Family therapy via medical missionary work

The initial doubts first surfaced mid-way through our flight bound for Montego Bay, Jamaica. In fact, we were not entirely sure that this trip was such a good idea after all. Our eldest son, 13 and in eighth grade, was already complaining about how much school he was missing and how much homework he had been assigned. Our daughter, a sixth-grader prone to procrastination, had her nose buried deep within a book. Ordinarily, this is not a bad thing. But when language arts and social studies assignments were beckoning, reading a stock, contrived, YA book for pleasure was not exactly what I hoped she would be doing. The first-grader, as most last-born children will do when not being listened to, was whining about something, and demanding to play on my phone — “or else!” While our week in Jamaica on a medical mission with all three school-age children in tow did not seem to have the most auspicious start, we had committed to helping out my friend and colleague’s non-profit group, and we were well on our way.

This particular non-profit was founded by a travel medicine specialist and an acupuncturist. Long drawn to the West Indian isle of Jamaica for its cultural richness and musical heritage, they felt it was an appropriate location to give back to their global health care community at-large. The Falmouth Medical Clinic, where their non-profit is based, during its two one-week missions every year, is run almost like a continuity clinic. The providers change, and the clinic is not always staffed. But the surrounding community knows when the doctors are in town. The church personnel line the patients up themselves and count them among their neighbors, families and friends. Because the church’s presence and direction are constant, there is actually quite a lot of order and stability to both the patients’ and the providers’ experiences.

As in all developing countries, the pervasiveness and degree of poverty in Jamaica is staggering. Ramshackle huts with an obvious lack of modern utilities line the same stretch of highway that leads to opulent foreign-owned resorts. Stray dogs that clearly share the same gene pool run alongside the roads, while small goats scattered up and down the hillsides keep the lush foliage somewhat in-check.

Despite the hardship of life on this island oasis, there is both a great happiness and a contagious element of forced relaxation that even the most harried visitor can feel and appreciate. Our family of five — although encumbered with the typical societal afflictions that ail most Westerners (e.g., impatience, short attention span, an unhealthy reliance on technology) — was able to partake of these “irie” vibes while also offering up some of our own talents and resources.

I am a family physician by training, an urgent care provider by serendipity. My husband is an oral surgeon busy in private practice. Our three children are now proficient vitamin-counters and willing distributors of healthy living promotional material. Though initially shy about lending a helping hand, they discovered that the easy camaraderie of health care providers — in a setting other than our usual staid and sterile clinical domain — made it actually fun to participate in our workday, particularly when there was reggae music on the speakers and Jamaican patties for lunch.

Our motley crew of health practitioners saw many patients who presented with bread-and-butter chief complaints and left with diagnoses such as hypertension, diabetes and treated dental abscesses. On this particular trip were family medicine physicians, dentists, and even a physical therapist. In addition to attendings, residents and medical students, even ambitious undergraduates worked with us to diagnose and manage the patients’ illnesses. And although we came from a variety of professional and cultural backgrounds, we all shared a certain wanderlust and the belief that travel and exposure to other cultures can be both educational and, in fact, life-sustaining. While all of us participated in the day-to-day work of seeing and treating patients, we also enjoyed a good amount of free time to enjoy the local beaches or to go further afield and play tourist. Our family decided to spend most of our time at the beach taking the warm Caribbean waters, although we were also able to visit Rose Hall Great House (purportedly haunted by several long-deceased spirits) and ride horses on the shore (we even swam with them into the ocean).

The week, however, was not entirely bereft of familial strife. At various points in our trip, we encountered teenage ennui, pre-teen eye-rolling, and the occasional tantrum. The eighth-grader promptly declared his boredom at the beach after the lifeguard asked him to stop throwing sand at his little brother. The sixth-grader judged my appeals to get some of her homework done as ridiculously unfair. And the first-grader squealed in disgust at dinner when he came to the realization that chicken nuggets were not on the menu. But all of that would have happened at home anyway, and we would not have had the calming Caribbean Sea, the relaxing calls of tropical birds or the awe-inspiring display of an afternoon thunderstorm to placate us.

Despite the predictable challenges we faced as a family of five traveling during the school year, I would (and probably will) absolutely do it again. As with medical decisions in general, when the benefits outweigh the risks, therapy should be initiated. In this case, the therapy was a medical mission in Falmouth, Jamaica and the benefits are memories that will last a lifetime — for ourselves and our children.

Belen Gallarza-Wilson is a family physician.

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