About Me

We are the student pharmacists, pharmacists, and staff selected to participate in the yearly International Dominica Pharmacy Rotation offered. We hope you enjoy reading and sharing our adventures. If you are interested in learning more - contact us at abronsdominicarotation@gmail.com

Tuesday, February 3, 2015

January 23, 2015 - Jones Beaupierre Primary School Visit

Today's activities included the visit to Jones Beaupierre Primary School and making castor oil at Raphael's.

What was most significant about our involvement in community service as pharmacists?

The most priceless part of this experience was seeing the smiles on the faces of the children at Jones Beaupierre Primary School. It was an extremely eye opening experience to see how much they appreciate the little we could do for them. Days like these let us realize that becoming a pharmacist not only enables us to help our sick patients, but anyone in our reach. While talking with the children, we started the conversation asking if anyone wanted to be a pharmacist, and through talking about our paths and the career options that a pharmacy degree entails, the number of hands raised vastly increased by the end of our visit with them. It was satisfying to teach young people about pharmacy and help them become aware of the field as a career option.


How was this experience significant to you?   

Living in a rural community, we can't imagine that the children there have all the necessary resources to be aware of the endless careers options possible. For us, this was one of the most meaningful parts of the rotation because we had the chance to plant a seed by talking with the children about career possibilities with pharmacy. We hope that this will grow to increase the number of pharmacists in Dominica.


What did you learn about caring for others and improving lives?

Sometimes we tend to spend a little more than necessary because we have the money available. However, we need to take a step back sometimes and realize we can live without some of the luxurious things in life; we need to think about someone else for a change. Other times we complain about how bad our life appears, but there is always someone else in a worse situation. Next time we have some money to spare, hopefully we think to use it to help someone in need, and when we have time to spare, we can give our time to greater causes.

January 20, 2015 - First Clinic Day

Today was the first day of clinic, the “real meat and potatoes” as Tressa says. Our group was to go to Petite Savanne, but upon arriving there, we soon found out that it was cancelled due to an emergency. Dr. Abrons knew this was a sign we were all supposed to stick together today, so we went to La Plaine with the others. We started off in the waiting area and chatted with the locals by introducing ourselves, inquiring about the patient’s background, and then asking what brought them in to the clinic. This then led to further inquiry depending on whether they were in for a follow-up appointment or if they have a more recent problem to address.

We also had an opportunity to talk with the health aid at the center, and she showed us the casualty room, which is where acute situations are managed, such as wound care and motor vehicle accidents. She opened the cupboards and drawers for us and showed us the supplies that were available.
Through these interactions, we learned just how difficult it was for the patients in these rural areas to access healthcare as a single doctor and pharmacist are relied upon to serve multiple communities, and the system falls apart when one falls ill or is unable to make it to the center. We also learned that there are limited resources, as the pharmacy inventory was very small and equipment had to be sterilized in Roseau. We were pleasantly surprised to find that everything at the clinic, including the medication, was free for the patient. Unfortunately, adherence remains an issue, probably due to availability, lack of understanding of medication’s importance and worry of side effects.
Although we did not get to meet Kent today because he was ill, Dr. A filled us in on his role in the pharmacy and we were surprised to hear that he carries around much of his medication supply in a suitcase and is not only responsible for ordering medications, but also medical supplies. Dr. A informed us that he used to also perform blood draws to obtain labs, something that none of us would be capable of doing.

After clinic, Orrin from Jolly’s came to talk with us, and we found it surprising that there is no regulating agency in Dominica, allowing medications to be obtained from any country and for pharmacists to compound any medication they desire. Through this day, we have reflected on how we can make a greater impact at our next clinic days. We hope to have more time to talk with the patients and to have a chance to look at their medical record book before they see the doctor, as well as follow up after they are finished with their appointment. We also hope to find patients with the disease states that we have “become experts” on, and educate them on those topics and provide them with further resources like our brochures.

The three of us finished off the day with some advertising for our health fair on Monday at the La Plaine Health Center, riding around the La Plaine villages and Delice with a bullhorn and announcing details. “Bonjour! Sakafet! Come one, come all!” We’re expecting a great turnout!

