APPE International Rotation, Dominica; A Final Reflection

As we drove away from the Albany International Airport on Monday afternoon, the tires of the black Suzuki treading once more familiar paths, and the colorful autumn leaves dancing playfully in the crisp November breeze, it was with a heavy heart that I stared out of the window. Had it only been two weeks? It seemed like more. Dominica is like a peaceful home in the early morning, before the din of alarms and the creeping warmth of dawn conjures the rush of a new day; beautiful in its quiet, humble simplicity. I can see why some travelers never leave. In Dominica, time seems absent. This is written upon the eternally young faces of its people, and their amusingly vacant concept of punctuality. The vicissitudes of your life at home slowly fade out of thought, like the last drops of rain chasing a midday storm. Just as our airplane had, moments before, hurtled out of the bright blue sky and landed forcefully along the slick black runway of Albany International, I too had just crashed back down to reality. It had only been a day and already I missed the lush green jungle, the precipitous, rolling peaks, the warm, moist air, thick with exotic scents and the smiling eyes of the Dominican friends I had left behind. Fortunately, as much as my tempestuous memory will allow, I will hold my experiences in Dominica close to my heart where they will stand boldly against the slow pursuit of time; one gift of many from the island.

I could regale you with an encyclopedic recounting of my experiences on the island, but my peers have just done so, admirably at that, in recent posts, and I would be remiss to bore our readers with redundancy. Instead, I’ll choose several little moments from the trip that still linger freshly in my mind as a snapshot of my experiences on the island. I still keenly remember our first morning. The previous day had been a trying one, complete with international connecting flights that boasted an impressively tight schedule and a seemingly endless stream of security checkpoints. The night had concluded, in a marvelous Dominican welcome, with a harrowing ninety minute drive from the airport to Jungle Bay. We soon realized that our cottages were no mere stone’s throw from the resort proper, and the hike to our beds was both exciting and foreboding. I presume we all slept well that night. But soon the morning dawn spread silently across the horizon, pouring across the Atlantic Ocean and beaming through our wide open windows in a beautiful wash of gold and orange. Untangling myself awkwardly from my mosquito net and stumbling over hastily removed sandals, I found myself standing on the balcony, staring awe struck into a morning view that I cannot do justice to with words. The cool morning breeze wafted a slight scent of ocean air mingled with the damp jungle floor to my nose. I wasn’t alone. A small gecko, several inches by my untrained eye, perched gently upon the balcony rail, staring intently at the dawn. “I agree”, I said to my new friend. And we sat for awhile, taking in the morning together.

Another moment I keenly recall was during one of our visits to a school in Petite Savanne. This was the second school we visited as a group, but there were numerous differences between this school and the one at Delices. Our plan was the same; break into small groups to effectively tackle all of the classrooms, engage the students in discussions, activities and games regarding pharmacy and medication safety, and then dive headlong into physical fitness activities to exhaust the sugar-rush we were soon to induce. The morning went reasonably well. Our resources were stretched thinner than predicted from our time in Delices, but we all worked with what we had and the demonstrations went off without a hitch. As a whole, the school seemed somewhat better organized than Delices, and the children better contained. But the classroom that Nicole and I had chosen proved to be a memorable exception to this trend. The Smarties candies we had finely crushed, in exorbitant amounts no less, for the purposes of a pharmacy demonstration, were rapidly consumed - sometimes trapped within our arro root base, and sometimes just as the straight powder itself. It didn’t take long for the sugar-rush to take hold.

