LaPlaine Clinic 01/29/13

On Tuesday, we had the opportunity to visit LaPlaine clinic for the second time.  I met a young mother who was using bush medicine in combination with Western medicines to control her morning sickness. One of the bush medicines she was trying was a bay leaf infusion she drank as needed and she felt it was very helpful.  She also used mint candies and dry crackers to help settle her stomach. I felt it was a great opportunity to learn more about the bay leaf and its uses. Additionally, I appreciated how open she was about her use of herbal medications, as this is not an attitude often seen in the States.
My second encounter was with a young girl who had been bitten by a centipede and this had subsequently led to an infection. I counseled her on the use of her antibiotic and she quickly verified the directions and possible side effects. When asked what questions she had, she timidly told me that she was in pain and wanted to know what would work more quickly than the antibiotic to provide relief. I explained the antibiotic would take a few days to show signs of improvement, but some options would be paracetamol (Tylenol) or ibuprofen. I reviewed her medical file and noted that the doctor had not prescribed any pain medications. Understandably the girl was upset.  I wanted to help her and I recalled that I had ibuprofen in my bag. I spoke with the preceptor, quickly explaining the situation and asked permission to share my medication with the patient. He agreed and I was able to give her a few tablets and some instruction on further pain relief.  This was a previously unknown situation for me as I could not recall a time when a patient did not have access to a medication as 'common' as ibuprofen.  My simple encounter with this girl really drove home how limited medical resources are on the island. 
My realization brought about a conversation about medical donations with Kent, the local pharmacist.  Through him, we learned that medications can be sent to the island via the government as donations. However, if this is done the officials may redistribute items they feel will be more beneficial if they were located at the hospital or another district. This means that even though a package was labeled specifically for the pharmacy at LaPlaine, some of the items might not make it to Kent or his patients! I was disappointed when I learned of this attitude towards donations, however, I can also understand this point of view -- if there is a particularly rare medication a patient needs it may be better to have the supply centrally located so everyone will know where the medication will be.
The experience at LaPlaine clinic has opened my eyes to the issues facing many people in the world today.  Before my visit to Dominica, I do not think I ever would have considered a medication as ubiquitous (to me) as ibuprofen would be in short supply elsewhere in the world. This also made me realize that there are going to be many other necessary medications that are limited in Dominica. I will never take for granted all the resources available to us in North America and upon our return I hope the group continues to give back to those in need, both in Dominica and in our own local communities.

Courtney Thomas