Thursday, August 22, 2013

August 21, 2013

Today we had the chance to make our own cinnamon sticks from scratch. We were invited by Ceurvon, a Jungle Bay tour guide, to go to his house since he grew cinnamon trees in his yard. The tree looked like a normal tree until he described that cinnamon trees were a reddish tint, and thus we were able to find our cinnamon tree. 
Our next task was to find a tree that was easy enough to peel the bark and cinnamon off of. After finding the right tree we were given the responsibility of cutting down an entire tree, which mostly all of us have never done before. We cut down the tree with a machete, and for most of us this was the first time we had ever even held a machete, and carried it to the front yard for Ceurvon to show us how to harvest cinnamon. After cutting the tree down, we had to scrape the bark off of the tree using a knife. This task was somewhat difficult because we had to scrape off just a small amount since putting too much force and scrapping too much would reveal the underpart of the cinnamon we wanted to extract. The next step was to cut the cinnamon tree into smaller pieces and to section off how long the cinnamon sticks would be.  Next, we cut back layers of the cinnamon tree and took a dull knife to slowly peel back the cinnamon in order to make sheets. We brought back the sheets to Jungle Bay and laid them out in the sun to dry. The drying process typically takes about 2-3 days to fully dry and at the end of the process will give cinnamon sticks. 
Cinnamon has many medicinal properties, for example it may be used for weight loss, diabetes, insect repellent ingredient, upset stomach, runny noses, blood thinning properties, and much much more! After seeing how grueling the process of making cinnamon really is, all of us are able to appreciate the preparations that are available and already prepared for purchasing in the United States. 
After making cinnamon we continued on our tour to Tony's. Tony is a local resident of Dominica who has been farming for over ten years! All of his products are organic and he produces a variety of fruits and vegetables to sell to other locals, of which includes Jungle Bay. Tony's farm consisted of at least two green houses in addition to a multitude of land for farming. He gave us avocados from his farm and explained his techniques in farming. One of the interesting techniques were to grow cabbage above ground, of which his reasoning was to keep animals from eating his crop. We also noticed that with the above ground planting, he was able to use less soil and did have to worry about where rain water would go. After seeing all of his farm, we were able to learn about the importance of eating healthy and utilizing organic farming towards our advantage. We were able to learn about GM or genetically modified fruits and vegetables and why they were bad for us. 
After touring Tony's farm, we came back and ate lunch and were given the afternoon to finish our herbal scavenger hunts. Overall today was very educational. Being given the opportunity to harvest our own cinnamon taught us how hard it is to harvest cinnamon and to think twice about how much cinnamon costs in the grocery store in comparison to how much work actually goes into making dry cinnamon. The tour of Tony's was also a good learning opportunity since it taught us how to create sustainability in terms of farming in addition to the importance of eating healthy while emphasizing on Sam Raphael's philosophy of putting in hard work but getting rewarded in the end. Tony puts a ton of time, work, and sweat into his farm, and in return he helps to feed many people, including us at Jungle Bay, with fresh, healthy, and organic food.

Theresa & Bianca

Wednesday, August 21, 2013

Sea turtle sighting: August 20th

Last night we had the opportunity to go visit the beach where the NET program is currently active.  The NET program is working to protect sea turtles from poachers and the environment.  Turns out a turtle needs to lay nearly 1000 eggs for one turtle to survive! Simon, who currently heads the project as a volunteer, had hopes that a nest would be emerging last night.  However as he dug through the sand he realize that there would be no baby turtles that night.  We did get to see a mother emerge from the ocean and had a chance to pet her!!! Follow this link to read more on the project--http://www.avirtualdominica.com/seaturtles/.

                                                                      Katie & Dani

Tuesday, August 20, 2013

LaPlaine Clinic- Tuesday, August 20th, 2013

Today we all passed on yoga to make it in time for our big day at LaPlaine Clinic. We got our things together and headed to our usual group breakfast. I am really going to miss all the fresh fruit and juices I've gotten accustomed to having here. On our way to the clinic, we stopped and picked up the pharmacist Kent. Today was my first time meeting him, and I learned a great deal. When we arrived at the clinic he introduced our group to the patients out in the waiting area. He also explained to us that it would be a slow day as there was no doctor today, and there was a funeral in the afternoon for a younger member of the community that most people planned to attend.
I learned that Kent is a government pharmacist and went to school in Jamaica for 4 years to become a pharmacist. He told us that some people continue their pharmacy education in Canada, the US or England; but he elected to return to Dominica to work. He works everyday and stated that pharmacists are always on call if a doctor needs a medication for a patient. He used to own a private pharmacy in his home, but it was too much work.
Kent also taught us about pharmacy in Dominica and about how prescriptions are dispensed to patients at the clinics. He even let us help him dispense and label prescriptions from patients.
Here is the process:
1. Patient comes up to pharmacy window and hands over their medical record (notebook).
2. Pharmacist looks in notebook to see what medications need to be refilled.
3. Medications are counted and put in plastic bags and labeled with patient name, drug name and strength, directions and quantity. Patients are usually given a 30 day supply.
4. A manual log book is filled out with the patients name and what medication and quantity was dispensed.
5. An inventory balance sheet for each drug is added on to.
6. The patient is given the prescription and counseled on it.
After learning how to fill prescriptions with Kent, I went and interviewed some patients in the waiting area. One of my patients was particularly interesting. She was 35 years old and at the clinic as a caretaker to an elderly woman who was there to see the dentist. She told me that she had no diseases, but she was showing signs of Dengue fever. She was given acetaminophen and would see the doctor if her symptoms of headache, rash and weak joints continued. She told me that she just moved back here from Canada, and had been living there for 12 years going to school. She told me that many of her friends left and went to college in the US or Canada and then got married and became citizens. She ended up having a baby in Canada but was never married so she was asked to leave a few months ago. She took her 5 year old daughter, but had to leave her childs father behind. She was hoping to find a way to move back to the US or Canada. She told me that in Dominica it is mainly the older generation who are using herbal medications and the younger people are using western medicine. She really liked how the medical system in Canada worked a lot faster and you could always see a doctor if needed. In Dominica she said it could take a month.
Today I tried to be more effective at the clinic by trying to ask the patients more about the herbal medications they use. Last week, I hadn't learned as much bush medicine so I wasn't as comfortable with it. Today I asked the patients more about these methods and learned a great deal. I gathered as much information as I could to prepare for my case presentations and tried to focus on the complete wellness of the patients, rather than just the medications they were taking. I also made recommendations for them to see the doctors at the next clinic for certain conditions. All in all, I think the clinic today was a great experience. I learned a lot from Kent about practicing pharmacy in Dominica, and I learned a lot from the patients about bush medicine. I am definitely learning many things here about alternative medicine, that I will incorporate into my practice of pharmacy in the US.

