Early Mornings (are a health hazard)

I’m hoping this becomes a trend.

Waking up early, I mean. Not suffering from smoke inhalation. It’s day six (?) of the Retirement Dump fire in Montego Bayor as we who live close by call it, “too damn long”. It’s really uncomfortable to wake up and go to sleep in the smell of smoke. Even more uncomfortable to do yoga in it. Not to mention the laundry. My bed sheets are soaking up the smog as we speak, and I don’t even want to think about my hair.

 

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DEATH FOG

One of my favourite things about our house-in-progress is that we finally have work desks right in front of the windows. But peering out my windows to contemplate the flowers in the garden is now a health hazard because I have to contend with emissions of carbon and god only knows what else in the air.

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Please ignore the cables and focus on the haze of death fog.

So on top of the probably indefinite State of Emergency, St. James is now slowly choking to death or at least serious illness. If bad things come in threes, I can’t wait to see what else is going to kick us when we’re down. That’s not true, I can totally wait. At least until I can breathe again.

 

 

 

Hopefully we come out of this with no serious ill effects. You know, other than migraines, chronic cough, upper respiratory infections,  exacerbated asthma. . . I could go on, but run on sentences are harder to do when the air is full of noxious fumes.

Til next time.

the Beginner’s Guide to Calabash Literary Festival

Disclaimer: This post is unofficial and unaffiliated with the Calabash Literary Festival, and not endorsed by the producers either. Just my own opinions and reflections. 

Who else loves literature? If you raised your hand, you’ll probably agree with me that book fests are the new music fests. Let’s face it: comfortable seats and soft spoken word beats standing for hours having your ears screamed off any day.

After about a dozen years of impatience and envy (bruk pocket and bad mind) I finally managed to attend the Calabash Literary Festival, the best little festival in the best little village on the best little island in the world.

A brief introduction

Calabash (as it is affectionately known) was started in 2001 by Jamaican founders Colin Channer, Kwame Dawes and Justine Henzell. After being staged annually for a decade, Calabash now draws crowds to Treasure Beach every other year. And the wait makes it even sweeter.

The Locale

At first look, Treasure Beach is a happy sleepy little town on Jamaica’s south coast. Driving down from Montego Bay my first sight as I rounded a corner and began the downhill drive was a gorgeous green plain that melded right into the Caribbean sea, dotted with houses and tiny lakes. It was breathtaking.

Treasure Beach is friendly to the pedestrian and avid step-counter. It’s much easier to walk around than it is to drive and the scenery is so pretty you’ll constantly be stopping to snap pictures. One weird element – at least weird in my north coast opinion – is that the sand is actually a dark colour, nothing like the white sand beaches I’m used to. But it still has a rustic beauty to it.

Lodgings

Places to stay are hard to come by in Treasure Beach around the time of Calabash. Most hotels are fully booked out months in advance but we luckily got in touch with an AirBnB host and managed to secure a hut for the weekend. Yes, a hut. A ‘comfortable hut with options’ as the listing went, and it was pretty comfortable. Once we got past the outdoor shower (cold!) and strange scratching noise in the thatch roof at nights (despite my worst fears, we did not get eaten).

Food

For a Jamaican village, Treasure Beach has a wide variety of meal options. Tourism does that to a place I think. Aside from Calabash itself which sold breakfast, lunch and dinner, there are a number of restaurants along the village road. We tried unsuccessfully to eat out at a different place every night – Jack Sprat kept drawing us back in – and for the most part the food was pretty good. I was amused that everyone served pizza! And being Jamaica naturally jerk chicken was the most common topping.

For breakfast there was only one option: Smurf’s Cafe. I still have mouthwatering daydreams about this eatery, which is right behind a bar of the same name. They serve home brewed coffee and a delectable selection of local and continental dishes. I can’t sing their praises enough. Their reputation speaks for itself though, because every single morning of Calabash there was a large crowd of people waiting for tables to free up.

Festival Grounds

Walking into the Calabash venue you will pass stalls featuring a variety of entrepreneurs and artisans. Even though Calabash boasts no admission fee, you should walk with plenty plenty pocket money to spend on the jewelry, accessories, clothing, natural products and more that are all for sale on site.

