Milca Nunez Project HOPENext Monday will be our fourth week in this field experience with Project HOPE in the Dominican Republic. We are almost halfway done, so I am anxious to learn as much as possible while I am here. I do not know if I will ever have another opportunity such as this one, where I get to travel, gain university credits and earn work experience. I am thankful for being here every day, although I feel nostalgic at times. But I decided to take on this challenge so I am determined to finish strong! Last week was a very busy week full of interesting and distressing things. I will elaborate further in the following lines.

First of all, I will describe day-by-day our activities during these past few weeks. We met with Colin Credle, the director for the Gift-in-Kind donations for Project HOPE in Central Asia and the Americas. He was a wealth of knowledge and took every opportunity he could to make it a teachable moment for us. I appreciated that. He needed to conduct a few visits around the city because he oversees the GIK program with private and public institutions in the DR and other countries.

It was very interesting to see how the GIK donations function. It’s a “pull and push” system that is common in the business world and logistics management. The donors try to push some organizations to take their supplies while other institutions pull donations from the donors by requesting the desired items and their quantities. We facilitated communication by interpreting when it was needed. At times, it would be difficult because they would keep on talking on and on about a certain subject without allowing for interpretation. However, it was quite a thrill. On Monday, we visited the national immunization program called PAI (Programa Apliado de Inmunizacion).

We met with the director Dr. Arbajo, and we discussed the needs for the national program. We were given a tour of the facility and were shown the huge refrigerators to store the vaccines. We learned about the importance of the cold-chain to maintain the temperature needed to preserver the vaccines. They have an alarm in place that warns them of abrupt changes in temperature. I was grateful we were able to see some of the immunizations Project HOPE had donated to PAI. 

On Tuesday, we visited a hospital that, in my opinion, was of poor quality. We also went there to figure out what the main needs were in terms of medicine/supplies for the population they serve. That day was a distressful one for me. There were so many people crowded in the hallways waiting to be seen.

Personally, the saddest part is realizing that there are healthcare institutions that are in worse shape. Not just here, but all around the world. And this is all people have access to. I recognize worrying about problems does not help solve them, and I really cannot do much about this issue at this point in time.  So once I am an accredited public health official, I vow everywhere I go to influence my co-workers to raise the standards of quality for healthcare. I believe there are ways to increase the quality and sanitation of a healthcare institution, regardless of income. I am confident we could investigate solutions that are low-cost and that could be implemented with collaboration.

On Wednesday, it was a religious holiday and nobody worked. So we visited the colonial zone, the area of the island of Hispaniola that was firstly seized and plagued by Christopher Columbus and others. Once again, being there was interesting and distressing.

On Thursday, we visited another hospital that was newer than the previous one we went to. Like the other times, we asked for the essential list of items that were needed for that population. The director, Dr. Diaz, was very hospitable and resourceful. He invited us to return to the hospital, and we are absolutely planning on it. We got a tour and were shown the medicine/supply storage areas. 

We also went to the storage building for the Order of Malta. It is impressive to see upfront how donations are requested, received, and distributed where it is most needed. On Friday, we went to the Ministry of Health for the same purpose as the previous visits. The facility is a decent size and it offers many services to the people in the DR. Most of the needs are diabetic medicine, antibiotics, vitamins, medical supplies, etc.

After this, we went to visit the clinic in the town of Haina that is being constructed by the Order of Malta. Project HOPE will be responsible for staffing, implementing health programs, and equipping the clinic. It is anticipated to open its doors in February of next year.

This week we worked in Project HOPE’s office on Monday. From Tuesday till Thursday we were at the clinic. I shadowed the community health nurses and the vaccination program, since I am more interested in that department. I visited the lab some, although the majority of my time was spent with the nurses.

The nurses are informative and explained to me their daily routines. They take measurements such as temperature, weight, height, blood pressure, babies’ cephalic perimeter, etc. They ensure proper growth and development. They also report any abnormalities, and when needed, make referrals to other healthcare institutions or departments.

On Tuesday afternoon we assisted in the facilitation of the discussion on values and how they are related to certain occupations. On Thursday we participated in the self-esteem discussion where we talked about recuperating after losing self-esteem or feeling negative emotions.

We are getting prepared for next week's discussion on sexuality and anatomy of the human reproductive systems. This will be exciting, since I am writing about teenage pregnancy prevention and would like to get a few ideas of why adolescents are becoming pregnant (besides the obvious reasons).

I have been able to recognize health systems in action while visiting the various health institutions. Public speaking has always been reinforced in the college’s curriculum through many courses so I felt prepared when facilitating discussions to school-aged kids. Being in a predominantly catholic country, we must respect the culture and the religion in healthcare institutions.

We are almost half-way through this field experience semester, and I am looking forward to our upcoming adventures here at the DR. It has been quite an experience already, and I am excited to see how I develop personally and professionally in the forthcoming weeks.