Tag Archive for Dominican Republic

Reflection before we go: ABSN Dominican Republic

Tomorrow morning we will begin our journey to San Francisco de Macoris, Dominican Republic as part of a Quality and Safety Improvement Project. In preparation for this journey, our group of 8 students obtained $390 worth of funds through hosting a “Kid’s Day” fundraiser and through donations of our families in order to purchase medical supplies for Hospital de San Vincente de Paul. This morning we met at the nursing school and divided up the supplies into all of our suitcases. These supplies included, but were not limited to, infant stethoscopes, a newborn blood pressure kit, pediatric resuscitation equipment, surgical drapes and gowns, surgical instruments, vaginal speculums, prenatal vitamins, tylenol, baby blankets, pacifiers, preemie diapers, and sterile gloves.

For our Quality Improvement project, we will be talking with members of Proyecto ADAMES, an organization that formed to address maternal and infant mortality in their community. We will be speaking (in Spanish!) to nurses at the hospital, community leaders in the surrounding barrios, and people at the university.

Dominican Republic is a country in the Carribbean that shares the island of Hispanola with Haiti. Approximately 9 million people live in Dominican Republic, with over half living under the national poverty line (Foster, et al, 2010). As with many lower-income countries, Dominican Republic is marked with financial inequalities as the poorest half of the country owns less than one-fifth the GDP and the richest 10% own two-fifths the total GDP (Foster, et al., 2010). Although 97% of all births occur within a hospital, there is a high rate of maternal (150-160 deaths/100,000) and infant (22 deaths/100,000) mortality (Foster, et al., 2010). While this rate is much lower than that of other “developing countries,” hospitalized births with skilled birth attendants are not the norm in other countries, as it is in Dominican Republic. Therefore, a need exists to improve quality care.

Foster, J., Burgos, R., Tejada, C., Caceres, R., Altamonte, A., Perez, L., Noboa, F. (2010). A community-based participatory research approach to explore community perceptions of the quality of maternal-newborn health services in Dominican Republic. Midwifery, 26, 504-511.

 

Alternative Winter Breaks – Recap of Bahamas, Dominican Republic, Jamaica

The weeks following my Alternative Winter Break – Bahamas trip have been both challenging and rewarding. With the start of my final semester in Nursing School, I’ve begun a variety of different tasks and processes to complete my transition from “Student Nurse” to “BSN-prepared Registered Nurse”! There have been so many wonderful moments throughout the past years of Nursing School, but I can’t say I’m not incredibly excited to graduate and begin working. However, that process can still seem quite far away, especially when getting caught up in readings, assignments, papers, quizzes, and tests. I know I’m not alone, though, as many of my fellow Senior Year classmates are always able to provide the exact countdown to graduation – 96 days as of today! Overall, though, it’s the little things throughout the process that make the entire journey worthwhile – one of the most recent ones being the presentations of all the Alternative Winter Break students.

Over 30 Emory School of Nursing students (from juniors to nurses in Master’s programs) traveled to either Jamaica, the Bahamas, or the Dominican Republic in the early part of January. We reconvened just a short while ago to present our trip highlights and information taught (and most importantly – learned) to a variety of fellow students and faculty at the School of Nursing.

The Bahamas group focused on the variety of care that the nurses provide on the rural island of Eleuthera, and the way that these nurses act in a variety of roles that far surpasses the work I’ve ever done as a student nurse. We spent a great deal of time either in the clinics, working directly with these nurses, or at schools providing health talks and education on a variety of topics. The Bahamas group was also especially amazed by the level of community involvement, knowledge, and caring throughout this culture. We couldn’t overemphasize how welcomed, respected, and appreciated we felt throughout the entire trip.

The Dominican Republic group similarly felt this same sense of welcoming and appreciation while they were working with a variety of different patients in the DR. Many of these students were able to work in a maternity/labor & delivery clinic, where they were able to perform perinatal and neonatal assessments, as well as actually deliver some infants! They described how the nurses in this community were able to do so much with the limited resources that they had; a finding also similar in the Bahamas. Many of these students participated in a new infant care system in this clinic known as “Kangaroo Care” – a process in which there is almost constant skin-to-skin contact between mother and baby during the initial days after birth. This Kangaroo Care is able to keep a great deal of premature babies alive at this clinic, despite the fact that they do not have many technologically advanced tools and resources.

The Jamaica group had a variety of different experiences, some of them arguably the most challenging of all three groups. These students explained how the majority of the patients they interacted with were incredibly poor, needy, or abandoned. Much of the time was spent at the “Missionaries of the Poor” Catholic monastery near Kingston, where different missionary Brothers provided care to anyone who was in need. They described the importance of religion in this care, and how it was incorporated into their daily lives. These students also had the initially heartbreaking experience of working with many abandoned and disabled children through this program. The students expressed their initial feelings of overwhelming sadness, but soon learned to see the joy and resilience of these young children. One of the students emphasized how much happiness she found in these patients, despite their obvious hardships. Finally, two of the Missionary Brothers actually came from Jamaica to sing a song for us and promote a concert they are having in March to raise money for the Missionary, which is funded completely through donations.

Overall, it seemed quite clear that all of the students not only had an amazing experience and provided a great deal of teaching while abroad, but they also learned so incredibly much. Some of the common words throughout all three presentations included: “helping,” humbling,” and “enlightening.” We all expressed that all of the hard work before and during the trip was more than paid off whenever we received a smile, hug, or “thank you” from any of the patients we interacted with. We’ve all gained so much respect for these countries, and especially the work that the nurses and medical personnel do there. We’ve learned how dedication, perseverance, and motivation in any situation can enable such incredible things to be accomplished, especially in healthcare settings with such low resources. I’m sure that for many of us, including myself, these trips were some of the best highlights of our entire Student Nursing career.

Vamos por la playa!

Today was our first official day in the Dominican Republic. We arrived yesterday to our hosts and Dr. Foster waiting with “banderas” the Domincan Flags in hand ready to take our first picture! We loaded our suitcases full of supplies and medicines into our bus with the help of Leo our bus driver and our new friends from the community, and we took off for our 2 hour bus ride to San Francisco Macoris. To our surprise we arrived to a delicious meal of chicken, beans, rice, veggies, and passion fruit juice awaiting us at Rosa’s house. A little exhausted from the trip, after an hour long wait for the cold shower we were ready for bed, but our neighbors had another plan… a celebration for Three Kings Day including loud, loud music luckily some of us had our ear plugs.

We awoke this morning to cockadoodledoo from those same neighbors roosters… and we headed for the beach! We had a few detours along the way, and after 2 hours we arrived at the beach! Only to find the beach was not as beautiful this morning because of all the rain the previous night. So we walked back to the road through the mud… waited for our bus that went to pickup lunch from Margarita’s house (who woke up at 4am to make us our delicious fish lunch!). Then we drove another hour to another beach… Las Terrenas, where we had lunch and got to know our hosts who we will be working with this week.inflatable bouncer

Tonight we had a little debrief and here are a couple things we observed today…
The colors
The language
The driving
The culture
The feeling of being home (some of our team members are from other countries)
The welcoming personalities
And how much fun we are all having!