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

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!


Dear Dominica Rotation Student,
Congratulations on getting the chance to be a part of this great life changing adventure!  The island is the most beautiful place I have ever been to and offers many other amazing things.  My advice for you is going to come from 3 lessons I have learned thus far on this rotation.  

Lesson 1:  Be adventurous, going out of your comfort zone will allow you to enjoy the trip even more!
Before even leaving I had to make sure I had everything packed keens, Chacos, water bottle, flashlight, energy bloks, and lots of workout clothes and much more but do try to pack light.   I had to make sure  I was working out, they are not kidding around when they suggest this!  Once here I feel I have contacted my inner adventurer and have loved every minute of it!  Some of the adventures being my first international travel, hiking up mountains  every chance I got and trying new foods.  Each of the hikes they offer as daily excursions are a great way to push yourself physically and mentally!  In the Dominican culture herbal medicine is a way of life.  Alternatively, I know in most of our educations herbal medicine is not a large part of 'acceptable medicine' but honestly they must have something right because a women had lived to be 127 here on the island!  I have even tried a few remedies  myself to treat my skin since being here, and thus far they have worked better than anything else I have tried.  On a daily basis we have fruit and foods that have been freshly picked right off the tree or just dug up from the ground.  You will never find food this fresh anywhere else.  

Lesson 2: Be willing to learn about yourself and those around you
Dr. Abrons, the Albany faculty, the fellow students and anyone you meet while in Dominica is here for you and wants to get to know you as a person.  For example as soon as we got off the plane and there were people there greeting us from Jungle Bay with huge smiles and hugs for all!  I suggest taking advantage of the time you have here beacuse the time you get with some of these people is limited to your two week experience.  Even with all of the people I have met and gotten to know, I have still found this to be a reflective time to learn about myself. You get one chance to be here and decide what type of impact you are going to leave on this amazing island.  But the better question may be, what type of impact will the experience leave on you?

Lesson 3: Have an open heart and open mind
This was my motto for the whole rotation,  I knew that if I had thins kind of attitude I couldn't go wrong.  A large part of this rotation is philanthropy and giving back to the community by donations, patient education or even something as simple as painting a mural on a wall you can make a huge difference.  An eye opening occurrence happened on my first visit to one of the clinics when Kent--the districts pharmacist-- wasn't able to fill a patients prescription for aspirin, a medication we have readily available in the states.  Along the same lines I was floored to find out patients are often given only 10 insulin syringes for a whole month, and they use them until the needles are dull.  Hard lessons like this make me appreciate what we have offered to us and pushes me to want to help the clinics in any way possible.  Sometimes with what little the may seem to have in our eyes the people of the island are the happiest people I have met!  Not only are they happy to be here they are even more excited to meet us.   

These lessons are just a few of the number of things I have learned but are the ones that stand out most in my mind!   I have enjoyed my time here so much and I am hoping to get the chance to return someday!  One last thing to make note of their is a schedule they run on here it's called "Caribbean Time", also known as everything will get done eventually so you have to be flexible.   

Best wishes in your future endeavors,
-Dani Harris

PharmD Candidate 2014
Dear Future Dominican Rotation Student,

Congratulations! You have been given an amazing opportunity to grow not only as a student pharmacist, but also as a human being. This will be the rotation that has the greatest impact on who you are when you walk across that stage at graduation. You will push yourself physically, intellectually and emotionally in ways you have never imagined; and the tremendous impact on your life will never be forgotten.

Here is some advice for the rotation that I can leave you with:

Packing: Plan on wearing mostly active wear. I recommend gym shorts and wicking under armour shirts to keep you the coolest. Bring roughly 6 cotton dresses and skirts for clinic days. Keens are essential and you will wear them almost everywhere you go, but you may want a pair of dressy sandals for the clinics. Bring any medications you can see yourself needing as supplies are limited here. You will also want two bathing suits, some various toiletries and a notebook for recording everything you learn. A water bottle and plenty of gatorade packets are also essentials.

Donations: Bring as many supplies as you can. Almost everything you can think of is needed. Among the most popular would be diabetic supplies, bandages and bandaids, antibiotic and antifungal creams and OTC analgesics. Everything you bring will be put to great use and be extremely appreciated.

Resources and the Health Fair: I would recommend making handouts on issues that women of all ages will be interested in, as they tend to show up much more than men at the event. Try to make your activity colorful and hands on to attract attention to it. People are extremely interested in learning from you so bring as many handouts as you can. Pretty much any game that you play with the kids will go over well, they truly enjoy your company more than anything else.

Clinic Days: Work up the courage to go and talk to patients. They are extremely receptive to you and value all the information you can give them. It is easiest if you create a "Patient Data Collection Sheet" to bring with you and use it as a guide in your patient interactions. This way you will also get the information necessary to complete case write ups later on. Patients carry around a notebook with all of their medical information in it, so try to look through them as much as possible. Be prepared to take blood pressures, pulses, respiratory rates and to give immunizations. The staff are very grateful for anything you can help them with.

House of Hope: Before you arrive here, try to keep the mindset that these people are in a place where they are cared for and loved. It can be a little shocking when you first walk in and see everyone, but try to stay positive. Paint uplifting sayings and pictures on the walls as it really brightens the place up and has an impact on the lives of the patients as well as the volunteers. Don't be shy in being around the patients. They crave interaction with you even though they cannot communicate.

Herbal/Bush Medicine Component: Keep an open mind. Forget what you learned in school about not recommending anything that isn't FDA approved. Realize that the majority of medications you work with today came from plants. There is a high efficacy associated with many of the herbal medications so ask as many questions as you can, take pictures and write down what you learn.

Physical Activity: Be prepared for this before you come. You will be walking up steep hills almost everywhere you go (even to your cabin). Try a challenging hike like Paix Bouche, if you can. You will feel very accomplished for doing it. I really recommend starting the day with morning yoga as it will help stretch out your muscles after all the hiking you do.

Miscellaneous: The food is great at Jungle Bay and they kitchen staff really work with you if you have any special requests. It is important to wear sunscreen whenever you are outside as the sun is really strong here. If you do get burned, ask for aloe at the front desk and they will give you some leaves of a plant. This works much better than the aloe in bottle that we are all used to, so don't bother bringing that along. Bring some sort of motion sickness medication with you (Transderm Scop patches or meclizine) even if you don't normally get motion sick, as the roads are quite narrow and have many turns.

In summary, the most important thing you can bring with you is an open mind. If you immerse yourself in the experience fully and leave your comfort zone as much as possible, I can promise you that it will be life changing. This rotation will help shape you into the pharmacist you become, but more importantly it will change you into a more open and compassionate human being.


Susan Kane
Pharm D. Candidate, Class of 2014
Albany College of Pharmacy and Health Sciences