Yesterday was our fifth day in the Dominican Republic. We returned to the hospital San Vincente de Paul. The students floated to the maternity floor, pediatric floor, emergency, and the Kangaroo Care clinic. It was very exciting to work in the Kangaroo Care clinic after learning about the program at the public health center. Mothers can come in, ask questions, and receive consultation for themselves and their newborn.
Students on the Maternity floor had a wonderful experience. Two students were reunited with the mother they coached through labor two days ago. She had her baby Monday morning and was getting ready for discharge. The students were pleased to be able to complete their journey with the mother.
After lunch, Emory Nursing students taught Community Resiliency Model (CRM) training to Dominican Republic nursing students. The Community Resiliency Model aims to teach resiliency, particularly after a trauma, by educating patients on the importance of understanding the nervous system and dealing with chronic stress. The Dominican Republic nursing students recognized the significance of this training when caring for patients after a natural disaster.
After the training, we toured the labor and delivery room. A few of the students stayed and assisted with two labors at the hospital. It was a very rewarding experience to assist in bringing two new lives in the world.
We began our day in the Casita de Salud (Little House of Health). This is a local clinic in San Francisco de Marcoris, where community nurses work to provide care for people who live in the village. There is a lot of poverty in this village and the people face many barriers to accessing their healthcare needs.
We visited several homes in the village and provided primary care services. Our patient age demographic ranged from newborn infants to elderly adults. Chronic disease management, in particular, was a specific problem within the community. Some patients with diabetes had their own glucometers, but could not afford the test strips in order to check their blood sugar regularly. These barriers brought forth more discussion about how to solve complex healthcare problems.
There were a few pregnant and postpartum mothers within the village. We assessed both the mother and the baby. We provided education about using a sustainable contraceptive method to prevent pregnancy after the first six months of giving birth. We also provided breastfeeding education about the importance of not supplementing breastmilk with formula in order to sustain an average milk supply and to prevent early onset of menstruation.
This experience provided a lot of forethought about encompassing western medicine and natural remedies, sustainable health care management, and barriers to accessing health care. We are so pleased the collective care Emory Nursing students are providing through this program will significantly impact this community.
Today was our third day in the Dominican Republic. We started our day in the public health center called Servicio Regional de Salud Nordestre. Here we learned about the Kangaroo care program.
The Kangaroo care program is a public health initiative that was instituted in the Dominican Republic hospital setting in 2009. The program teaches mothers how to provide skin to skin contact to the baby for 24 hours. Babies receive this care up until their 40th week of gestation. Since the institution of this program, the Infant Mortality Rate has decreased significantly in the Dominican Republic.
The Kangaroo care program was first designed in Columbia by Dr. Edgar Reyes Sanabria. Nurses from the Dominican Republic traveled to Columbia to become trained to teach Kangaroo care.
After lunch, we divided into smaller groups to work in various units of the hospital. Some of the units included the Emergency room, the NICU, the maternity ward, and the pediatric floor. Students in the maternity ward provided comforting techniques to assist mothers in labor. Students in the pediatric floor utilized developmentally appropriate techniques to comfort children in pain. One student made a balloon out of a glove which was very calming and therapeutic for the child.
After returning from our experience in the hospital, we reflected on the many resources available in American hospitals in comparison to the Dominican Republic hospital. Many of the nurses in the Dominican Republic were very resourceful. We observed a nurse using a glove as a tourniquet to wrap around the patient’s arm when inserting an IV. Little things like this are simple things that nurses in America may sometimes take for granted.
Tonight the nursing students are separating prenatal vitamins and Tylenol to provide for the community tomorrow. We can’t wait for another exciting and heart warming experience in San Francisco de Marcoris.
Yesterday we landed in the Dominican Republic and drove to the city of San Francisco de Marcoris. On our drive to the homestay houses, we saw the different ways people live. There is a lot of poverty, but there is a genuine sense of community. People know their neighbors and are very friendly toward one another and toward our group. We were greeted by our homestay families, who are also nurses in the community. We ate a very delicious meal consisting of chicken, vegetables, black beans, and rice. We went to bed early in order to get ready for the next day.
Today we took a tour of the hospital San Vincente de Paul. We visited the NICU, labor and delivery room, maternity ward, emergency room, pediatric unit, the kangaroo care center for mothers and premature infants, and other units. At the hospital we met postpartum mothers. We also talked to mothers and children in the pediatric unit. We learned about the children’s illnesses and the lives of these families. We had a good time practicing our Spanish language skills.
After lunch we went to the Mirabal sisters’ museum. This museum is a very important part of the history of the Dominican Republic. The Mirabal sisters were revolutionaries in the June Fourteenth movement. They were resisting the dictatorship led by Rafael Trujilio. The Mirabal sisters felt that it was their civic duty to resist the dictatorship in order to conserve the present and improve the future for their children. Three of the sisters were assassinated in 1960 and their deaths are commemorated at the museum where they are buried. Today the Mirabal sisters symbolize the hope and the spirit of the Dominican Republic, which continues to live on. Right now, as I write this blog, people are playing music, laughing, and dancing in their homes. The party never stops in San Francisco de Marcoris.