Today was ward review at my service site. What that consisted of was a class including all of the medical interns where we went over every patient in the ward from start to finish. It included what they were admitted for, their family and dietary histories, their treatment up until this point, and the future of their treatment plan. For some patients this was really interesting - such as a 16 month old with complex febrail seizures.
They also discussed some of the prominent issues facing medicine in Trinidad and Tobago. One of these is that free healthcare is not necessarily ‘free.’ While it greatly reduces the disparity in care between those in poverty and those who are wealthy, in Trinidad and Tobago’s case it increased the patient to doctor ratio. This wasn’t because there weren’t enough people to do the job of being a doctor, but rather that the government didn’t want to hire new people, or wanted to pay them less than a standard salary in order to cut costs. This is not the only area that is seeing budget cuts though. This is due in large part to the fact that oil is a quickly dwindling resource and Trinidad and Tobago are attempting to make their budget match their actual income.
One of the other major issues that we discussed is rampant neglect and abuse of disabled children. This was brought up for the most part because a mother needed a ‘break’ from her disabled daughter and so plans were being made to leave her at the hospital ward to prevent possible abuse. The girl is approximately four and was born with a traumatic brain injury, due to this she had some kind of mutilation syndrome, or a lack of ability to feel pain, and dug her own eyes out. They had to be surgically removed to prevent infection. She is thus blind in both eyes and entirely dependent on a caregiver. She is just one of dozens of cases every year in which the ward is taking care of children who need a home.
After our site I went to Bacolet Beach and relaxed in the sunshine for a couple of hours. This beach has been truly wonderful because of the short walking distance, and secluded atmosphere. The actual beach is also very clean, though the waves can be rough, some locals use them to teach beginner surfing lessons.
At 4:30 Allie and I left for Pigeon Point Heritage Park to go on a bioluminescence excursion on stand-up paddleboards. After five it’s free to get into Pigeon Point (it’s also free on the fourth Sunday of every month.) At the end of the beach is Radical Sports Tobago, where we picked up our paddleboards, and I got into a kayak, and got in the water. From start to finish the experience was quite unforgettable. We landed at No Man’s Land and stargazed while the sun finished setting on the horizon, and then immediately our guide began telling us about the nocturnal animals we would see. He shined a light out over the water and we could see dozens of fish-eating bats getting a taste of the Joshua Fish. Then we went out into the water to about our waist and by shining a light they all came around and started bopping into your legs and jumping just out of the water. I held my hands just beneath the surface and was able to catch one in my hands! We got back on our paddleboards and kayaks and continued to Bon Accord’s Lagoon, where we couldn’t see the lights of Scarborough or the moon and were only guided by the gorgeous stars above us, more visible here than I had ever experienced before. We learned that the reason there is so much bioluminescence in Bon Accord’s Lagoon is that the mangrove trees that line the perimeter change the alkalinity of the water to be perfect for the dino flaggelae plankton. The water was perfectly flat and still except for us gliding through it, and as we reached the edge of the mangrove trees we jumped in and played in the magical glowing waters. Everyone saw the plankton as different colors, but to me they were a vibrant green. Like the radioactive slime in cartoons like Rick and Morty or the Simpsons, or the green fire of Disney villlains like Maleficent and Scar. I felt like Tinkerbell with her pixie dust, or Cinderella when her fairy godmother turned her tattered clothes into a ballgown. And I imagine I looked a bit like that too, surrounded by flashes of light as bright as the stars in the sky. On our way back we saw a baby Eagle Ray, which paused while we went around it allowing everyone to get a close look at the spots on its back. The entire trip was almost six km, though it was remarkably easy. If we had more time I would absolutely go on another trip with this company and absolutely recommend that you do too.