And the books! Of course a book festival comes equipped with its very own bookstore, and the Kingston Bookshop came prepared with titles from all the speakers and then some. One complaint – the books were so expensive. It would have been a nice gesture to offer a festival discount so that those with less well-lined pockets could still buy a book and get it signed by their favourite writer.

The Festival!

Saving the best for last it seems. Calabash prepared such a refreshing blend of creative voices: novelists, short story authors, poets, writers who defy genre, artistes and DJs came together in a delicious pepperpot soup that I imagine left the audience feeling satisfied and sated.

Confession: I didn’t attend every single event. I was waist-deep in exam preparation that weekend, and I really love sleeping in. But the beauty of Calabash is its buffet style presentation. You can pick, choose and refuse events and sections without feeling like you’re missing out, especially since hashtags keep you in the loop from a distance with Twitter. It’s casual, a la carte and tech-friendly so it fits right in with the ethos of today’s evolving interconnected world.

One complaint: directions on the festival grounds would have been super helpful. The first night I ended up waiting in front of the main stage when the festival was going on at the adjacent property. Long time attendees may be in the know, but us newbies can get lost pretty easily.

Verdict

Am I hooked on the Calabash bug and totally enamored of Treasure Beach? Guilty as charged. The festival delivered, and was every bit as #LitUp as the producers promised. The Open Mic sections sparked my muse and now I’m excited to start writing again. Next time I’ll be up on that stage too.

Here’s to Calabash 2020, I can’t wait!

 

on the Commercialization of Black Excellence

 

This past week I’ve been ruminating.

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Corporate U, a networking company based in Western Jamaica, is hosting a red carpet style affair for the premiere of the Black Panther movie, and charging $3000 for admission (roughly twice the cost of a regular movie ticket). Though it claims to be giving the profits to charity and though I love dressing up for fancy tête-à-têtes, the high-priced ticket is giving me pause.

The revolution will not be televised

My mind keeps turning over, uncomfortable and questioning. Black Panther has become so much more than a superhero movie, has evolved into a political statement: a blanket, a balm, a battle cry. Just look at Twitter, where the hashtag #whatblackpanthermeanstome has generated an outpouring of emotional and hilarious observations on the realities of black life. It feels cheap to take this movement and capitalize on it for material gain. Because charity or not, profits will be made and someone’s pockets will end up fatter.

The revolution will be . . . commercialized?

The second question, of exclusivity. That the celebration of black excellence somehow comes with a discriminatory price tag. “You must be this wealthy to attend this premiere”. I elected to skip the red carpet experience, with the distinct and discomforting awareness that this only deepens the divide between the haves and the have nots. Between the bawdy bandwagonist half price movie goers, and the tawdry trend-setting full price movie lovers. Further, between the curly-haired light-skinned BMW driver and the kinky-haired dark-skinned pedestrian. Drives home the distinction between ‘State of Emergency’ and ‘enhanced security measures’. The ropes around the red carpet isolate us ironically, at a time when we should be celebrating the things that make us the same.

The last question, of overthinking. Black Panther is just a movie, after all, not some kind of altar call for black power. No matter how poignant the timing is. Corporate U is just another business, doing what businesses do: making money. And the red carpet affair isn’t driving wedges between the hearts of Jamaicans any more than the latest all-inclusive party or ZOSO. My perceived discomfort is exactly that: perception. The people who want the full ‘African Royalty’ experience will go, and enjoy the many scheduled after-parties. And the people who don’t want or can’t afford it will watch the movie on discount night, same as always.

The world keeps turning
and only time will tell
which side of history we stand on

Notes from a State of Emergency

Sometimes I forget why I like writing so much. It’s not a habit or some intrinsic drive. Lord knows if I had internal motivation this blog would be updated with something resembling regularity (perish the thought). I like writing because I’m convinced that there are stories out there waiting to be told, and I am the one who needs to tell them. Like the nebulous dreams in The Land of Noddy (credit: Roald Dahl) waiting to be caught and dreamt, there are stories floating in the ether waiting to be heard and written. This is one such story.

This post has a soundtrack. Plug your headphones in and enjoy ‘Caution’ by Damian Marley.

Living in Montego Bay these days feels a lot like living in a fish bowl. Everyone keeps peering in at you and tapping the glass, wondering how you breathe in the same fluid that you keep pooping in. There’s a distinct ‘This is Water‘ kind of vibe, and most residents are aware of the Elephant in the Room in an abstract “Oh yes, that’s a problem” way. The Elephant is, of course, gun violence. St. James has been running hot for a while, with a body count that far outstrips the rest of parishes in terms of people murdered since the start of the year. We closed out 2017 with a record 335 murders.

