Holistic care

(Top picture- me interviewing patient Bottom picture- our pharmacy)

Today we went into Santo Domingo to do a free clinic. The population here was very different when compared to the population we worked with yesterday. Most of the patients here in the city had actually seen a doctor during the last couple of years. Since they have some access to care their complaints were more focused. When we asked them to follow up with their primary care doctor in a couple of weeks, because we changed or added a medication, we actually had hope that they had the resources to do so. I did not have one patient in clinic yesterday that actually had a primary care doctor. When I asked, they looked at me like I was crazy. A family doctor that they could see on a regular basis to care for their family was not a concept that they are familiar with. One of the highlights of today was teaching Mary, an ER nurse tech at Randolph Hospital, how to give IM injections. She has held many patients for me as we have worked together during the past years in the emergency department. This time I was holding the patients for her! She was so excited to learn and she did a great job! Another highlight today was a couple of patients today asked me to pray for them. I love the idea of providing holistic care for my patients and today I feel like I did just that. Although it is more difficult for me to pray in Spanish, my patients were very grateful for the time that I spent with them. Oh yeah, during lunch we had to run to the supermercado to buy more sandwich bags to dispense the medications in. I found the candy section in the store and asked a Dominican woman on the same aisle where the best Dominican candy was. She showed me some of her favorite candies. We bought some for the group to try for dessert. Tomorrow we go back out into a small village.

First day in Clinic

Today was our first day in the community. We set up clinic in a small church. The church pews worked perfectly as exam tables! My mom managed the pharmacy and did an incredible job. Suki, Kendra, and Adia helped mom count, package, and label all of the medications. Michael, Dallas, and Mary worked in Triage. Jeff helped out in different areas of the clinic, wherever we needed him. Michelle, David, Faith, Bob, and I all were the providers and we examined each patient. We saw approx 150 patients today. We worked hard, but had a great time. We treated a lot of patients for parasites, scabies, pinworms, and fungal infections. These are things that I haven’t seen very often at home so it is good to get to learn more about them. I had one 10 year old girl that had a history, since age 6 months, of multiple urinary tract infections. She has 4-5 UTI’s each year. This, of course, is not normal in a 10 year old little girl. If she were in the states she would be referred to an urologist in order to search for a reason or source of the infection. But here, due to her limited resources, she can not obtain this level of care. So, she continues to struggle with this problem. It frustrates me that I can’t do more. On a positive note, the children were so much fun to watch and were so excited to get a tube of toothpaste and a toothbrush! I have never had a kid in the states beg me for a toothbrush or toothpaste. They were anxious to get dental varnish and practice brushing their teeth. The dental hygiene students stayed busy the entire time. Children continued to show up all day once they heard that we had toothbrushes and toothpaste.

Getting ready!

Today is Sunday 6/28/09, this morning we went to a Dominican Church. In the past, my favorite part of being in church down here in the Dominican has been listening to the little children around me sing. This church service was no different. They knew every word to every song, sang loudly as if with every ounce of their being, and had a big smile on their faces. We adults could learn a lot about how to worship in church just by sitting back and watching these little ones. The rest of the day was spent packing and preparing for our first day of clinic. The team worked together for 4 hours in order to get everything prepared. Everyone is very excited about going out to the villages.

Trying to be flexible and positive...

So I have not slept in 36 hours except for a quick nap on the plane. We had a little mix up with Delta airlines. They changed our flight from 7:15 am departure to 6:00am without letting us know. So, in the middle of the night after having talked with Delta airlines extensively on the phone, and after Delta apologized, we still had to call everyone and tell them to be at the airport at 4am. Oh well, there are only so many things within our control. We just got here to the Dominican Republic. We all arrived safely with all of our luggage. We have had a lot of fun so far just helping 1/2 of our group go through the process of customs for the first time! Everything went very smoothly. Tonight we rest and tomorrow we will start planning and preparing for the rest of the week.

A day in the life...

This Saturday will be my first day as a 4th year medical student. (Woo-Hoo!) I am starting off my last year of medical school by doing a unique elective in international family medicine. My first 9 days will be spent in the Dominican Republic working in medical outreach for the sugarcane village farmworkers in small towns close to Juan Dolio. The last 3 weeks will be spent working with farmworkers in Randolph and Guilford Counties here in North Carolina. I will be doing medical work with an organization called the North Carolina Farmworkers Outreach. I am very excited about this elective and all that is in store for me this month!

I have entitled this blog "A day in the life." I hope this blog will give you a glimpse of "a day in the life" of farmworkers here and abroad and the barriers that they face. Also, I will share personally the things that I experience during the upcoming month so you can have a view of what "a day in the life" of a 4th year medical student looks like as well.