The multistory concrete structure trembled under the pounding feet of a dozen sugar-crazed children as they exploded out of their chairs, through the classroom, and gushed like soda from a shaken can, through the doorway. They jumped, skipped, hopped, bounced, slid and ran through the second story balcony like little blue blurs; screaming, laughing and playing. We never did regain control. Fortunately, lunch time arrived, followed by our physical fitness activities and the pent-up energy had a suitable method of release. Exhausted after a rousing game of futball in the blazing Dominican sun, I collapsed onto the ground floor walkway, taking advantage of the shade. As I rummaged through my pockets, trying in vain to identify and organize the artifacts accumulated throughout the day, I withdrew several long, white sleeves covered, on one side, by a myriad of Hannah Montana stickers. It took only a fraction of a second for my mind to register the immense treasure in my hands, and it was a fraction of a second too long. Suddenly, as if she had teleported instantaneously at the sound of Hannah Montana stickers being removed from a damp cargo-short pocket, a cute little girl, her hair awash in blue ribbons, bows and beads, planted herself firmly on the walkway besides me, her eyes locked hungrily onto my stickers. “Could I have one?” she asked, her eyes boring into the sleeve. I knew the danger, but couldn’t resist. I twisted the sleeve awkwardly, contorting my entire arm around the scene to protect from any wayward eyes and slowly showed the stickers to the girl. “Which do you want?”, I asked. “That one!” she said, pointing to a large, full body depiction of Hannah. I began slowly peeling the sticker from the back. I didn’t even get to Hannah’s shoulders before the air grew quiet and the prickling of a hundred tiny eyes raised the hair on my neck. 

The sun disappeared.

I was suddenly plunged into a sea of bodies. Arms, too many to count, thrust themselves plaintively before my face. “Please sir!”, “I want one!”, “No me!”. It was a tornado of hands. The only thing between me and suffocation at the hands of immense American popstar adoration was several dozen stickers. Innumerable index fingers pointed desperately, and I peeled stickers off as fast as I was able. One sticker off the page, placed delicately onto an outstretched finger which instantly disappeared. The small hole where the previous arm had been was rapidly filled with another arm, another hand, and another frenzied “That one sir! That one!”. As piranha can strip a carcass in moments, my sleeve of stickers was gone in a flash. Dozens of children whirled around the area, stickers on faces, arms, hands and notebooks. Giant smiles spread from ear to ear. I inhaled a deep breath of fresh air, my first in over a minute. I looked over at Kristen Felthousen, who sat several feet away. “You brought that upon yourself”, she smiled. And I’m glad I did.

I have dozens, if not more, of these moments from the two weeks I spent on Dominica. In the interest of brevity, if brevity hasn’t already been grossly surpassed, I will leave it to those two. The intention was demonstrated, nonetheless – that the powerful experiences during this rotation were both internal and external. In my two weeks on the island I did as much inward learning as outward learning. The implications of this experience will resound through my near and likely distance future. It was truly an unforgettable experience.

Final Reflection

At first, it’s hard to describe what impact studying aboard has on you as a person.  This is not because changes have not occurred but because the changes occur subtly and slowly.  You know that something is different.  You feel there may have been a shift in your perspective but you cannot pin point the change to one thought or idea.  

Travel always results in a new perspective, an education, and a new twist on what is really important in life.  You learn about a different culture or lifestyle.  It may be something as simple as speaking with a child about his/her daily activities that transforms you.  You may even discover that other healthcare systems of the world are better than your own.   In the end, there is no one event during travel that alters you.  It is the entire experience. 

Reflecting back over the last two weeks it is hard to really comprehend what events took place on which day and what my expectations were before going.  The truth about study adventures like this is no expectation could prepare you for what it is really like.  You have to just go.  We can share about our experiences, the culture, the education, the health system, the people and the island itself all day and never get our point across.  You must experience it first hand to feel the reality placed before you in pictures. 

I always have trouble after returning from travels aboard on how to readjust back to the “American lifestyle”.  Over time I have come to realize that people in other cultures have a much greater awareness of what is important in life and what can wait until a later time.  Almost all other cultures can take a step back from the high-speed pace conquering America and breath life before moving forward in their day.  It is hard to jump back into the belief that every detail is of utter importance and must be completed immediately.  The truth of life is that the most important detail is living it and not letting it rush by.