The government’s initial response to the wave of crime sweeping the country was the creation of ‘Zones of Special Operations’ which gave soldiers and police officers license to set up shop in specified communities where they could question and detain ‘persons of interest’. The first ZOSO was in Mt. Salem, and at the time I lived in a neighbouring community. The ZOSO didn’t really change much about my day to day life, but then I have the privilege of (1) being a woman and (2) living in a community with significantly less stigma. Additionally, I don’t bleach my skin and I don’t drive a so-called ‘scammer car’ (you know, the super expensive ones that ghetto youths buy overnight) so I didn’t fit the typical profile of a ‘person of interest’.

Fast forward to January 2018 and the establishment of a State of Emergency for the parish of St. James. The SOE again grants police officers and soldiers the “power to search, curtail operating hours of businesses, access places and detain persons without a warrant” (JIS, 2018). The Prime Minister reassured citizens that law enforcement officers have been trained in human relations and are expected to treat all persons with dignity and respect.

But the gap between the rich and the poor looms ever wider.

Privileged business owners like Jason Russell complain that the change has hampered Pier 1’s delivery of the ‘tourism product’ (read: Pier Pressure lock off too early). Meanwhile people from poorer communities retaliate futilely against the invasion of their homes and lives as in the case of Lasco, Lost and Found. Overcrowding in the lock-ups creates a public health nightmare, and some of these ‘persons of interest’ are as young as 16 years old. Always the scales are tipped against the disenfranchised, the impoverished and the uneducated. If the US struggles with systemic racism, then institutionalized classism is Jamaica’s cross to bear.

The system designed that stony is the hill dem cyaa climb

Too much, cry the privileged whose lives are only hampered by violence when steps are taken to prevent it. Long lines of traffic at parish border checkpoints cause frequent delays. Businesses forced to close early lose profits.

Too little too late, cry the families whose lives have been shattered by gun and steel. Just last week my hairdresser buried her 26 year old son, gunned down with his baby mother on their way home. He was three months younger than me.

***

I straddle a world of relative privilege (a world I work hard to stay in), but my eyes are glued to the harsher realities that exist outside of my immediate bubble. The struggles and paradoxes that perpetuate our systemic inequalities have continued to be forced into a harsh light by the social media coverage of this State of Emergency. But not many of us are ready to see it, to stare without blinking at the uncomfortable truth.

The most obvious, ubiquitous, important realities are often the ones that are the hardest to see and talk about.

This is water. Pay attention.

Reflections and Re-purposing

It’s officially a year since I left hospital medicine and ventured into the clinics and primary care. Like Lot’s daughters I never looked back to watch the world I once lived in burn, almost literally. I’ve wholeheartedly embraced this strange new territory and I’m coming to think of it as my home.

There’s a lot going on with primary care in Jamaica. One news story just a few months ago reported on the high level of dissatisfaction patients have with the way service is delivered. Primary care is plagued by low resources, for a number of unfortunate reasons. And primary care as a system is badly fragmented. There are many gaps in this new world.

When I walked sprinted out of secondary care I did it with a vow in my heart: I would try as hard as I could to prevent the untimely deaths and strokes and heart attacks that were caused by manageable chronic diseases. I was eager, I was willing and I was hopelessly naive. Stepping into clinic was like being splashed in the face with cold water; determination would only take me so far, about as far as the burnt out bridges of patient behaviour and system capacity. My sprint slowed when I realized this could not be the only direction I expended my efforts in. I needed to study the system to understand how to improve it.

So I began to learn, as much as I could and as often as anyone would let me. I didn’t just start to learn about holistic patient care, I started reaching for every training session that passed my way. The closer I got to the source, meaning the Ministry of Health, the more I was able to identify the gaps between protocol and reality. We play a hard-core game of Chinese telephone with our standards that usually ends with the front-line health care worker simply doing the best they can with what they have. This system was a mystery I was determined to unravel, and that curiosity illuminated an unexpected career goal.

