Dominican Republic- Day #3 - Monday, July 4, 2011- Batey 50

Happy Independence Day!!!

Monday was the first full day for me and the medical team. We went to Batey 50, one of the poorest of the bateys that the group goes to.

When the bus pulled up, all the kids ran up to the bus very excited!!

Each day at the med clinic, some things are primarily the same regardless of the batey. Once we arrive we scope out our surroundings, usually a church or a school, and decide how we will set it up to run the clinic. We need an area for "bug juice." All the kids in each batey get Pipearzine, an antiparasitic, to kill any worms they might have. We also set up the teeth section, where we have Caroline, a dental hygienist, clean and varnish all of the childrens' teeth and provide them with toothbrushes and toothpaste. Most days these two areas were set up outside. We then set up an area for heights, weights, and blood pressures; an area for the dentist, who came with us from the hospital; an area for family planning, which was run by a family planning doctor from the hospital; the consult area, which included about 4-6 stations of clinicians who saw patients; an area for the pharmacy and and area for clothes distribution.

Once set up, the patients begin to come in. Prior to our arrival, the health promoters inform the people that a clinic is coming. In order to attend the clinics, the members of the community must purchase a card from the health promoter in that batey. The cards are, I think, 35 pesos (the conversion is $1 to 38 pesos). Only with a card can they receive care. The people wait in line and hand in their card in return for a yellow ID type card that gets their name, batey, height, weight, BP, and medical complaints or problems on it.

They then can see a clinician. Each of us clinicians had a interpreter if necessary, and depending on how many interpreters we had with our team that day, we would team up or work alone.

On Batey 50, we saw about 80-90 patients, and Caroline varnished about 70-80 kids' teeth. I worked with Libby, a physicians assistant at Yale, and had Andrea as our interpreter. It was challenging to communicate through an interpreter. Sometimes I felt as if i wasn't getting the important information across correctly because I didn't really know what the interpreter was saying, especially with the patients that spoke Creole. ( I can understand some of the Spanish)

A lot of the complaints were pain and stomach related. A large number of the people have stomach pain, which is often attributed to hunger and the lack of enough food. The pain issues were often joint and back pain or headache, which were work related or caused by dehydration.

A large number of the people have a misconception about what adequate water consumption is. I asked a man who was complaining about dizziness when working and headache how much water he drinks. He told me (he works out in the sugar can fields all day) that he drinks 1 bottle of water a day. I don't think I need to say that that isn't enough, but he believed it was. I educated him on how much water he should be having and gave education on how to clean the water. Some bateys are equipped with water filters ( another project of the team) while others do not, and the people have to either boil the water or clean it with Clorox. Hypertension is also another common ailment.

After seeing the clinicians, the patient goes to the pharmacy to get all the medications prescribed. Every patient receives multivitamins. Fortunately, our pharmacy, which is stocked by all donated medications, had a variety of medications to treat all of the common issues in the bateys, including infection, hypertension, acid reflux, pain, scabies, and other skin infections.

Libby and Me



Libby, Leah and Crystal
 

Pat, a pediatric APRN



Ana, a pediatrician and anesthesiologist and Crystal, an ED nurse



 

The pharmacy



People waiting to be seen
 

During the clinic times, we have a part of the team that sets up activities for the kids on the outside. During lunch, I was able to join them and interact with some of the kids.



Team B digging the foundation for another home

That night we got a tour of the hospital. Years ago, the group started building it and now the first 2 floors are completed and functional. The third and fourth floor are still being worked on.



This room was dedicated to Tony Vance and his family who have supported the group and the hospital and who have helped with the building of the hospital. This room will be used for patients who may not have all the funds to pay for their stay and for their families.





The Operating Theater



CT Scan

 



Xray



Mammogram






Water Filter- Because of the ability to have clean water, this is the only hospital that can do dialysis


 

They have Bible verses posted throughout the hallways of the hospital






Me and Estela, a psychology and family planning doctor


 The tour of the hospital was nice! It was so cool to see how much progress has developed within the hospital.