I know that there was not an event that triggered a switch in my brain to say, “This is the moment, this is the event of this trip that will forever change you.”  On the other hand, I know I have been changed.  Every event, conversation, interaction, activity on this trip has impacted me as a person and will alter the way I engage as a healthcare provider.  It was appalling to see physicians, nurses, and pharmacists unable to provide patients with necessary medication due to a lack of supply that will never come close to filling the demand.  And yet, every individual was extremely thankful for whatever care they could be given.  To see a community that came together to create a home for physically and mentally disabled individuals overwhelmed me with the reality that people do the best they can with what they have.  It was amazing to learn about the history of their dance, and see the healthy long lives of Dominicans (who all look about 20 years younger than his/her stated age).   It was a struggle to see the beginnings of Americanization on the culture.  I was torn emotionally after a conversation with a man living out in the woods with his family because he was scared to see the changes occurring in his culture.  His comment about, “the KFCs, and Pizza Hut, and increased number of cars,” influenced me, profoundly.  I was sickened by the truth of our fast food nations shifting the flow of this great nation.  I was devastated to hear that diseases that used to be rare in Dominica, diabetes and stroke, were now the leading causes of death.  It was hard to comprehend that patients who use to solely survive on natural treatments were forced to turn to Western medication for treatment.  Overall, there were and are definitely other factors in the Dominican environment that could be increasing the number of these diseases in their society.  However, it was hard not to say that American culture was not having some impact on the health of this country.

In the end, I wish everyone could see first-hand the changes that occur after travels like these but it sometimes takes years to come to the conscious awareness.  It takes time and often occurs very slowly.  However, some day you may look back on travels you have had and decisions you have made and note that there is a difference in who you thought you were.

Impact of Dominica

Completing the Dominica rotation was an experience that will henceforth have a positive impact my personal and professional life.  The people with whom we interacted were in all cases friendly, open, happy, and warm.  Weeks ago I had been telling people I was going to Dominica and that I wasn’t quite sure what I was doing, but I was going to be helping and teaching people; the rotation was to be sort of a medical mission where we would be offering assistance.  Now that I have completed the rotation, I am quite aware that the experience was so much more than that, and for that I am grateful.  I was not always the teacher, the helper, or the expert.  The people of Dominica had so much culture, knowledge, and philosophy to impart, and they were ready and willing to share all they had to offer.  

I have learned the beauty of living simply and the splendor of working with nature as opposed to against nature.  Many people in Dominica live as one with their environment and as part of nature.  For example, Moses is a medicine man whose livelihood is growing food as a means of sustenance for himself and his family, and herbs for treating a wide spectrum of ailments.  Moses is well-versed in traditional Dominican uses for herbs, which he learned from his grandmother, and he has written an internationally-selling book on herbal medicine.  Pomme is another individual who exemplifies simple and happy living.  Pomme lives completely off the land, and the only way to access his home is through an hour and a half hike through the jungle.  A huge plot of land supplies Pomme and his family with everything they need; it is easy to see that Pomme has his work cut out for him, as managing this garden is a huge task.  Nevertheless, it is a task that imparts great satisfaction and reward; it must be a combination of hard manual labor, fresh healthy foods, and lack of outside stressors that keep Pomme and many other Dominicans looking about 20 years younger than their chronological age. 

Interactions with individuals at the primary schools, health clinics, and house of hope also were learning experiences for me.  At the final school we visited, Dara and I were lucky to have a culture lesson from the fourth graders.  The class captain and vice captain explained the meaning of the different colors and symbols on their flag.  The other students taught us about their independence day.  The students performed several different cultural dances for us, including bele and heel toe.  I was fortunate to have one girl take my hand and try to teach me one of the dances.  At the health clinics I enjoyed interacting with different individuals and having conversations that resulted from their interesting and insightful questions regarding medicines and health care. 

This rotation provided me with many valuable learning opportunities.  I experienced a different culture and was able to combine my knowledge with theirs, which provided me with a more well-rounded understanding of health that will last me forever.  I learned a lot about myself and had some amazing experiences with great new friends.  I challenged myself physically and mentally to complete some really tough but even more rewarding hikes and adventures.  I feel so lucky to have had this experience in Dominica, the nature island of the Caribbean.

Final Thoughts

After only being back in the states for a little over 24 hours, I am already missing Dominica.  The two-week trip was a wonderful experience and I had an amazing time.  I am so thankful to be apart of this experience; spending time in the country made me feel like I was in another world that was often breathtaking.  From the beautiful scenery, to the people, to the food, Dominica really is the nature island of the Caribbean. 