I love organization. I love rules and protocols and standards and guidelines. It tickles my fancy to improve system efficiency, to find innovative and easier methods to meet goals and targets. And as it turns out, all those things that people in high school called me weird for liking are actually super important to the world of work. Those skills and interests can translate into actual jobs, with the right qualifications to back them up.

So it seems that after all these years of worry about a loveless career I am now falling, stumbling, eagerly crawling toward a purpose that resonates with my own ‘weird’ frequency. Hurrah.

Oh, Say it Ain’t ZOSO

The latest buzzword in the Jamaica crime scene is these Zones of Special Operations (ZOSO). ZOSO is an Act recently passed by Parliament which allows for the use of “special measures” to uphold public law within “certain geographically defined locations”.

At face value this Act sounds like an Act of Discrimination, like the Prime Minister is giving the security forces full permission to kick down people door and mash up dem tings, but only within specifically designated areas of course (aka ghettos). But according to the Jamaica Gleaner, the Bill is trying to balance the need for extreme measures in the battle against crime and violence with the fundamental need for the protection of citizens’ rights.

On September 1 the PM declared Mt. Salem, St. James the very first ZOSO. Acting on information that was later challenged by residents of the community (backed up by the Councillor for the area), Mr. Holness may well have moved somewhat rashly. But despite the less-than-sinister statistics, Mt. Salem is still perceived as a tension-driven melting pot of criminal activity. Driving through that community just last week I heard one woman cussing another spit menacingly, “You feel seh ah you one know gunman!”

So there is no question about the need for increased police attention, even with a police station already on the main road. What I do feel needs to be questioned is the approach to the citizens on the left and right sides of the Mt. Salem main road. And yes, I’m talking about a literal representation of the ubiquitous class divide.

After you pass the hospital, on the left hand side going into Salem the side streets display large, well-painted two and three storey houses. There are garages with cars, the houses are populated by a mainly middle-aged and retired set of citizens, and the streets themselves are paved (for the most part) and wide enough to accommodate two lanes of traffic.

Flip the script, and observe the right hand side of streets. They are narrow and winding, descending sharply into one way lanes and dead ends. There are two and three storey concrete structures at the intersection yes, but as you advance further along, there are more board houses, less space for cars to fit and a dramatic increase in shady characters lurking on street corners. Some taxis don’t even carry people here.

Obviously infrastructural problems have played a huge role in this divide, and real estate prices drive people left and right as their pocketbooks allow but my real contention is that there are two very different classes of citizens living in Mt. Salem and my concern is that one set will end up with the “special measures” while the other enjoys the “protection of citizens’ rights”. So far I haven’t heard anyone cry foul (quite the opposite) but in these cases the voices of the downtrodden rarely make it past the streets where they are stepped on.

What ZOSO excels at is highlighting the blurred geographical lines of Jamaica’s class divide. It is a truth universally acknowledged that beside every uptown is a ghetto: Ironshore has Flankers, Westgate Hills has Mt. Salem, Mango Walk has Paradise and Norwood. . . The list goes on, and this is just in St. James. But as time has progressed, social climbers (including scammers) have managed to straddle these communities and erase the demarcations. ZOSO is a potent and pointed reminder that “ghetto people” are considered criminals before they even open their mouths. Reminds me of that Etana song.

Ultimately, I don’t think ZOSO will be an effective crime-fighting strategy. It is too much of an acute solution to a long term problem, too much of treating the symptom and not the disease.

Man goes to the doctor and says Doc, I have these headaches. Doctor says, Take these painkillers. Man dies of a brain tumour*.

What have we learnt?

Crime and violence in our society is directly related to our social infrastructure: education, employment and parenting, underlined by systemic political and judicial corruption. Opportunities for legitimate engagement are scarce while guns are plenty and every little boy is raised to be ‘tough’. Legal jobs grant you enviable social standing but it’s the under the table stuff that sends your kids to offshore schools. This culture is entrenched and serves far too many powerful people for it to be overturned overnight.

But that doesn’t say we can’t try.

In his Letter to the Editor, Dr. Canute Thompson expounds on the theory that attacking these root causes will ensure a sustainable decrease in crime statistics. He lays out an innovative approach to community development involving skills training and infrastructural reform. Granted it raises a whole new set of questions, but it’s a solution that just might make Jamaica the place of choice to live, work, raise families and do business.

