Jamaican Me Crazy Part 3

Tuesday night at the hotel Marla shared her vision for ACE and the various outreaches it sponsors. One of the most exciting projects is the GreenLife farms. Designed to be the first self sustaining, totally organic farm on the island, it will serve as not only a revenue source for local farmers, but a haven for abandoned and abused children. ACE is committed to integration in the community and all of their projects have Christ at the center, but wisely they acknowledge that there are many ways to show the love of God. ACE began with a vision of what could be, and has found a way to make it what is. How often is it that we either don’t listen to what God is telling us or drown out His vision with our own schemes? I know I do with the regularity of a Swiss watch. In fact, when I first visited ACE a couple of years ago I never dreamed I would return, much less in a medical capacity. I kept thinking that my only usefulness was limited to waiting for someone’s water to break or counseling Jamaicans on hot flashes; not exactly high priority needs in a tropical setting. I was looking forward to going on a medical mission about as much as I was excited about attending a Britney Spears concert. A wise mentor ( my wife) sat me down and simply said, “Listen dummy (it’s a term of endearment) it’s not about you! It’s about you listening and responding to something more than you.” She was right, as I tell her on an extremely regular basis, and I made her promise that if I found myself heading to Jamaica on a medical mission that she would have to go with me. She reminded me that it was not about her either, but I prevailed, and so we rented the kids out for a week and here we were. Initially we had wanted to bring the whole family on this trip, but school commitments kept the kids at home. They were ecstatic at the prospect of being rid of us for a week (their grandmother was to look after them) but I made them promise if we came back when school was out they would come. It didn’t take much
convincing.

Wednesday morning arrived with the music of Lady Antebellum blasting from my phone alarm. How appropriate that Angie, one of the team members, had given birth to one third of this ridiculously successful music group many years ago and had given up a trip down the CMA red carpet that night to commune and serve with us in Jamaica. We were to reward her in our own way that night. I rolled over and nudged Susan and reminded her that we had promised to run with Maggie, another team member, that morning. If it had just been me she was snubbing she would have told me to go jump off the cliff but since she knew Maggie was depending on us, and we had been given explicit instructions to run in a pack (like rabid dogs) if we left the property, she aroused and donned her running outfit. Our morning runs in Jamaica were amazingly refreshing and allowed us to start the day with more than the java jolt provided by the Blue Mountain coffee. We opened up the runs to any and all comers, yet most of the team was infinitely wiser than us and opted to exercise in their sleep. Dr. Mal, our token colo-rectal surgeon, ran in the mornings also, but he elected to be a renegade and travel solo surprising the night watchman on a couple of occasions. Once our run was completed, we showered and donned our scrubs and headed to breakfast. Food at the Galina Breeze is purchased locally and prepared by a Jamaican staff and it is a treat to the senses. I have a basic tenant of not eating that which I can’t classify as animal, vegetable, or mineral, yet here I made an exception. Even though I was unable to ID some of the dishes, largely due to my ignorance of anything culinary, I trusted the kitchen staff and was not disappointed. Learning that they can “jerk” about anything, including coconuts and any four footed creature on earth, I even found plenty of vegetarian fare to my liking. Fruits, breads, and greens all combined to dance across my poverty-stricken palate to provide an eating experience that would shame Rachel Ray. My most favorite dish, peanut butter fish, is an amalgamation of, you guessed it, some kind of fish and a jar of Skippy, and it was to die for. I have decided that you could put peanut butter on a anchovy and it would be palatable. The abundant and delicious bounty became a challenge to my practice of “Hara Hachi Bu” or the Okinawan’s health habit of eating until 80% full. Nevertheless, the Galina Breeze culinary staff took the bounty of Jamaican farms and created nutritious, delicious meals that replenished our energy and kept us regular!

The minute we drove up to the Albany clinic we knew we were in for a special day. Not only was there a crowd already milling about, but a few rain clouds loomed ominously to the West. As was the common practice, the dental clinic set up outside under a tarp and proceeded to work its magic in front of God and an ever present crowd of onlookers. The dental team, led by Dr.Mike, a huggy bear of a guy who could pull a tooth faster than my wife can pull out her Visa, was a diverse mixture of non medical and medical/dental folks who didn’t know each other at the beginning of the week. By the end of the week, they were putting each other in their wills and picking whose house to spend the holidays at. They meshed like tattoos on a biker chick, and by the end of each clinic day had a pile of pulled teeth stacked higher than ice cream on Rosie O’donnell’s desert tray. This was a well oiled (thanks to Richard the autoclave wizard) machine. Jamaicans have a huge dental problem secondary to poor access to proper dental hygiene and prevention and a diet that screams cavities. You can almost guess someones age by the number of teeth remaining as there tends to be an inverse relationship. Some of the most appreciative patients were those who smiled as best they could with mouths packed with gauze after having a tooth pulled that had been hurting them for weeks. After seeing the dental clinic in operation I made a mental note to call my dentist when I got home and schedule an immediate check up.

Along with dental caries a huge number of Jamaicans have diabetes and hypertension. This is largely due to a diet rich in fruit, sodium, sugars, and processed food. You would think that a predominately plant based diet rich in fruits and vegetables would be a healthy one, yet the problem lies in the limited varieties of fresh foods, access, and education. Almost all the food staples are sugar based and virtually all the diabetes is the type 2 or adult onset, which is diet dependent. We were going through metformin, a medicine to lower blood sugar, as fast as we could package it up. We tried to provide a 90 day supply of meds since the clinics were set up to be staffed once a quarter, and we knew if the medicines ran out before someone returned the sugars would rise like the morning tides. The same applied to the blood pressure medicines we distributed. For many Jamaicans, the choice to buy medicines or to buy food is very real one, and it often means months or years of frighteningly high blood pressures or blood so packed with sugar that even Dracula would pass. All this leads to a disturbingly high morbidity and mortality rate that devastates the population of middle aged Jamaicans. These are preventable diseases that simply need education and a minimal amount of care to overcome. Not surprisingly we see the same picture in the US in certain demographics where fast (fat) food and cheap calories predominate. As I related over and over to my Jamaican brethren, eat less, mostly plants, low sugar, low fat and high fiber. And never, never eat anything you can get from a drive in window...even if you walk up to it!

We saw over 200 patients that day in Albany, in spite of a few showers that quickly turned the dental clinic into a makeshift mud wrestling ring. Dr.Liz Ann, our much needed and infinitely patient pediatrician, looked in more ears than a piercer at Claires in the mall. Susan, my wife, was the patient router and she wisely sent most kids to Dr.Liz Ann while I got the Paps and assorted itches and “female” stuff no one else wished to see. Dr.Mal saw all comers with a smile and kind word. I suspect he was just thankful he didn’t have a proctoscope handy. I can’t say enough about the docs, and our nurse practitioner MaryAnn, who all rose above our perceived level of competence and realized that we were there first to care, second to serve, and last but not least to treat medical problems. We may only be scratching the surface, but if you happened to be one that was scratched, it mattered to you. Jesus loved one person at a time and we kept reminding ourselves that the next person we saw may not see another doctor for a year or two, so we best love on them all we can now...we may not get another chance.