I recently returned from a four-day medical mission over Labor Day weekend to Point Fortin, Trinidad as part of the Hands International Team. The team was led by Dr. and Mrs. Reynold S. Agard (Internal Medicine) and Drs and Mrs. Lester Horrell (Pediatrics) and their families. Both families are natives of Trinidad. Dr. Agard is President of Hands International, which is a nonprofit agency dedicated to Health Care Delivery with compassion as well as Health Development around the world. This group has traveled to areas of natural disaster, most recently in Nepal and Haiti a few years ago.
Also, Dr. and Mrs. Agard also kindly accompanied my Father and I to India for our Medical Mission in February 2016.

Having participated in the planning and executing of two medical missions to India in 2014 and 2016, I was glad to serve solely as a Cardiologist and
leave all the planning, logistics, and politics to Agards and Horrells! Though the country needed our assistance, there were tremendous amounts
of red tape. We heard that the week prior, a team from England that arrived was not allowed to practice as their paperwork was not in order.

The team consisted of about 70 people from the USA and Trinidad. Our Team included Doctors, Nurses, Pharmacist, and non-medical volunteers.
We had physicians from various specialties who are listed below; there was three cardiologists on the team, including myself.

We received tremendous support from the Point Fortin, 7th Day Adventist Church. This group welcomed us with open arms and provided much love and support, not to mention local cuisine. As someone who practices a different religion, I felt at ease with them and in their place of worship. They welcomed all those from our team who had different faiths and religions.

Our team treated about 1800 patients. We worked for 10 hour days, only with a few minute break for lunch. The temperature was about 96 degrees with 78% humidity. This made hydration essential. The team worked tirelessly without complaint.

Most patients were seen for the usual complaints seen in a primary care doctor’s office. We did have a few very sick patients. Though the patients have access to physicians, it seems their physicians lacked the time to truly educate them about their disease. This is the same issue we are face in the US Healthcare system. Declining reimbursements and increased staff labor costs due to massive amounts of mandated paperwork and regulation.

There’s also a large waiting list for procedures; we were told there’s a six-month waiting list for an elective hernia repair.  Our general surgeon is likely to return soon to help with that backlog.

All of us found that the patients were very respectful. Many had waited for hours to be seen and had arrived at sunrise. We did not hear any complaints. They had a great command of the English language, not surprising given a 98.8% literacy rate of those over age 15.  Most patients came prepared with a list of all their medications and dosages. They even brought medical records with them.  Surprisingly a very high percentage of patients that I treated for hypertension owned home blood pressure kits and came with a bp log.

A highlight was working very closely with my fellow colleagues from Delaware. Normally, we chat on the phone or meet briefly in the hospital to discuss and co-manage patients. But, for four days we worked side by side and were able to have instant consultations. In addition, we had time to learn from each other.

Another highlight of the trip was being able to perform a cardiac ultrasound. Ultrasound is a special interest of mine but I don’t often get time to scan due to time constraints and the need for efficiency.  Many thanks to Ava Horrell and Dr. Amar Sortur for helping me figure out all the new buttons on the portable ultrasound machine.  Hands international’s ultrasound greatly enhanced our evaluation and management.

Of note, I was also able to scan and work with Cardiologist, Tony Furey who helped train me in echocardiography while I was a Cardiology Fellow
at Christiana Hospital. Also, Dr. Kamar Adeleke was on this trip and he taught me in medical school.  Working with my teachers made me realize
how much I have progressed.

There’s talk of a new hospital in Point Fortin and the Health Ministry is looking for collaboration from abroad to help with setting up their departments and helping with healthcare delivery. Hands International is keeping abreast of the situation and seeing if they can help.

Now that I have a valid Trinidad medical license for one year, I am looking forward to returning. It was very refreshing to practice medicine without the restrictions imposed on our profession by our government and policymakers.

Trinidad and Tobago is a great melting pot of multiple cultures. This shows in the people, cuisine, and national holidays.

Thank you to the Agard (Ingrid, Rey, and Richard) and Horrell (Ava, Lester, and Carlyle) Families and the 7th Day Adventist Church in Point Fortin for making this happen and for a wonderful introduction to Trinidad.