–*–

*I am compelled to disclaim that headaches are not usually the presenting symptom of a brain tumour. Not every headache needs a CT scan. The point is that you need to rule out a more serious problem. /medic

House-Hunting in Mobay: Part Deux

If you haven’t already, start with Part One here!

Now that you have your game plan, it’s time to dive into the apartment search. But where do you even start?

Scour rental ads in the newspaper classifieds

Western Jamaica, the Mirror is your new best friend. With three publications per week, the Western Mirror is replete with ads from landlords all over St. James, Hanover and Trelawny looking for prospective tenants. Some days (like Wednesdays and Fridays) and some months (like September/January) carry more listings than average. So grab that red pen and start circling because these apartments and homes move faster than Time and Patience bread.

Don’t be afraid to look online

In the beginning I was skeptical about finding a place to live online in Jamaica, let alone Montego Bay. But the top real estate companies have outdone themselves, and the online offerings from the websites of Coldwell Bankers, Victor Brown & Associates, Century 21, and Hoshing Realtors among others are usually quite extensive. Just make sure to sort by price from ‘low’ to ‘high’.

Keep your eyes peeled

Bulletin boards and notice boards are usually filled with boring ads and weird services but it’s possible to find a gem underneath all the irrelevant papers. I found my first apartment in Mobay on a bulletin board at work – very lucky!

Call and/or talk to people

Word of mouth is one of the best ways to find a new home. Put your social media to good use and crowd-source some apartment or house options. Chances are someone in your friend group knows someone who knows someone who can hook you up. Whatsapp groups can be invaluable in this respect – if the group is somewhat professional members will sometimes share helpful information like rental offerings.

Think slow but move fast

Because listings can appear and disappear in less than 24 hours, it can be tempting to make snap decisions just to secure a spot. But this is generally impractical (especially if you’re house-hunting for more than) and will almost always lead to regret. I often hear stories about tenants who stay for just a few months then pack up and leave because the rent was too high, or the situation was inconvenient.

If there’s no penalty for breaking your rental agreement (which usually lasts at least a year) and if you love the hassle and stress of moving then apartment hopping might be just up your alley. For the rest of us who plan to remain stationary for a year or so, it pays to look twice before you leap. If your current situation is uncomfortable but not life-threatening (whether your life or the life of the landlord who you want to murder) it can be more beneficial to stay put until something that fits your needs comes along.

Having said all of that, as much as I love house-hunting and living on my own (with partner and cat in tow), I understand that we’re all at different stages. I’ve been lucky enough to have a job that lets me live where I want to live, and still put food on the table. (not Mango Walk Country Club money but I really can’t complain). I’ve also been lucky to have a partner who shares the financial burden. I’ve been lucky to find places to live that I have enjoyed, rented by people who were actually kind, if not 100% reliable.

You might have worse luck or you might have it better, but since luck is when preparation meets opportunity I hope these posts help you to prepare for whatever living opportunity comes your way.

Pax.

House-Hunting: the Mobay Edition

Finding somewhere to live is hard, whether you’re in university, freshly graduated or bouncing around with three kids and a stable career. Fortunately or unfortunately house hunting is something I love to do (is that weird? It’s probably weird), and I’ve picked up a few lessons over the years that I think can be useful to my fellow 20-something Montegonians (all five of you who read this blog, if so much).

I only hope that this two-part series will make wading into the waters of independent living a little less scary, and that it will be a guidepost along a path that can be confusing and muddled. If it’s not time for you to leave the nest for one reason or another, that’s okay. Work hard and save. Living with parents is by far the cheapest option – no rent, free food and your mom will probably do your laundry too. But if you absolutely have to get out there on your own, then maybe this little blog will help you do it.

General rules:
  • Be prepared to pay at least two month’s worth of rent up front (sometimes three). This is the rent for your first month plus a security deposit in case you ruin the place and don’t pay bills.
  • Take everything with a grain of salt. I’ve been told an apartment was on Brandon Hill and after following the directions ended up, disgruntled, in the middle of Farm Heights.
  • If it sounds too good to be true, it definitely is. Look for the catch.
  • Read that rental agreement cover to cover. Get any promises to fix things in writing before you sign. Document any pre-existing damage and make sure the landlord knows about it.

Once you’re ready with that rent money and a healthy dose of skepticism, it’s time to plot your game plan.

