Wednesday, August 7, 2013- Falcemia
Liz and Cindy left today, they were invited to a forum for the Lactancia Materna week in Santo Domingo in which Project Hope and Teresa will be recognized and receive a few awards. The house was not the same without them (super sad face).
For the first half of the day we shadowed Dr. Rodriguez again. It’s crazy how prevalent sickle cell anemia (“falcemia” or “anemia falciforme”) is in the DR. One of the patients today was a carrier but when the doctor asked what “falcemia” was the mother responded by saying “I think it’s some type of virus.” When lunchtime rolled around, I went to look at the community health room and there were no handouts or information regarding sickle cell anemia. So now we have a project concept- basic patient health information handouts. When I helped Liz do some of the surveys some of the patients told me that they would be interested in knowing more about high cholesterol so Sara will be making one for that and I will be focusing on sickle cell anemia.
We had two patients who had giardiasis- a parasitic disease, which inhabits the digestive tract. Symptoms include loss of appetite, diarrhea, hematuria, stomach cramps, upset stomach, etc. The parasite blocks nutrients from being absorbed. Like other parasites this is passed via fecal-oral route so proper hygiene is very important. This is very hard to detect so most of the time it’s misdiagnosed and several tests must be conducted but since people can’t afford that Dr. Rodriguez just prescribes them metronidzaole or albendazole for 10 days. If symptoms get worse they are to return to the clinic immediately or just return in 10 days for a follow up.
Thursday, August 8, 2013- Eid
Today is EID (it began last night after sundown)- it marks the end of Ramadan, a Muslim holiday in which fasting occurs from sunup to sundown for ~29-30 days. Eid is celebrated with families and friends (similar to Christmas to Christians/Catholics). Since this was going to be Sara’s first time away from her family we asked Teresa for permission to go to the capital to go to a mosque so that Sara could pray and celebrate. We left in the morning and made it to the afternoon prayer.
1st Pic: Mesquita Al Noor in Santo Domingo (pretty much the only mosque in the DR)
2nd Pic: Sara and I at the mosque (I wore a hijab to respect their tradition)
Later on that day we met up with Liz and Cindy. We walked up and down El Malecon, which is like a seaside boardwalk, it goes along the coast for almost half of the city, there are several restaurants, hotels and even an outdoor gym along its’ way. After asking around we ended up at “La GuaGua,” an amazing restaurant that actually had a “guagua.” There was a variety of different foods, majority were American style- like nachos, French fries, sausages, empanadas… it was delicious!
Our EID feast!!!
Friday, August 9, 2013- Dermatologist
Sara has been getting a rash on her hands. Dr. De la Cruz saw it the other day and recommended her to go to a dermatologist. So we woke up early and headed to a Dermatologist Institute where the majority of physicians in this country rotate. It was a very big building with hundreds of people in the waiting area. After waiting for about 3 hours we received a prescription for “Mometasone” and were just told it was contact dermatitis (luckily the visit was like $3). The doctor told us to come back in 15 days, although she didn’t say why, but luckily the cream has been working and there is no need to spend half a day waiting to be seen for 5 minutes.
Saturday, August 10, 2013- Farewell Cindy (sad face)
We woke up super early today because we were so excited to go to Sambil. Apparently it’s a new huge (& expensive) mall in Santo Domingo, which has an aquarium- AQUAMUNDO!!! We had lots of fun at aquamundo, we learned about so many different species of fishes and sea life… and were even able to hold starfishes!!!! After we ate lunch we went to see Despicable me 2 in SPANISH… movie tickets here are about $3 – CRAZY!
Sunday, August 11, 2013
Today was a rather sad day since Cindy left us (good luck Cindy in your last year of undergrad!!!) We went to a vegetarian restaurant (my first time) surprisingly it was really good! Then we walked to a nice bakery were we ate yummy blueberry cheesecake and a phenomenal tres leche cake.
On our way back we stopped by what looked like a chain pharmacy… Farmacia Carol. This is the first pharmacy we have seen in the DR that actually has a staff pharmacist at all times. It was what Sara and I consider a “legit” pharmacy! It was a great feeling finally meeting a pharmacist in the DR. We spoke with her for a while, apparently pharmacists only go to school here for like 5 years max.
1st pic: Farmacia Carol- Speaking with the pharmacist
2nd pic: Farmacia Carol’s mission and vision statement
I’ve been doing further research on sickle cell anemia in the DR and many physicians consider it an epidemic. About 10% of the population has sickle cell anemia! I have been working with Dr. De la Cruz to come up with a message to target patients to get tested and to know whether or not they are carriers. Knowing if you are a carrier is important because if 2 carriers have a baby they have a 25% chance of having a baby who has sickle cell anemia.
Sickle cell anemia is a genetic problem more commonly seen in people of African descendant, in which the body produces abnormal shaped red blood cells (RBC). These cells are more like a half moon (crescent) or sickle shaped and because of this they don’t survive as long as normal RBC, which leads to anemia. In addition, the sickle cells get stuck in the blood vessels causing a blockage of blood flow that causes the patient lots of pain and eventually organ damage.
We also came up with counseling points, which help reinforce the “teach back method”, that Jillian and Derek taught the staff. The majority of our time these last few days have been in the community health center, counseling patients on their prescriptions. If a patient needs their first dose, we administer it!