Le Plaine Clinic Visit 1

This blog entry is dedicated to Katie Hassebroek for being there for me while climbing Paix Bouche ("pay-bush)!! Pictures will be uploaded at a later day!

Today, my group of Jane, Jessica, Theresa, Bianca and myself, ventured South of Jungle Bay to the LePlaine Health Clinic. Once there we ventured into the clinic with our supplies and a large group of patients excited to discover why we were there visiting them. Present at the clinic today was Kent the pharmacist, 1 doctor, 2 nurses and a dentist with their staff. After we got settled we joined Kent in the pharmacy a small room with a sink, fridge, counter, non working computer, 3 cupboards full of medications along with more in containers along the counters. The room was only the size of approximately 10 feet x 10 feet--note that is by my estimation. Kent was very open to sharing the story of his journey to becoming a pharmacist and the role that he played in the district. This description I'm about to share only briefly summarizes the type of role he fills and his commitment to the district over his 20 years as their pharmacist! He is the only pharmacist for the district--of the ten total on the island--serving 5 health clinics, orders both medications and medical supples for the clinics he serves, compounds some of his own medications on a bi-weekly basis in order to have them on hand in the clinics, makes home visits and stays at the clinics until the last patient is seen and gone. This may not seem like much different form a pharmacists ordinary scope of practice but for him he visits each clinic only on a weekly basis, he must travel to each of the clinics each day, is on call 24/7 for emergencies and non-emergencies, and even has patients coming to his home. He has enough vacation built up to be on leave for 3 months! But due to the lack of staffing he has not been able to use his well earned vacation time.

Pharmacies in the Caribbean are set up in a way that all of their allotted funds go into a joint purchasing account in order to allow the islands greater purchasing power. Once they ordered the drugs get distributed amongst the islands and their clinics. Kent only places a drug supply order once every 2 months and sometimes still does not receive all of the medications he requests. For example diazepam and phenobarbital have not been available to him because there needs to be some sort of special ordering license that has been in the process of being approved since 2011. The island has a universal healthcare system set up where patients can go to clinics receive basic care and medications at no cost. So what to do when he doesn't have a medication? Well the patients have the opportunity to travel an hour and half to Roseau (the capital city) in order to pay for their monthly maintenance medication in the private sector out of their own pocket. Most times patients can't afford the cost of the medications or the trip to Roseau.

After our first discussion time with Kent he introduced us to the patients in the waiting room and why we were there. He informed them we were all students from the U.S. here to be a source of information for all of them about any health or medication questions they may have. As soon as he was done, we had our first patient approach us and ask if they were supposed to form a line or if we were going to come around to them! Each of the three students (Bianca, Theresa and I) started circulating around the room interacting with as many patients as possible and performed patient interviews with almost all of the 20 patients in the waiting area. All of the patients were very receptive to us being there and they were willing to share anything with us. Sometimes communication was a barrier due to understanding the "accents" and differnt usage of terms. As we neared the end of our time with the patients we re-entered the pharmacy and asked Kent a few questions about the patients we had talked with. We were all amazed at his ability to rattle off a patients whole medication list just by knowing their name! Along with that he was knowledgeable about their past medications as well. The clinic had come to more of a lull as we departed after our amazing afternoon with Kent at the LePlaine Clinic! I can't wait until our next clinic day at the Rivirie Cyrique Clinic!

 Enjoy reading! -Dani