Work Update

Two months in the DR so far! We're having a quiet afternoon in the house. There's some dark clouds rolling in from the east - cross your fingers for a big storm to break this heat. Through my window I can see an animal trotting back and forth on the roof of a building in the next block. Is it a dog? A small goat? A large pig? No matter how hard I squint, I just can't tell.

It's been a while since I've written about work at the clinic, but there's still a lot of exciting things going on! I'd like to answer some FAQ's about the clinic and its services. There are four sections of offices: primary care, HIV/AIDS, physical therapy, and vaccinations/pharmacy/lab. Here's a "virtual tour":

Through the front door is a waiting room and long hallway with several primary care examination rooms and offices. The docs here treat injuries and infections, and do a little bit of prenatal care and a fair amount of gynecological care, though they don't deliver babies. A typical exam room is big and clean with open windows, a desk, and an exam table. Unfortunately, the rooms lack practical things like sinks. (A well-meaning charity didn't ask the docs what they needed before re-doing the rooms.) The best bathrooms are down this hall on the left. And if you time it right, you can walk past the door to the one air-conditioned room in the clinic while it's momentarily open. Great doctors and the occasional AC - the place to be!

The primary care/administration section takes up the short leg of the "L"-shaped clinic. The longer leg starts with the HIV/AIDS clinic, called Esperanza y Vida (Hope and Life) - my home base. In three rooms with green curtains and an ocean breeze, we do HIV testing, counseling, medicine distribution, and doctors' visits. Several of us double up as the community health team and also work out of this space, for lack of our own. We do programs like the Health Promoters in Villa Faro, education/support programs for at-risk groups, and regular home visits. Last week, we did a Health Promoters training session on fever and respiratory diseases and met with the neighborhood association to divide the Villa Faro map into promoter regions. I have to say, I think our section of the clinic has the most fun! We get to develop real relationships with our patients since they come regularly. They bring us their babies to play with and bags of limes from their yards, and we swing by their homes to check-in during the week and bring food or medicines. The staff is entirely young women, except the Drs. Dohn, and we trade language lessons during slower afternoons or sit together to plan Elena's wedding (coming up next month! Yay!). It's like a big extended family!

Down the hall is the physical therapy area. The therapists see a lot of people recovering from motorcycle/work accidents and strokes; and also quite a few babies and small children who need treatment for congenital problems. The kids don't like PT much, but, for some reason, they tend to quiet down when I'm around. (I like to think the children are soothed by my charming and magnetic personality, but more likely they're fascinated by my unusual face and the goofy Spanglish I speak to them.) The therapists have begun to call me in whenever there's a particularly fussy kid and I'm not busy, which I enjoy. And, to add to my role as Child-Soother, they're teaching me to do heat treatments and ultrasounds for pain relief on the patients! Time spent in physical therapy is a great way to practice Spanish, and I get to hang out with kids! A full rotation there might be in the works for later this year.

Finally, at the very end of the "L," are the vaccination room, the pharmacy, and the lab. I don't actually know much about these offices except that babies are often crying in the vaccination room, just like in the States. The pharmacy is very small - it was hoped that it might be a money-maker to help fund clinic needs, but very few of our patients are in a position to pay the full cost of medicine, so we give families the necessary meds and find our money elsewhere. Otherwise, these offices are a mystery. Maybe I should go explore them....

So that concludes our tour. There is a second floor with some offices and storage, but the roof is so hole-y and full of animals that we can't do any patient care or meetings up there. There's also a big, newer room upstairs for group meetings with a big air conditioner right next to a huge hole in the wall to the outside, which sort of defeats the purpose. That room isn't used much, though it has a pretty view of the ocean.

The clinic is a great place to work, with plenty of interesting things to see and do, and lots of ways to help. The people I work with are all incredibly nice and understanding, and we have a lot of fun together. Last week, we community health people received a big shipment of donated food to make our monthly food bags for patients. We formed an assembly line and loaded rice, sugar, pasta, tomato sauce, canned vegetables, salt, chocolate powder, beans, soup mix, toothpaste, laundry soap, and much more into plastic bags to hand out. It took half the clinic space and nearly a full day to do it, but we had fun! Here are some pictures:

Diana, Ana, and I load food on one side...

Stefanie, Elena, and Greysi load food on the other side...

...and, finally, some of the finished product!

Have a good week everyone!

P.S. To answer a question from last week: My camera stayed dry on the river hike because one of the leaders brought a big waterproof bag and carefully carried everyone's cameras/phones in it. Lucky, huh?