Our trip was filled with many different activities such as visiting different schools, going to health clinics, painting at the House of Hope, going on hikes, visiting the market and much more.  There were several moments on this trip that have really stayed with me.   One of my favorite times was going to the Delice Primary School.  Being able to spend time with the children and have them be excited and energized to see us was such a great feeling. I enjoyed talking to the kids about the profession of pharmacy, playing games, helping with their schoolwork and reading with them.  It was great when I took out my camera and started taking pictures and then all of a sudden the kids ran up to me wanting to test it out.  I have to say they took some great shots.   Visiting the school made me appreciate the importance of education and encouraging younger students to stay in school and pursue their dreams.  When we stopped back toward the end of our trip and the principal and students presented us with a thank you gift, it brought chills to my body.  I was touched and humbled at how much the students and staff cared about us being there. 

Another great moment for me was visiting Pommes house.   Pommes, a man who lives a few miles from the main roads with his family, lives completely off of the land and built his house and surroundings on his own.  To see his acres of land filled with gardens of fruit trees, flowers, and vegetables was breathtaking.  He described it as the “Garden of Eden,” from the Bible.   I was just in aw the whole time I was there as I was so impressed at how he and his family live their lives.  To see how he is able to utilize nature to survive is remarkable.  It made me realize how reliable we are in the states on materialistic items that we probably do not need.  Seeing Pommes house made me want to expand my diet to include more natural products and live a healthier lifestyle.  Also, I will now try to question myself the next time I want that new electronic gadget to see if I really need it.

This rotation was a great learning experience for me.  I learned a lot about myself on this trip.  It opened my eyes and took me out of my little environment bubble I am so use to.  I know this will help me in my future career as a pharmacist by having a better sense of care, compassion, and empathy for patients I encounter.

I want to close by saying I am grateful for the kindness of the people of Dominica, including the staff at Jungle Bay, for making our stay lovely.  I always felt welcomed everywhere we went on the trip and that meant a lot to me.  I am thankful for the efforts Dr. Abrons put into this rotation to make it such a success.   This trip would not have been possible without her hard work and dedication.  Many thanks to our other preceptors Jess, Theresa, and Kristen who took time out of their work schedules to help us on this journey.   To my fellow student pharmacists on the rotation, it was a pleasure spending time with you and getting to know you better.  The days I spent in Dominica were some of the best days of my life and I know I will remember this trip for many years to come!

An Element of Nature, a Rewarding Cultural Experience: Dominica

This rotation to Dominica was my first trip traveling outside of the United States. Before leaving for Dominica, I had a general picture of the island in my mind; however, after spending two weeks in Dominica the depiction of the island I created was mistaken, and I realized this was an experience which has become very difficult to describe. Initially, I was clinging to an idea which was formulated from pictures I viewed from past rotation experiences to Dominica and from other pictures I had researched online of Dominica. However, you actually have to physically stand on Dominican soil, breathe in deeply the ocean air, and speak to the people of Dominica. The reality of viewing the spectacular terrain, the associations I made with such down to earth individuals, and the education I gained about Dominican culture was truly unique. To be able to immerse myself in an entire new world in which the utilization of natural resources is necessary for survival was absolutely incredible. To the majority of people living in America, this concept appears ancient. Overall, this rotation to Dominica was an experience I believe many individuals should have an opportunity to discover.