Pick an area and know your budget

The first step is to know how much money you can feasibly spend on rent. Be realistic here not ambitious. One of the awesome things about Montego Bay is that you can find a home for any budget, especially if you’re flexible. If you’ve only got $10,000 to spare you can still find a place to live. It will probably be a shoe-box but it will be your shoe-box.

A good rule of thumb is that your budget for rent and household expenses shouldn’t exceed 30% of your total income. Like the pirate code, this is more of a guideline. To find a more exact number, once you’ve figured out 30% of your monthly salary go ahead and subtract an estimate for your utility bills (if not included in the rent) and any associated costs of the rental home like maintenance fees and such.

Once you know what your budget looks like, go ahead and pick an area (or a few) where you’d like to live. Bear in mind that location is everything in real estate and nice areas usually come with really nice price tags. There are ways around this, like smaller homes in uptown areas, or sharing common spaces. Which brings me to my next piece of advice. . .

Be cautious about sharing utilities and common spaces

The first rule will help you in weeding out your prospects. Once you have an amount and a location in mind, you’ll quickly skip those listings that don’t match your specifications. But even though you might want to compromise on that one bedroom apartment in Westgate Hills where you ‘only share a kitchen and the light bill’ take a minute to think about what sharing a kitchen means: dirty dishes in the sink all the time, and people eating your food from the refrigerator. Sharing the electricity bill means constantly arguing over who burns more current. And if you’re anything like me 2AM on a weekday morning will find you angrily trying to calculate the estimated energy consumption of your toaster oven vs her microwave.

Just don’t give yourself the headache.

Be cautious about living with a landlord

People can be . . . sensitive about their homes. Which is understandable. But as a tenant it can be frustrating to have someone constantly looking over your shoulder. This might be okay if you’re a fledgling graduate just starting out in the world of independent living (almost like having a surrogate parental figure – if you have a good relationship!) but gets much more tedious once the independence really settles in. Their ‘friendly advice’ turns into nagging, and all of a sudden you’re desperate to move. My advice would be to avoid living with the landlord altogether.

In the same vein, try to find landlords that are reliable and respectful. Avoid the ones who flake on fixing infrastructural problems, or go into your home when you’re not around. Ask other tenants (if you can) what their experience is like, and when you meet the landlord make sure their temperament is one you can work with.

Make a list of your preferences/needs

This helps to refine your search, and comes in handy when you’ve viewed a prospective home. After you’ve done your ooh’s and aah’s on the walk-through it’s important to drill the landlord with some hard-hitting questions. How stable are utilities? Is there parking available? How do you feel about extra guests or loud noise? Pets? Smoking? The list is endless and subjective. Knowing what’s important to you comes with time and sadly a little trial and error. The awesome thing about moving is if you absolutely hated something about your last apartment you can make it a definite deal-breaker with your next one. Hurrah for starting over!

***

That’s it for part one! The second installation, where I talk about how to find these elusive apartments, will be posted tomorrow. Stay tuned, and feel free to share your strategies for house hunting. Do you agree with me on the shared spaces? What was your worst landlord experience? Let me know in the comments!

 

“Senior” House Officer: Doc, where’s my steth?

Firmly in the category of Things No One Asked For (wedged between merchandising coffee mugs and your annual pelvic exam) this one is all about how I spent my Senior House Officer year. If anyone is still reading this to get some idea about medical life in Jamaica, you’re in luck. Everyone else, bear with me.

For my SHO year (the second year of relative supervision, coming after internship and before postgraduate study), I spent four months at the hospital in Internal Medicine and eight months in primary care bouncing around the clinics of St. James and Hanover. I had wanted an even six month split but the powers-that-be changed the schedule from two six-month rotations to three rotations of four months each, likely as an incentive for doctors to spend at least some of their time in primary care (which is woefully understaffed).

While I enjoy solving the diagnostic mysteries of Internal Medicine and relish the mental challenges of our limited resource setting, I did not particularly like my time at the hospital. One of the reasons is the aforementioned limited resources, which made it exponentially harder to get the job done (the job being getting the patient better and out of the hospital) but another more important reason was the unhealthy and sometimes toxic working atmosphere.

