I’m starting to really regret not following through on my initial plan to wear my rain boots on the plane. It would’ve been a less comfortable flight, but after five straight rainy afternoons I miss them dearly. And all of you, of course. But the boots would be especially helpful.
Today was was almost painfully slow. Highlights include going to a meeting at the provincial public health office about preventing the spread H1N1 (aka swine flu, influenza A), which has reemerged and killed several people in the DR in the past month or so. A couple of these cases were in the Monte Plata province. While we waited for the meeting to start, I checked out the various posters and information on the room’s wall, including a bulletin board with some provincial health stats. One chart showed Monte Plata province’s reported cases of HIV, which seemed disproportionately common amongst pregnant women probably because an HIV test is part of prenatal care.
The meeting was attended by a variety of key players in the province’s public health services–in addition to the public health officials there were also representatives from a couple hospitals, a doctor who coordinates some very rural clinics, and there might have been some insurance company reps. People seemed to know each other so there weren’t really any introductions. H1N1 prevention is a priority for the Dominican public health authorities, and has been incorporated into the Project HOPE clinic’s community health “charlas” and door-to-door promotion, as I saw yesterday morning. Endemic diseases, like dengue, were also discussed at the meeting, with the goal of preventing H1N1 and these other illnesses with integrated measures/campaigns. That discussion was especially important because it is the beginning of hurricane season, which involves lots and lots of additional standing water in both urban and rural areas. A troubling point made at the meeting is that there are no more flu vaccines available, which was attributed to the fact that they weren’t strictly reserved for the vulnerable/target populations (small children, pregnant women and the elderly). It was unclear whether the shortage is nationwide or just in this region.
Another highlight of the day was the fresh passionfruit juice that Udelina made us. I know I don’t need anyone to cook or clean the house when I’m here alone, but I am going to miss Udelina’s juices! Yesterday she made a limeade, which was also really tasty, and perfect for the heat. The third and final highlight of the day was making labels for the two jugs of new cleaning liquids that have labels written only in English. Orlando asked me to translate the instructions and warnings for him (orally), which I did to the best of my abilities, but he didn’t write anything down. This worried me because he’s definitely not the person who will be using them and he’s only at this clinic once or twice a week anyway. I grabbed K (& B followed) and we went back to the supply shed so she could make sure I read the germicide label right and we could put instructions in Spanish on the jugs. Taping paper labels securely to the jugs turned out to be much more difficult than expected, but we succeeded. We had lots of time on our hands, and enjoyed the challenge. B took pictures of our handiwork–I’ll post one when I get it from her.
These are some of the main daily functions of the community health nurse/team in the ciinic:
