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.
Susan
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