Sign Out: 'Hold your fire!'

Those were the words on the streets of Kingston, Jamaica during the week I visited in September. Along with 30 other health-care professionals, I was there on a medical mission for PRN Relief International, a group I co-founded.

Kingston is known for gangs, drugs, and violence. The murder rate is five times that of the United States, and the third highest in the world. Unemployment approaches 70%. Kingston Public Hospital treats an average of five gunshot victims every night, monopolizing scarce surgical and emergency room resources, and resulting in little care available to the general public.

Violence is the norm for survival. Mothers have no money to buy acetaminophen if their children have a fever. No doctor will see them, nor will hospital emergency departments, because their resources are stretched so thin. Even through PRN, some people couldn't get care. Gang violence and fear are rampant and simply crossing the street to our clinic could mean entering a rival gang's turf. As one gang member said, "Livin' in one room, gotta take up a gun. There's no other way. Person's hungry!"

What can you do to help? Volunteer to help the underserved through a charity in your area, or make a donation to PRN to help us with supplies.* Last month, we brought $1 million worth of medication to distribute-a year's worth of antihypertensive or oral hypoglycemic medications for each patient who needed it, pain and fever medications, reading glasses, and antibiotics. We performed surgery and paid the hospital bills for 59 patients who had general or gynecologic surgery that otherwise would not have been possible in these communities. And we made house calls on shut-ins who had not been out of their homes for many years.

I believe that PRN can make a difference. I know that our annual trips have improved the health of many people, and given the citizens respite, if only for a week, from the shootings and violence in their communities. One hug from a patient, a heartfelt "thank you for helping me," and the look of children laughing as you hand out stickers and bubbles makes it all worthwhile. My relationship with the Jamaican people has changed my life. I feel good about myself, and happy that I am a doctor. I encourage you to try it yourself. It's a wonderful way to enjoy medicine again.

*For more information, write to Dr. Rosenman c/o Bridgeport Hospital, 267 Grant Street, Bridgeport, Conn. 06610 or e-mail psrose@bpthosp.org