Despite a temporary injury which limited my participation in hiking to the Boiling Lake, Pomme’s Paradise, the White River, Victoria Falls, Zom Zom, and Paix Bouche, I remained positive and open-minded. I was not going to struggle with the idea of my immobility limiting the opportunity for me to learn all I could about Dominica.  I was still able to attend yoga instruction with Nancy each morning with my classmates and participate in meditative breathing exercises. During each meal at the Pavilion Restaurant, a friendly face was always there to greet us before, during, and after each of our meals. The relaxing passing rain showers and the sounds of the Mountain Whistler in the morning reminded me of the natural grace of Dominica.  With each visit to the three schools: Delices, La Plaine, and Petite Savanne, the children were ecstatic to spend the day with us. Their energy and naivety to the world was refreshing. It made me step back and realize the simple things in life such as a smile, a hug, or reading a book together was enough to bring them happiness.  The conversations I had with patients at the clinics and during the Health Fair enabled me to understand their perspective on health care and the importance of Bush medicine. I spent a considerable amount of time engaging in conversations with two particular individuals at the La Plaine clinic. Looking back at those individuals I had a conversation with, I am sure we will remember each other. There is no doubt about it. There were some of the same emotions felt: caring, respect, understanding, and laughter. It is this human connection observed among two very different worlds which made me recognize we are not very different at all.

At this time I want to extend a special thank you to Sam Raphael and the staff at Jungle Bay for their hospitality and the last minute accommodations because of my injury.  Also, thank you to Dr. Abrons for encouraging me to travel to Dominica despite my broken foot and dependence on crutches, and to Kristen, Jess, and Tressa for your support and guidance.  Lastly, thank you to Peter, Hassan, Mike, Josh, Rachel, Krissy, Bridget, Nicole, and Brittany. We were the core team which made this rotation experience to Dominica worthwhile for each other. Your thoughtfulness, encouragement, and unfailing strength made this rotation a reality for me.  I certainly would not have been able to participate in most of the activities without your help.  With no doubt, our journey to Dominica has impacted us all personally, but the memories we created together will remain a shared experience for the rest of our lives.

Dominica Reflection: Bush Medicine to Boiling Lake

When I thought about the Dominica rotation and all the possibilities for learning about natural medicine and cultural competence I did not fully comprehend just how much I truly would gain. Dominica was amazing in so many ways and I am so grateful to have had the opportunity to visit this wonderful country and interact with its people!

From the very beginning Jungle Bay was not what I had expected at all. We stayed in very nice cabanas that were made of beautiful wood and you could tell the artistry and craftsmanship that went into making each one. I remember vividly the hill that we had to walk up that first night to get to our cabana as well; thinking wow never should have wore my danskos for this! Not to mention how hot and humid it was in this place. It was definitely going to take some getting used to from the very different climate I had just come from in the Midwest.

The rotation activities that we were able to participate in were great! We went to three different schools where we did a pharmacy day activity with the children and physical activities. The students were so excited to see us and play with our cameras. It really felt like you were making a difference in their lives.

I had my “this is what I came to Dominica for” moment when we took part in the first ever rural health fair at the La Plaine Health Clinic. Before coming to Dominica I was tasked with becoming the “expert” in women’s health and focused on women and pregnancy as well as self-breast exams for screening for breast cancer. While at the clinic I talked to a woman who was five months pregnant who had visited a smaller clinic in one of the local villages and had not been put on folic acid yet. We had a long discussion about her health and that of her unborn child and through the help of the La Plaine nurses we were able to get her the folic acid that she needed. At that moment I felt like I truly made a difference in the life of a Dominican!

In addition, I cannot say enough about the Jungle Bay staff, Sam, Nancy, Joanne, Justinian, Brother, and the rest of the guides. I unfortunately became ill while in Dominica and they went to great lengths to help me feel comfortable by cooking special food for me and making bush tea to help me feel better. We came to Dominica to learn about the natural herbs and bush medicine that they use but I never thought for a second that I personally would have to use it myself. While I was ill they made me ginger tea which was very helpful in settling my stomach and also guava leaf tea which actually made me feel the best. The guava leaf tea was very mild in taste but made the terrible stomach cramping that I had go away completely. I was definitely somewhat skeptical about natural products before this trip; however, I can now say that they definitely do have a role in our health!

Finally, the opportunities to explore the countryside of Dominica are numerous. I was able to go on the epic boiling lake hike (14,000 stairs in total and 6 hours long.) I can honestly say that this hike taught me a lot about myself and who I am as a person. I am so glad that I completed the hike and was able to take in the magnificent scenery that it had to offer as well as the friendships that I created in the process. I will never forget the feeling I had when I made it to the top of the mountain and when we reached boiling lake (soaking wet and all)!!

