project were made. One was for a closed formulary where only a few medications class would be available making ordering the medications easier, use easier, and with possible increase savings with ordering a larger quantity of any one medication. This formulary should mirror Jamaica's formulary to permit obtaining refills of the medication by the Jamaicans. The specific medications to be present in the JMUSA formulary would be determined by pharmacists and physicians from both JMUSA and Jamaica. If a specialist were to volunteer for the project specific medication could be obtained for that specialist at that specialist's request.
More suggestions were made concerning the number and type of volunteers at various positions. Three people in pharmacy, three people in triage, and three people as runners were all suggested. Further, there was only one person in education on this project. This area could be emphasized more and additional personnel provided. Each provider should be asked if a scribe is desired.
More involvement by Jamaicans is to be encouraged in the fair. This year 1/3 of the medical and education teams were born in Jamaica. This trend of Jamaican involvement is to be encouraged.
The workload of providers may be changed to permit seeing and treating more Jamaican patients. It takes considerable time for providers and pharmacists to provide medication to Jamaican patients who already have prescriptions from local Jamaican physicians or to only refill medication and not treat any new medical problem. This role of refilling medication or rewriting prescriptions could be carried out by another member of the team as long as this activity is supervised by the provider. Bringing water to maintain hydration was appreciated and should be continued.
John H. Kopchick, MD