Time for Clinic!

Our primary purpose for being in the campo was to provide the people of the area with a free clinic.  For many people in the campos, health care is difficult to come by, either because there are no resources nearby or because they simply can't afford it.  We had clinic 4 days a week for 4 weeks and were rather busy most days.  We had both a medical and a dental clinic.  Total, we saw over 400 patients in the medical clinic and over 200 patients in the dental clinic.  This includes a day we only had for women, in which we did 56 pap smears (I only assisted by handing the physician supplies).  That was a busy day!  Our clinic was located in the community's school.  We had one room for the medical clinic, one room for the pharmacy, and a pavilion out back for the dentists.

The school/clinic

Medical clinic

A view of the mountains in the distance on our walk to clinic

Prayer before clinic

My main role in the clinic was doing intake for patients in the medical clinic.  This was very difficult at first because Spanish in the DR is very different from the Spanish that I learned in high school.  They use words that I'm not used to hearing, have an accent, and they talk incredibly fast.  For the first few days I had a "translator" help me out.  I say "translator" because they were actually 2 Dominican teenagers from Rodeo who didn't speak English.  However, they were incredibly helpful.  They would repeat what I said faster and then simplify whatever the person said back to me.  Besides intake, there was not a ton of nursing-like things to do.  This was the thing that frustrated me the most at first because I felt like I was not able to practice anything that I learned in school.  The fact was that many of patients that came in did not require any nursing care.  We saw a lot of headaches, low back pain, urinary tract infections, hypertension, joint pain, and cold/flu (also known as the gripe--pronounced greepay). Everyone in the DR had the gripe.  In Spanish, gripe technically means flu, but in the DR it can mean anything from a sniffle to a fever and vomiting.  Everyone wanted a pill for the gripe which was frustrating because there was really nothing we could give them to get rid of their cold.  The biggest problem we saw was dehydration.  Rodeo was very hot, and most of the Dominicans would only drink 4 small glasses of water a day or less.  I think the thing the doctors prescribed most was drinking more water! So, I did not do very many nursing tasks.  I did get the chance to clean a couple of fairly large wounds, do a couple of ear irrigations, and obtain many, many urine samples.  Lori (the other nursing student) and I also tried to do patient education whenever we could.

Our dental clinic was always packed.  Dental care is not high on the priority list for many Dominicans, so many people have mouths full of rotting teeth.  Our dentists were busy doing many fillings and lots of extractions during our 4 weeks.

We also had a pharmacy for dispensing medications, although it was extremely limited on resources.  Because so many people don't have regular access to medical care, they are all looking for a pill to fix themselves. We could give them 1 to 2 months supply of drugs, but after that they would need to go to a pharmacy and buy more.  For many people we did not have the required medication, so the pharmacy dispensed a lot of ibuprofen, tylenol, and vitamins just so the patients would feel better about taking some medication home with them.

The unfortunate part about clinic is that we saw a lot of people with chronic diseases that we did not have the resources to treat or properly diagnose.  Luckily, ILAC has a referral system in place.  For those that we thought needed further follow up for a newly diagnosed disease we would refer them to one of ILAC's physicians stationed in Santiago.  ILAC also has several surgical teams that come to Santiago during the year, so we were able to refer many people that needed some type of surgery.