I am so grateful to have been able to go on this rotation and learn all that I did! I feel as though I am a little bit of a different person than I was before. I have learned from the wonderful Dominican people that it is ok to keep busy in your life but you definitely need to have balance and slow down a little and enjoy life as well!

Thank you Jungle Bay for your hospitality and welcoming us into your family! I hope to return in the future!!

An Experience of a Lifetime

Over the years, I have travelled to many different countries but none of them compare to the island of Dominica, West Indies.  I have always wanted to complete a medical mission trip when I was younger, even if it was to make a difference in just one person's life.  Little did I know that I would be making a difference in many people's lives, both young and old on this rotation. 

While there, we visited multiple clinics, one being located in the area of La Plaine.  Kent, the pharmacist of that area (and a few other districts) explained of the lack of supplies available to them and how he must order all needed supplies for his clinics, including first aid items, only once every two months.   From this statement, I realized how much our society takes advantage of things available to them and they do not appreciate the access they have as much as people in other countries do.  Though Dominica’s health care is a free health care system, there are restrictions as to how many products are allowed to be purchased.  I, along with others on our team, accumulated various types of donations in which to leave while in Dominica for those who are in need.  Though I felt as though some of these gifts would not be as appreciated as much as others, I was pleasantly surprised that items such as OTC eye drops and saline rinses were very much in need.  Kent had assured me the items donated were extremely valuable and it has made me want to reach out and help as much as possible in the future.

Finally, the primary schools are the places I feel were the absolute most rewarding part of this rotation.  The children at all three schools gave us kisses, held our hands, and even said "I love you miss" while we spent the day with them.  After leaving one school in particular, Petite Savanne, I had the revelation, "this is the reason why I came to Dominica".  From here on out, I feel as though we all have left a forever impression on the people of Dominica.

I want to conclude saying thank you to everyone who helped make our trip so amazing and helped me grow not only as a person but also to become a better pharmacist.  It is my hope to be a part of this rotation in the future for other students at ACPHS and Drake and re-unite with the friends I have made on the island of Dominica.

Reflections on Something Learned About Me on a Walk from Delices to Petite Savane

Dominica, known as the Nature Isle, stands true to its nickname. The natural beauty of the youngest island in the West Indies is breathtaking. First and foremost, there are 365 rivers and streams- enough for every day of the year. The landscape is mountainous with its high peaks and low valleys. Then there is the bio-diversity, the flora and fauna of its rainforest makes for spectacular sights, sounds, and interesting bed mates (on more than one occasion I woke up to find at least one lizard sleeping in bed with me). Luckily for me, there are no poisonous or deadly animals on the island.

However, on the first full day after arriving in Dominica, none of that matter, in fact, everything in my life, both home and abroad, meant little as I prepared for my first hike on the island. I was trying to spot a power line on the top of Paix Bouche, a mountain that separates the villages of Petite Savane and Delices (I had to crane my neck and squint to find it). Paix Bouche, which in English means Keep Quiet, is a fitting name. The hike follows the road to the top of the mountain, which is roughly 2 miles. The vertical distance is 600 meters (about 1968 feet). The average gradient is 35 degrees. By no stretch of the imagination it is a difficult hike. For the next 26 minutes, I struggled physically and mentally, as I dug to the deepest portions of my soul for the willpower to complete it. I knew and understood that if anything would fail me it would be my mind, therefore, there was no gimmick, no mantra, no New Age philosophy that would get me up that hill, instead I focused on the task at hand and relied on the perfection of thousands of years of evolution- my muscles, my lungs, my heart, my body. 26 minutes and a liter of sweat later I completed the hike.

 It was an amazing success. As I waited for the rest of the group to finish I had to time to reflect. I reflected on the perfection of the human body, mind over matter, and the fact that people do this hike on a daily basis, not because of a desire to remain fit, but out of a necessity (e.g. to and from work). After the rest of the group completed the hike, I found that two members of the team did not finish. I was devastated. What turned out to be a personal success resulted into a team failure. It was at this moment that I realized that I, in some ways, failed them. I then reflected on myself as a team member. I reflected on the evolution of healthcare, as it continues becomes more inter-disciplinary and team based. I reflected on my personal shortcomings. I then set out for a new goal, to ensure that I am a focused on the goals of not only myself, but also the team.