Monday, August 19, 2013

Dear Future Dominican Rotation Students...

      I think one of most important things to think about when you're preparing for Dominica is actually mental preparation.  Yes, it's a completely different terrain from either Iowa or New York so you'll need to be in pretty good shape to keep up with the rigorous exercise associated with the activities, but I think the bigger thing is just to mentally prepare.  Chances are, Dominica is completely different than anything you've done before. It's not a vacation where you deal with the heat and rain for a few days and then leave, you are here long enough to have to adapt.  
      Bring your raincoat and put pretty much everything in ziploc bags - especially electronics.  Make sure the majority of your clothes are dry fit material because you will sweat... a lot. Bring 4-6 nice outfits for clinic days, but otherwise pack workout clothes.  We had a small bottle of laundry detergent to wash our clothes and brought a clothes line that we put up in our cabin to dry things out.  It is essential that you take care of your feet!! Test out your water shoes before hand to make sure they are comfortable to wear pretty much 24/7.  I got water tennis shoes make by Columbia Sportswear and they worked perfectly for me.  Along the trails, especially in the rain, some of the girls were getting rocks and twigs stuck in their Keens and had to keep stopping to dig them out since they aren't enclosed shoes.  
      Mentally prepare for the physical challenge of the rotation.  No matter how much you work out before hand, you are going to be pushed to your limits as far as what you can physically handle.  If you've got a positive attitude saying you're going to take on each challenge as it comes, you're likely to get through each one and learn a lot from it.  Do yoga in the mornings if you can.  Not only does it help stretch out sore muscles, but it gets you moving and gives you a little more energy to kick start your long days! 
      Have an open mind when learning about the herbals and natural remedies.  The people have a lot of knowledge that they're eager to share, so make sure you ask a lot of questions!  If you're like me, you might struggle to understand them at first, so make sure you pay attention, listen hard, and try to rephrase things if it seems like they didn't understand what you said.  I know we are told natural remedies are inferior to Westernized medicine in school, but these people use it all the time and seem to really benefit from it so try to push all the judgments aside and really learn from them and embrace their culture as much as you can!  
      Go outside of your box and try new things, especially regarding the food.  Everything is so fresh and delicious.  If you don't eat fish, try mahi mahi first... they told me it was the "gateway fish" :)
      One more note about living things... get used to things that crawl.  There are geicos everywhere and you'll see crabs, lizards, snails and other little things around your cabin.. Nothing will bother you, but there are nets above your bed if it makes you feel more comfortable.  I never used mine.  Just give them a name and make them your pets.  
      As always, if there's something you aren't comfortable doing, that's okay, but really try to push yourself if you can!! You will learn just as much about yourself in Dominica as you do about plants and natural medicine.  Lean on the other students when you need to.  You're a team, going through the same things together.  You'll become really good friends in a few short weeks, and sharing this experience will be something you'll always take with you!  Congrats on being selected, I hope you have a great experience in Dominica! 

Megan Schwartz 
University of Iowa College of Pharmacy
PharmD Candidate 2014
Today, we spent most of the morning at the local primary school in the town of Delice.  While there we all got in touch with our artistic sides and painted the library and a couple of the doors at the school.  We will be returning on Wednesday to finish up our masterpieces but here is a sneak peek!