Promoting Public Health in the Dominican Republic

Promoting Public Health in the Dominican Republic
January 17, 2014 Callie Daniels-Howell

by Jose Vazquez

Jose is Timmy’s Medical Programs Coordinator in the Dominican Republic. He recently worked with a group of volunteers from the Montana State Nursing school to develop a public health focused medical trip to Monte Cristi, a region in the north-eastern corner of the DR, bordering Haiti. This blog post highlights what the group did to promote public health and train community health workers, and sets the stage for Timmy’s future public health initiatives. Click here to read about Timmy’s other public health initiatives in Ecuador.

Community Health WorkshopThis November, Timmy hosted its first public health trip to our site in the Dominican Republic. Trip participants included nursing students in their last semester of classes at Montana State University and two faculty members. Due to the high prevalence of hypertension and diabetes in communities, this public health team focused on chronic disease.

The week began with a chronic disease focused workshop given to the health promoters of BANELINO, Timmy’s partner organization in the DR. BANELINO’s health promoter group on the coastal town of Montecristi, is comprised of 10 women who assist in logistical organization during medical clinics. When not working at Timmy’s medical clinics, health promoters assist BANELINO’s physician, Dr. Miguel Garcia, during daily community visits in organizing patient records, taking vitals and disbursing medications. These women also live in the communities we serve.

Health promoter training

During the workshop, nursing students covered topics such as, ‘What is hypertension and diabetes,’ ‘Measuring blood pressure and blood glucose,’ and ‘Nutrition and Healthy Lifestyle Changes.’ The health promoters were trained on how to properly measure blood pressure and how to take blood samples to measure blood glucose. Additionally, in reinforcing healthy lifestyle changes, nursing students lead a ZUMBA class, adding an unexpected level of fun!

The workshop had several purposes: 1) To provide students with more context about how information regarding chronic conditions would be facilitated; 2) To empower health promoters through educational and interactive modules; and 3) To train health promoters in measuring blood pressure and blood glucose in order to provide assistance during medical clinics as well as daily community visits.

Timmy Nursing Volunteer

The following day, public health participants headed to the communities. For this visit, students were divided into two groups, allowing outreach to two communities per day. In each community, group members were given a tour of the community, taken into schools to provide puppet shows on oral health and hand-washing, and continued on to conduct house-to-house visits for chronic patients. This model continued for four of the five days, with one day spent visiting local health facilities including the local public hospital, the private clinic, and a physical therapy facility.

As the Program Coordinator and trip leader, it was the first time I felt my role go beyond the typical logistical planning of our medical trips. This team allowed me to explore my creativity as well as tap into my previous role in community health outreach. I coordinated between Timmy, the MSU team, and BANELINO to brainstorm what our objectives would be for this week. From there, I conceptualized ways through which our work would be executed throughout the week. This was the first time I was able to match both my former work as a Peace Corps volunteer in community outreach, along with my work with Timmy in leading a week long medical trip.

Health promoter and patientAt a professional level, I enjoyed constantly staying on my feet, seeing how everything we had on paper (agenda’s, material, etc.), literally come to life as the week progressed. I reminded participants that the week would be a ‘flexible week,’ in which we would be doing something never done before, and thus, we had the freedom to modify anything we wished in order to ensure feasibility as well as effectiveness in our chronic disease awareness campaign. And, for the most part, it worked! We trained 13 health promoters (three from BANELINO in the town of Mao) on blood pressure and glucose measurement working in 15 rural communities, visited 145 homes (originally estimated 80 home visits for the week), and orientated 70 children on oral health and hand washing.

Personally, it was perhaps one of my most memorable Timmy trips to date. It was awesome witnessing a level of humbleness from the students as I watched them enter homes with extremely limited resources. It was also the first time I myself had stepped into one-room structures inhabited by our Haitian patients. These small rooms were sometimes meant to host entire families, and were used for sleeping, cooking, playing, and all else. It was also rewarding to watch how empowered the health promoters felt in being able to guide us through their communities, and take patients’ vital signs. Their level of engagement during this trip was by far much more involved than I had seen before.

In a way, this trip reignited my commitment to development work, and in particular, work with vulnerable communities. The statement might sound trite, but at times, I forget why I am here—why I am in the Dominican Republic, away from family and friends, missing holidays, and birthdays, and other important things at home. I go about my day with my ‘to-do’ list on hand, until it’s time for dinner, a quick TV show on my computer, and off to bed. Sometimes I forget about my context and that every day I work and interact with people that have challenging housing and living conditions, and for the most part, live with one of two extremes of malnutrition and are undernourished due to lack of food, or undernourished due to lack of access to healthy foods.

I found that by walking into their tin roofed, one room structures, and feeling anger in understanding the real deprivation they experience on a daily basis, I rekindled a sense of purpose. And for me, nothing more could have been more rewarding. Physically, I felt as I always do after finishing a Timmy trip, exhausted. But mentally, I felt refreshed, and also satisfied. There are many things to change and perhaps experiment with during our future public health trips, but I am very pleased with how the first trip went and look forward to the future.



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