Doctors in hospitals across the world have to battle against so many barriers to effective patient care. Sure there are administrative and technical hurdles, but one of the most damaging and pervasive problems doctors face is other doctors. We can be unkind and unsympathetic toward our colleagues, we can be harsh and critical where kindness and compassion are needed. We can be overly competitive, deliberately misleading, and frankly aggressive. Specialties often argue instead of cooperating, departmental heads are sometimes overbearing and the support staff is at times less than supportive.

I frequently left work feeling like I spent the last 8-36 hours running a hamster wheel, exhausting myself and getting nowhere. For all my efforts I was yet to see any noticeable improvement in the quality of care being offered, and in fact quality of care was on the decline as Cornwall Regional was on the brink of a crisis by the time I had moved to my next rotation.

Unlike its older brother, primary care has no pretensions about the level of care it is able to offer. Clinics don’t promise CAT scans and then tell you the machine isn’t working; or promise urgent lab results that take hours to be processed. Primary care understands that its role is to prevent and screen, to catch the life-threatening emergencies before they become life-threatening. And that pace is so far suiting me just fine.

Hanover is the smallest parish in Jamaica, splitting its geography between enchanting sea vistas and rolling hills of green green bamboo. I spent my four months here really sharpening my clinical skills and patient interactions. I honed my management of chronic illnesses and developed some much-needed confidence (from all the time spent in clinic by myself because there weren’t enough senior doctors available). Hanover’s narrow, winding roads are where I learnt to drive and the country clinics reinforced all the stories I hear about the generosity of rural folk. I was sad to leave it behind.

(Spoiler alert: I’m stationed back in Hanover for the foreseeable future)

The camaraderie and team spirit were like a breath of fresh air after Cornwall’s sometimes hostile overtones. I felt more comfortable offering care at a less urgent pace (even though we had our fair share of emergencies!) and I appreciated the opportunity to effect behaviour change before it got to the stage where tertiary or secondary care was needed.

Despite challenges with patients’ educational level and access to care I still believe that primary care is where our efforts need to be concentrated if we are ever going to make our country truly healthy.

But enough about me. SHO year is all about testing the waters and seeing where your passion lies. It’s about picking up skills you think are important and spending time with physicians or surgeons or anesthetists who you think can teach you a thing or two. Internship is merely meant to be survived; SHO is where you thrive. Attack the smorgasbord of hospital specialties like an all-you-can-eat buffet, or settle down to dine at one specialty for the whole time – it’s up to you. Just remember that along the way you’re molding yourself into the medical officer or resident who will be the ‘senior’ by the start of the next year.

What kind of senior do you want to be?

Oops, (UW)I Did it Again

Despite claiming in February that the refurbished halls will not priced out of the range of a student budget, the UWI has implemented a 30% increase in hall fees on the recently remodeled Irvine Hall, a traditional hall of residence at UWI, Mona.

Earlier this year, Principal Archibald McDonald asserted that the cost of the new fees would first be approved by the UWI council. But in July a group of students started a petition to protest the unfair price hike of 30% for the new buildings. Deputy Principal Ishenkumba Kahwa argued that the fee increase only affected the minority of students who would be assigned to these new accommodations, mostly those in their final year. He added that subsidies would be considered on a case by case basis, saying (unwisely) that there are student who can afford the new cost.

I have noticed over the last few years or so that UWI has developed the habit of using financial means as an unofficial matriculation requirement. I first noticed it with medical school where students who didn’t make the cut for the government subsidy would be offered a place at the full-fee tuition (meaning if you can afford it, you’re in). Then lately, their costs of accommodation have steadily been increasing, with the addition of several new (and therefore expensive) halls. The traditional halls like Mary Seacole, Irvine, Chancellor and Taylor were substantially less expensive, less well-maintained and had obvious limitations on number but they provided an option for students who needed on-campus lodgings.

While it is high time these older halls were refurbished, I do think more could have been done to offset the cost of refurbishing so that the student wouldn’t have to absorb such a significant increase in price. The cost of accommodations on campus increases annually anyway, but I can imagine that many students didn’t budget for this level of inflation. And it is unfair that final year students who should be concentrating on completing their degree are now forced to find extra funds to pay the raised price or risk being barred from their exams for owing money to the university.

It is unfair, but unsurprising. University is a business, after all, and the bottom line is profit. Those who can afford it will always pay, and it makes no never mind that we are once again headed in the direction of elitist education that is limited to foreigners and the upper class.

 

 

Sources: here, here and here.