Off to the Hospitals!

Trip Start Jan 29, 2011
1
11
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Trip End Feb 26, 2011


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Where I stayed
ILAC Center

Flag of Dominican Republic  ,
Tuesday, February 1, 2011

Woke up to a foggy Santiago today! I was told later over breakfast that the fog is a sign for a hot HOT day! Go figure today was the day that I was set to go to the hospitals in Santiago! Luckily, the heat didn't get as bad as I feared it would and I was fine wearing my long khakis and Danskos around Santiago!

Breakfast today was bread with mango jam, fruit and oatmeal!

After breakfast, Edwin the ILAC driver drove us into Santiago to start our tour of Corominas Hospital. There is a picture below of the waiting area on one of the floors. On the bus ride (see attached video), we rocked out to Shakira until we got to the Hospital.

We met up with Eduardo, the son of Dr. Herrera who is an OB/GYN here in Santiago. His son Eduardo came up to Creighton to do some rotations and he agreed to meet with us and give us a tour of the hospital. We went to administration where Josefina, the Public Relations person who ensured we weren't stopped by anyone while on our way. She, like all working women in the DR, was dressed up beautifully. We first went to the Emergency Room where there was a triage area and a fairly new line of beds separated by all new curtains so that each patient had privacy. We were told that anyone who gets dropped off at Corominas (be it by Taxi, Ambulance, car, etc.) will be seen as long as they have health insurance. In recent years, more and more companies have been providing health insurance to workers of all professions, so it helps people be seen at the better hospital and pay less as well.

Currently, the government has not payed the heatlh care workers (due to improper dispersement) and a couple of days the public hospital, Cabral, was closed. due to the health care workers being on strike.

After the Emergency Department, we went to check out the ICU, the NICU, the OB/GYN floor and the surgery departments and the new GI lab/chemotherapy and sleep lab (somnography) labs. Everyone was pretty nice and the hospital was very much well equipped. They were definitely a step down from facilities in the states, but there were a lot of pieces of equipment there that I did not expect. They had a 64 slice CT, 7 ventilators in the ICU, CPAP machines that patients could take home (these had data cards to record the info that the patients brought back to the sleep lab for follow up), isolettes no different than the States. It was pretty amazing to see a facility like this. Yes, some of the hallways were crowded but overall this hospital looked capable.

After we left Corominas, we went to lunch at a Chinese restaurant walking distance between Corominas and the second hospital we were to visit: Cabral. When we walked in, there were a total of two Asian men sitting at a table eating. I thought that was hilarious! We were sat at a huge
family style table with a gigantic Lazy Susan. The waiter and all the other wait staff were composed of Dominicans rather than family members of the restaurant owners. That was different. After attempts to write down our orders on separate checks identified by our names, the waiter told us the cook couldn't handle names on the food orders and so he had to come back out and assign us all numbers. It was hilarious. I ordered Chopsuey de res "Beef Chopsuey." Others ordered sweet and sour chicken, sesame chicken, beef with bell peppers, chicken curry, and of course, the meals were served with a choice of fried rice or fried plantains! Eduardo, our tour guide ate with us and he was making conversation about how he had heard that white tank tops are called "wife beaters" and, from hollywood and popular culture, he had thought that this was the actual term for the shirts! We shared with him the history of that term and explained how it's not accepted by a lot of people these days. Overall, lunch was pretty good and we were all full by the time we left the restaurant.

We walked to Cabral after that. We put on our white coats as we were walking inside and waited in the big lobby until our tour guide cam and got us. It turned out to be an OB/GYN Perinatologist, Dr. Ramon, who used to be a first year intern when Dr. Gray came over six years ago for the first time. As we introduced ourselves, he stopped and, because I had pronounced my name as it is pronounced inSpanish, he souned my name out slowly and then, out of nowhere, asked, "Are you Filipino?" That was the FIRST time in my life anyone has guessed my ethnicity correct based solely on my first name!!! We took a picture together!. He is half Filipino and speaks Tagalog. He was born in Spain however, and not the Philippines.

Dr. Ramon took us upstairs to show us where he works and then we went to the OB floor. We met his wife and saw pictures of his 1 year old daughter. She spoke English perfectly! We were shown where to put our belongings and then we left the OB department to see the labor and delivery room. We were met by Michelle, a med student who is on surgery at moment. Here, as at Corominas, the women who have vaginal deliveries are sent home after 12 hours and the women who undergo C-sections stay for a couple of days. We saw the NICU and the Cafeteria and then we went to see the emergency department. This was where there was a TOTAL 180 from Corominas. The minute you entered the ER, there was a slight stentch coming from the bathroom. It was a tiled bathroom but there were buckets to go to the bathroom in. There was a cast room where it appeared people were having family members put on casts. Here, you buy your medical supplies, like casts, and supposedly someone teaches you how to use them and then you do the rest yourself. The ER was separated into Internal Medicine, OB and general ERs. There were waiting lines for all of the different departments. There were people sitting in beds along the walls of the hallways. The general ER had lines of beds with people in each one. There were no curtains separating each patient. Each patient was surrounded by family members because here, unfortunately, the Public Hospital (Cabral is the largest in the nation) nurses have a union contract where all they take care of is getting medicine. The Internos (equivalent to our 4th year) draw blood for labs. They run their labs to the laboratory. They do vitals on the patient. Basically, they are the nurse. The minute to minute care in the ER, however, is managed by the family member. This was completelly foreign to me. How could there not be any nurses taking care of patients and how could a family member who may have little education be responsible for taking care of a family member?

After seeing the ER, we left back to ILAC. We said our thank yous to Michelle and said we'd contact her as we will still be shadowing at these two hospitals in two weeks. We hopped on the guagua going to Licey and got back at about 3pm. After resting a while and not being able to take a nap, we went to the Sirena downtown and I bought my Dominican Republic clothes - a sea foam green shirt for clinic as well as a sundress that I can wear when we go to the beaches! I also bought some chocolate goodies (one is called Mas-Mas which is the godsend to anyone who likes Goobers and Raisinettes as it is a chocolate bar with peanuts AND raisins! I also bought a deodorant (of which I have one from every trip I have been on) in the scent of lemongrass and grapefruit!

We took a guagua back and made it back in time for dinner! Dinner was fried chicken, fries, boiled vegetables and pineapple and watermelon!

After dinner, we had some free time and then we met with Dr. Gray to reflect on our day. This was the most exhausting so far because we were on our feet for most of the day. We talked about how to improve the health care system here for the future, about the overworked role of the Internos and the conditions of each hospital.

Following the reflection, we met with Father Bill to go over another lesson of the Examen prayer. He was telling us about the earthquake in Haiti and how there was a group of men who flew their private helicpopter from Miami to the DR to transport medical personnel into the Port-Au-Prince area. On the way from the area, these men crashed and lost their lives. The anniversary of their death is this Friday and we'll be having a mass for their families. The ILAC mission created a fundraiser to benefit the people who these men were trying to help save. For more information, please visit: http://www.showyourgoodness.com/

Last things of the day... showering and updating the blog!

~M
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