Reflections on Impact

                One of the most exciting parts of the Dominica experience will be working in the rural health clinics. There, I believe, I will be exposed to a facet of healthcare delivery that is not seen in most portions of America’s healthcare system: making do with what one has. There is no major diagnostic equipment, very little in the way of material resources, and manpower, but, I believe, a tremendous amount of healing takes place in these clinics. These practitioners know how to heal. I hope through my interactions with these healthcare professionals at the clinics I can learn skills that I will use throughout my professional life. Although I am sure that my time at the rural health clinics I will be impacted more by them rather than vice versa, my contribution or impact to the physicians and nurses will be my knowledge of prevention and treatment of tropical diseases and my passion for helping.

                As I will be the tropical medicine and parasitic infection expert on our rotation, I have the responsibility of disseminating information of pertinent tropical and parasitic diseases that Dominica is currently experiencing. These diseases include Dengue Fever, Typhoid Fever, and the constant threat of Malaria. Prevention is critical, especially in an economy such as Dominica, which is primarily agriculture (and to some extent eco-tourism) based. Control of the vectors of the disease, such as the Dengue Fever vector, Aedes mosquitoes, can be a cheap, environmentally safe, and saves the population from a terrible burden. Prevention can be as simple as not allowing for water to become stagnant and standing (e.g. used tires or garbage cans). Another preventive technique is the use of bed nets. By communicating with the rural health care clinics’ personnel and the patient’s these control mechanisms there can be a dramatic drop in the rates of disease, the burden of the parasites in the vector population, and most importantly mortality and morbidity. Treatment of tropical and parasitic diseases once it becomes endemic in a population, such as Dengue Fever, is also critical to decreasing rates of morbidity and mortality. By using guidelines from the Centers of Disease Control (CDC) and other sources, I can ensure that the rural health clinics have been educated on the proper resources to adequately diagnosis, treat, and use of prophylactic care tropical and parasitic diseases. Education, especially in signs and symptoms of certain diseases, does not only have to stop at the rural health clinic, but can be further disseminated to bush doctors, pa-/matriarchs, church leaders, and other para-healthcare providers or individuals of power. This can decrease the time from incidence of disease to proper healthcare, which in many cases saves lives.

                As I want to pursue mission work as part of my professional life, I want to learn as much as I can of the delivery of healthcare in the rural health clinics in Dominica. This passion, I believe, will drive me to help out as much as I can at the clinics. Anything I can provide, may it be secretarial work to helping the physician or pharmacist, I would gladly do. Although this impact is small and will only be in short duration, I want to create a relationship with the rural health clinic staff and with the patients that I hope will culminate into going back to Dominica during medical school or beyond. Also, the information on tropical and parasitic diseases will unfortunately become dated at one point and will need to be modernized. I think this is will be an excellent excuse to continue my impact in the rural health clinics in Dominica for many years to come.