It was a beautiful transformation that occurred to me on that hike. Many individuals told me that I would come back a different person. I believed them. What I couldn’t comprehend until I actually spent time in Dominica, is that the island naturally makes you reflect and change. No matter if it is a walk back to your room, a hike up Paix Bouche or Boiling Lake, a drive to Roseau, fording one of the 365 rivers or streams, speaking to school children or the sick, or listening to the symphony of nocturnal noise, you can’t help but to listen to your inner voice. That is what makes the Nature Isle special. That is also the reason why I must go back to Dominica, especially when I think there is nothing left I could learn about myself. I know from experience, there is always something to learn about yourself as you are kept quiet by the truly awe inspiring nation of Dominica.  

Dominica: Thoughts and Reflection

As I sit on my sofa in the United States searching for the words to describe how the trip to Dominica was, I struggle.

Amazing doesn't quite do the trip justice. Nor does fantastic. Awe-inspiring comes close, but lacks the immense self-reflection Dominica allowed me to do. I went to Dominica with a set plan in my head, a check-list of activities I was going to preform stringently so that when I left, I could walk away with my head-held high with the accomplishments I had performed.

That was a foolish notion.

Thanks to the guidance provided to my Dr. Abron's, I was able to indeed target the health-care issues I was responsible for. What I found however, was a nation whose patients' were much more receptive about the information I was offering them ever before. A nation whose patients' gladly spent hours informing me about the herbal products they used, explaining to me the generations of history that served as evidence for the efficacy of those products. A nation whose patients' did not shake my hand in farewell as they left the pharmacy, but who enveloped me in a hug before fondly saying good-bye.

When I think back to the two weeks I spent in Dominica, I can hardly believe all that we experienced. From the various schools wherein we taught children about medication safety, to the time spent in the House of Hope tending to severely physically and mentally disabled, to the time spent in the clinics interacting with patients, it is hard to believe so much could be seen within such a little time. The rotation has filled me with a drive to return to Dominica, to learn more about it's people and it's culture ant to devote myself to a scale of pharmacy much, much grander than I had previously imagined.

Humbled now, I look forward to a future shaped by the experiences of the last few weeks.

Dominica Reflection

When I signed up for the Dominica Rotation I never expected that it would have such a great impact on my future as a pharmacist. I feel extremely honored that I was able to be a part of this rotation! I met wonderful future pharmacists and worked with current pharmacists who are making a big difference in an entire country. I hope that in the future I will be able to continue making a difference in Dominica and be able to share my experiences with everyone I know.

I learned so much while I was in Dominica. I not only learned about herbal and bush medicine, but I also learned about humanity and a culture that is completely different than the United States. Domincan's are extremely caring and very friendly to new people. They open their arms to all which was seen by the staff at Jungle Bay as well as each member of the community. There was not a day that went by that I didn't meet someone who was wonderful and giving.

The schools that we attended were incredible as well. The teachers were wonderful with their students and each student was unique! They welcomed us into their classrooms to share with them and also to learn from them! We were able to work with the students and teach them about pharmacy and what we will do as future pharmacists. We also spent time getting to know the students and what they wanted to do when they were done with school. We were able to meet various members of their families within the community and also at the schools.

The health clinics were a wonderful way that we talked with individuals in the community. We shared our expert information with people and they really listened to what we had to say! It was also nice being able to spend as much time as we needed to with patients! Sometimes at work in the US we don't have as much time to sit down with patients and answer all of the questions that they may have. It was a very refreshing experience and made me realize the importance of finding the time for each patient! We held the first health fair ever in Dominica which gave community members a chance to ask questions, take home informative pamphlets and various gifts we had for different disease states. This will only continue to grow and be successful in the future which will mean making a difference in more people's lives!


Overall, I am very happy with everything that I learned on the rotation as well as everything I was able to contribute to the community!